Differential Diagnosis for White Part on Hard Palate

• Single most likely diagnosis
  • Leukoplakia: This is the most common diagnosis for a white patch on the hard palate, often associated with chronic irritation or tobacco use. It represents a potentially malignant disorder, necessitating close monitoring and possible biopsy.
• Other Likely diagnoses
  • Lichen planus: An autoimmune condition that can cause white, lacy patches on the mucous membranes, including the hard palate. It's often associated with other oral or skin manifestations.
  • Oral candidiasis (thrush): A fungal infection that can cause white patches on the oral mucosa, including the hard palate, especially in immunocompromised individuals or those with poor oral hygiene.
  • Nicotinic stomatitis: A condition related to tobacco use, characterized by thickening and whitening of the oral mucosa, particularly on the hard palate.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Squamous cell carcinoma: Although less common, any white patch on the hard palate could be an early sign of oral cancer, especially in high-risk individuals (e.g., tobacco users). Early detection is crucial for effective treatment.
  • Syphilis (secondary): Oral manifestations can include white patches or mucous patches on the hard palate among other symptoms. Missing this diagnosis could lead to severe health consequences if left untreated.
• Rare diagnoses
  • Pemphigus vulgaris: A rare autoimmune disease that can cause blistering of the skin and mucous membranes, including the hard palate, though it more commonly presents with ulcers rather than white patches.
  • White sponge nevus: A rare, benign condition that affects the mucous membranes, causing white, spongy patches, typically inherited in an autosomal dominant pattern.