Differential Diagnosis for White Tongue
- Single Most Likely Diagnosis
- Oral thrush (candidiasis): This is the most common cause of a white tongue, especially in individuals with weakened immune systems, poor oral hygiene, or those who wear dentures. The white appearance is due to the overgrowth of Candida fungus on the tongue's surface.
- Other Likely Diagnoses
- Leukoplakia: A condition characterized by white patches on the mucous membranes, including the tongue, often associated with chronic irritation or tobacco use. It can sometimes be a precursor to oral cancer.
- Geographic tongue: A benign condition where areas of the tongue's surface appear white due to the loss of papillae, giving it a map-like appearance.
- Oral lichen planus: An autoimmune condition that can cause white, lacy patches on the tongue and other mucous membranes.
- Do Not Miss Diagnoses
- Oral cancer: Although less common, a white tongue can be an early sign of oral cancer, particularly if there are other symptoms like unexplained bleeding, difficulty swallowing, or a lump in the neck.
- Syphilis: In its secondary stage, syphilis can cause a variety of oral manifestations, including a white tongue.
- Rare Diagnoses
- Pemphigus vulgaris: A rare autoimmune disease that can cause blistering of the skin and mucous membranes, including the tongue, which might appear white due to the formation of blisters.
- Kawasaki disease: A rare condition that mainly affects children, causing inflammation in the walls of medium-sized arteries throughout the body. It can lead to a white tongue among other symptoms like fever, rash, and swollen lymph nodes.
- Hairy leukoplakia: A rare condition seen in immunocompromised patients, particularly those with HIV/AIDS, characterized by white patches on the tongue that have a hairy appearance under microscopic examination.