Differential Diagnosis for Patches on Tongue
- Single most likely diagnosis
- Geographic tongue: This condition is characterized by the appearance of single or multiple, well-demarcated, smooth, red patches on the tongue, resulting from the loss of filiform papillae. It is a common and benign condition.
- Other Likely diagnoses
- Oral thrush (candidiasis): A fungal infection that can cause white patches on the tongue and other parts of the mouth. It is more common in immunocompromised individuals, those wearing dentures, and after antibiotic use.
- Leukoplakia: A condition where thick, white patches or lesions appear on the tongue or the inside of the mouth. It can be associated with chronic irritation and has a potential for malignant transformation.
- Lichen planus: An autoimmune condition that can affect the mucous membranes inside the mouth, leading to white, lacy patches; red, inflamed tissues; or open sores.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Oral cancer: Although less common, patches on the tongue can be a sign of oral cancer, especially if there are other symptoms like unexplained pain, difficulty swallowing, or a lump in the neck. Early detection is crucial for effective treatment.
- Syphilis: The secondary stage of syphilis can cause mucous patches in the mouth, which are painless, white, and can resemble other conditions. Missing this diagnosis can lead to serious complications if left untreated.
- Rare diagnoses
- Pemphigus vulgaris: A rare autoimmune disease that can cause blistering of the skin and mucous membranes, including the tongue, leading to patches or erosions.
- Kawasaki disease: Although primarily known for its effects on children, causing fever, rash, and lymph node swelling, it can also lead to oral changes, including redness and swelling of the tongue (strawberry tongue).
- Histoplasmosis: A fungal infection that can cause oral lesions, including patches on the tongue, especially in immunocompromised patients.