Differential Diagnosis for Spongey Area Inside the Mouth with Thickening of the Palate and Sloughing of the Skin

• Single Most Likely Diagnosis
  • Oral Cancer (Squamous Cell Carcinoma): This condition is a leading consideration due to the symptoms of a spongey area inside the mouth, thickening of the palate, and sloughing of the skin, which can be indicative of a malignant process, particularly in the context of oral cancer.
• Other Likely Diagnoses
  • Oral Lichen Planus: This chronic inflammatory condition can cause lesions and changes in the mucous membranes inside the mouth, potentially leading to a spongey texture and sloughing of the skin.
  • Leukoplakia: A condition characterized by white patches or plaques in the mouth that cannot be rubbed off, which can sometimes present with thickening or a spongey texture, especially if there is associated dysplasia or early cancer.
  • Oral Candidiasis (Thrush): An infection caused by Candida fungus, which can lead to white patches, redness, and sometimes a spongey or thickened appearance of the oral mucosa.
• Do Not Miss Diagnoses
  • Necrotizing Sialometaplasia: A rare but serious condition that can mimic oral cancer, characterized by necrosis of the salivary gland tissue, which may present with sloughing and thickening of the mucosa.
  • Gangrene of the Oral Cavity: Although rare, gangrene in the oral cavity can occur, especially in the context of severe infection, immunocompromised states, or vascular diseases, and would require immediate attention.
• Rare Diagnoses
  • Pemphigus Vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes, which can lead to sloughing of the skin inside the mouth but is less commonly associated with a spongey area or thickening of the palate.
  • Mucous Membrane Pemphigoid: Another autoimmune disease that affects the mucous membranes, potentially causing blistering and scarring, which might result in a thickened or spongey texture in advanced cases.