Differential Diagnosis for Tongue Lesion

• Single most likely diagnosis
  • Traumatic ulcer: This is often the most common cause of a tongue lesion, resulting from accidental bites or other forms of trauma to the tongue.
• Other Likely diagnoses
  • Aphthous ulcers: These are small, painful ulcers that can appear on the tongue and are often recurrent.
  • Oral candidiasis (thrush): A fungal infection that can cause white patches on the tongue and other parts of the mouth.
  • Leukoplakia: A condition where thick, white patches or lesions appear on the tongue or other areas of the mouth, often associated with chronic irritation or tobacco use.
  • Lichen planus: An autoimmune condition that can cause lesions or patches on the tongue and other mucous membranes.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Squamous cell carcinoma: A type of cancer that can appear as a lesion on the tongue, often associated with tobacco or alcohol use.
  • Tuberculosis: Although rare, tuberculosis can cause lesions on the tongue, especially in immunocompromised individuals.
  • Syphilis: The secondary stage of syphilis can cause mucous patches or lesions on the tongue.
• Rare diagnoses
  • Eosinophilic ulcer: A rare condition characterized by an ulcerative lesion on the tongue, often associated with eosinophilia.
  • Granuloma: A rare condition where a granuloma forms on the tongue, which can be caused by various factors including infection or inflammation.
  • Melanoma: Although extremely rare, melanoma can occur on the tongue, presenting as a pigmented lesion.