Differential Diagnosis for White Lesion on Lips after Biting

• Single Most Likely Diagnosis
  • Traumatic keratosis: This is the most likely diagnosis given the history of biting the lip. The trauma can cause a white lesion due to the formation of a keratin-filled crater or due to the irritation and subsequent healing process.
• Other Likely Diagnoses
  • Mucosal laceration with subsequent scar formation: Biting the lip can cause a laceration, and as it heals, it might appear as a white lesion due to the formation of scar tissue.
  • Irritation fibroma: Repeated irritation or trauma to the lip can lead to the formation of an irritation fibroma, which might appear as a white lesion.
  • Fordyce spots: While these are more commonly seen on the lips and inside of the cheeks, they can sometimes be mistaken for white lesions, especially if they become irritated.
• Do Not Miss Diagnoses
  • Squamous cell carcinoma: Although less likely, any persistent or changing white lesion on the lip should raise suspicion for squamous cell carcinoma, especially in individuals with risk factors such as smoking or excessive sun exposure.
  • Leukoplakia: This is a potentially precancerous lesion that can appear as a white patch on the mucous membranes, including the lips. It's crucial to monitor or biopsy these lesions to rule out dysplasia or cancer.
• Rare Diagnoses
  • Lichen planus: This is an autoimmune condition that can affect mucous membranes and skin, sometimes presenting with white, lacy patches. However, it's less commonly associated with a history of trauma like biting.
  • Pemphigus vulgaris: An autoimmune disease that can cause blistering of the skin and mucous membranes, including the lips. While rare, it's a serious condition that requires prompt diagnosis and treatment.