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Differential Diagnosis for Blisters on Tongue

  • Single most likely diagnosis
    • Oral thrush or candidiasis: This is a common condition, especially in immunocompromised individuals or those with poor oral hygiene, characterized by white patches and potentially blisters on the tongue and other oral mucosa.
  • Other Likely diagnoses
    • Aphthous ulcers: Also known as canker sores, these are small, painful ulcers that can appear on the tongue and inside the mouth. They are very common and can sometimes present with a blister-like appearance before they rupture.
    • Herpes simplex virus (HSV) infection: HSV can cause oral herpes, leading to blisters or cold sores on or around the mouth, including the tongue, especially during the initial outbreak.
    • Trauma: Accidental biting of the tongue or other mechanical injuries can lead to the formation of blisters.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
    • Erythema multiforme: A skin condition characterized by target lesions, which can sometimes involve the mucous membranes, including the tongue, and can be a sign of a severe allergic reaction or infection.
    • Stevens-Johnson syndrome: A rare but serious disorder of the skin and mucous membranes, usually a reaction to medication or infection, which can cause blisters and is potentially life-threatening.
    • Pemphigus vulgaris: An autoimmune disease causing blistering of the skin and mucous membranes, which can be severe and life-threatening if not treated promptly.
  • Rare diagnoses
    • Angina bullosa hemorrhagica: A rare condition characterized by the sudden appearance of blood blisters on the mucous membranes, often on the tongue or inside the cheek.
    • Oral pemphigoid: An autoimmune disease that can cause blistering lesions on the oral mucosa, including the tongue.
    • Behçet's disease: A form of vasculitis that can cause a variety of symptoms, including oral ulcers and potentially blisters on the tongue, though this is less common.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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