Differential Diagnosis for White Spot on Tongue
- Single most likely diagnosis
- Oral thrush (candidiasis): This is the most common cause of white spots on the tongue, especially in immunocompromised individuals or those with poor oral hygiene. It is characterized by white patches that can be wiped off, leaving a red base.
- Other Likely diagnoses
- Leukoplakia: A condition where thick, white patches or lesions develop on the tongue, often associated with chronic irritation or tobacco use. It can be a precursor to oral cancer.
- Lichen planus: An autoimmune condition that can cause white, lacy patches on the tongue, often accompanied by redness and discomfort.
- Geographic tongue: A benign condition characterized by patches of depapillation on the tongue, giving it a "geographic" appearance.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Oral cancer: Although less common, a white spot on the tongue can be an early sign of oral cancer, especially if it is persistent, growing, or accompanied by other symptoms like difficulty swallowing or a lump in the neck.
- Syphilis (secondary): In rare cases, a white spot on the tongue can be a symptom of secondary syphilis, which can progress to more severe complications if left untreated.
- Rare diagnoses
- Hairy leukoplakia: A rare condition seen in immunocompromised individuals, characterized by white patches on the tongue with a "hairy" appearance.
- Pemphigus vulgaris: A rare autoimmune disorder that can cause white blisters or patches on the tongue, often accompanied by other mucosal lesions.
- White sponge nevus: A rare genetic condition that causes white, spongy patches on the tongue and other oral mucosa.