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D.D of white lesion:D.D of white lesion: LeukodemaLeukodema White spongy neavusWhite spongy neavus Heredetary benign epith.dyskeratosisHeredetary benign epith.dyskeratosis Darriers diseaseDarriers disease oral keratosisoral keratosis Chemical burnsChemical burns Oral thrushOral thrush LeukoplakiaLeukoplakia Hairy leukoplakiaHairy leukoplakia Lichen planusLichen planus
leukodemaleukodema
Faint diffuse,filmyFaint diffuse,filmy
Numerous folds or Numerous folds or wrinkleswrinkles
Can’t be scrapped offCan’t be scrapped off
Disappear & fades upon Disappear & fades upon stretchingstretching
HyperkeratosisHyperkeratosis AcanthosisAcanthosis Perinuclear condensation of cytoplasmPerinuclear condensation of cytoplasm Vacuolazation of suprabasal layerVacuolazation of suprabasal layer
Bilaterally along Bilaterally along occlusal plane occlusal plane
Chemical burnChemical burn Transient non Transient non
keratotic white plaquekeratotic white plaque
Irregular in shapeIrregular in shape
Covered by Covered by pseudomembranepseudomembrane
Very painfulVery painful
Aspirin burnAspirin burn
Smokless tobacco induced Smokless tobacco induced keratosiskeratosis In the area of In the area of
tobacco contacttobacco contact
PrecancerousPrecancerous
May be wrinkled or May be wrinkled or foldedfolded
May be May be Accompanied by Accompanied by gingival recessetion& gingival recessetion& perio-destructionperio-destruction
Actinic keratosisActinic keratosis
Patient exposed for Patient exposed for sunlight for sunlight for prolonged timeprolonged time
Acute psdeudo Acute psdeudo membranous membranous candidiasis(oral thrush)candidiasis(oral thrush) PainlessPainless Soft creamy white plaqueSoft creamy white plaque Can’t be easily rubbed or Can’t be easily rubbed or
whiped off leaving whiped off leaving erythematous area or erythematous area or ulcerationulceration
Range fromRange from
Small flecks-wide spread Small flecks-wide spread confluent plaqueconfluent plaque
Prodrome of bad taste or Prodrome of bad taste or loss of taste sensationloss of taste sensation
High rate of malignant High rate of malignant transformationtransformation
diagnosisdiagnosisclinicallyclinically Cannot be stripped or rubbed offCannot be stripped or rubbed off Loss of elasticity & pliabilityLoss of elasticity & pliability
Lab investegation:Lab investegation: BiopsyBiopsy*hyperkeratosis*hyperkeratosis*acanthosis*acanthosis*chronic inf. Cells*chronic inf. Cells*signs of dysplasia*signs of dysplasia
Touluidine blue testTouluidine blue test
Oral hairy leukoplakiaOral hairy leukoplakia Corrugated white Corrugated white
lesionlesion
Lateral or ventral Lateral or ventral surfaceof tonguesurfaceof tongue
Immumunodeff pt (HIV)Immumunodeff pt (HIV)
confirm diagnosis by:confirm diagnosis by:
Demo of EBV by:Demo of EBV by: In situ hyberidizationIn situ hyberidizationE.ME.MPCRPCR