white patch diagnosis

Question 1

In terms of RMH, which drugs may be a cause of white patches?

Answer 1

1. Antibiotics (predispose to candida infection).
2. Immunosuppressants (lichen planus?)
3. Steroids (predispose to candida infection).

Question 2

What 3 things to look out for when assessing dental history in relation to white patch diagnosis.

Answer 2

1. Restorations causing a lichenoid reaction.
2. Cheek biting and trauma.
3. Chemical burns.

Question 3

What tests should be done in the diagnosis of a white patch?

Answer 3

1. Blood tests
2. Swab for candida
3. Incisional biopsy

Question 4

If the white patch was sublingually, what would be the differential diagnosis?

Answer 4

Sublingual Keratosis

Question 5

If the site of the patch was unilateral, which differential diagnoses would be considered?

Answer 5

1. Idiopathic Leukoplakia
2. Squamous Cell Carcinoma

Question 6

If the site of the patch was bilateral, which differential diagnoses would be considered?

Answer 6

1. Lichen Planus
2. Fordyce Spots (overgrowth of ectopic sebaceous glands)
3. Cheek Biting (frictional keratosis)
4. Candidiasis

Question 7

3 examples of white patches indicating neoplastic/potentially malignant disease:

Answer 7

1. Leukoplakia
2. Carcinoma
3. Keratosis (although rare)

Question 8

3 examples of white patches potentially indicating inflammatory conditions:

Answer 8

1. Candidiasis
2. Hairy Leukoplakia
3. Papilloma (HPV lesions in the mouth)

Question 9

2 types of non-infective conditions:

Answer 9

1. Lichen Planus (potentially pre-malignant)
2. Lupus Erythematous