What is the differential diagnosis of oral leukoplakia (white patches) on the tongue in pediatric patients?

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Differential Diagnosis of Tongue White Patches in Children

Single Most Likely Diagnosis

  • Oral Thrush (Candidiasis): This is the most common cause of white patches on the tongue in children, especially in infants and toddlers. It is a fungal infection caused by Candida albicans, which is often seen in children with poor oral hygiene, immunocompromised status, or those taking antibiotics.

Other Likely Diagnoses

  • Trauma: Accidental trauma to the tongue, such as biting or sucking on the tongue, can cause white patches or ulcers.
  • Allergic Reaction: An allergic reaction to food, medications, or other substances can cause white patches or lichenoid lesions on the tongue.
  • Irritation: Irritation from sharp teeth, dental appliances, or other oral habits can cause white patches or ulcers on the tongue.
  • Leukoplakia: A benign condition characterized by white patches on the tongue, often associated with chronic irritation or habit.

Do Not Miss Diagnoses

  • Lichen Planus: A chronic autoimmune condition that can cause white patches, ulcers, or erosions on the tongue, which can be painful and debilitating if left untreated.
  • Oral Cancer: Although rare in children, oral cancer can present with white patches or ulcers on the tongue, and early detection is crucial for effective treatment.
  • Immunodeficiency: Certain immunodeficiency disorders, such as HIV/AIDS, can increase the risk of opportunistic infections, including oral thrush, and white patches on the tongue can be an early sign of an underlying immunodeficiency.

Rare Diagnoses

  • Pemphigus Vulgaris: A rare autoimmune disorder that can cause blisters and white patches on the tongue, which can be life-threatening if left untreated.
  • Darier's Disease: A rare genetic disorder that can cause white patches or papules on the tongue, often associated with other skin and mucous membrane lesions.
  • White Sponge Nevus: A rare genetic disorder that can cause white patches or spongy lesions on the tongue, often associated with other oral and skin lesions.

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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