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Leukoedema lesions disappear when the mucosa is stretched, which helps to differentiate it from other white lesions in the mouth. [2] The differential diagnosis is with leukoplakia , oral candidiasis , oral lichen planus , white sponge nevus , morsicatio buccarum , [ 3 ] hereditary benign intraepithelial dyskeratosis and dyskeratosis congenita.
Desquamative gingivitis is a descriptive clinical term, not a diagnosis. [1] Dermatologic conditions cause about 75% of cases of desquamative gingivitis, and over 95% of the dermatologic cases are accounted for by either oral lichen planus or cicatricial pemphigoid. [1]
In about 90% of cases, Candida species are involved, [4] which are normally a harmless component of the oral microbiota in many people. Denture-related stomatitis is the most common form of oral candidiasis (a yeast infection of the mouth). It is more common in elderly people, and in those who wear a complete upper denture (a denture which ...
It is seen in patients using inhaled steroids and smokers, and is usually a kind of chronic atrophic oral candidiasis, but hematinic deficiency and diabetes should be excluded. [3] Median rhomboid glossitis in a child. Note atypical appearance of the lesion, which is more commonly an erythematous, atrophic area of depapillation
Allergic reaction to toothpaste, mouthwash, breath fresheners, dyes in confectionery, plastic in dentures or retainers, or certain blood-pressure medications (ACE inhibitors) Administration of ganglion blockers (e.g., Tubocurarine, Mecamylamine). Oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris; Heredity
Oral candidiasis may develop with long term topical steroid use, and sometimes antimycotics such as miconazole gel or chlorhexidine mouthwash are used to prevent this. Topical ciclosporin is sometimes used. Dapsone is sometimes used as a steroid sparing agent. The dose is often increased very slowly in order to minimize side effects.
Lichen planus: A chronic inflammatory disease with different forms of oral presentations. The most classic appearance of lichen planus is the presence of white streaks in inner cheek, tongue, and gum. Desquamative gingivitis can be seen in patients with lichen planus. Biopsy is done for definitive diagnosis of lichen planus. [18] [23]
Diagnosis is mainly clinical, based on the history and clinical appearance. The differential diagnosis includes other oral white lesions such as Leukoplakia, squamous cell carcinoma, oral candidiasis, lichen planus, white sponge nevus and contact stomatitis. [7] In contrast to pseudomembraneous candidiasis, this white patch cannot be wiped off. [7]