Differential Diagnosis for White Patch on Tongue that can be Wiped Off
- Single Most Likely Diagnosis
- Oral thrush (candidiasis): This is the most common cause of a white patch on the tongue that can be wiped off. It is a fungal infection caused by Candida albicans, which is normally found on the skin and mucous membranes. It can overgrow and cause infection, especially in immunocompromised individuals or those with poor oral hygiene.
- Other Likely Diagnoses
- Leukoplakia: Although typically cannot be wiped off, some early forms or specific types like pseudomembranous candidiasis might initially present similarly. Leukoplakia is a condition where thick, white patches or lesions develop on the tongue, often due to chronic irritation.
- Lichen planus: This is an inflammatory condition that can affect the mucous membranes inside the mouth, including the tongue. It may present with white, lacy patches, but these are usually not easily wiped off. However, in some cases, the presentation might be atypical.
- Oral hairy leukoplakia: This condition is seen in immunocompromised patients, particularly those with HIV/AIDS, and presents as white patches on the lateral surfaces of the tongue that cannot be wiped off. However, early stages might be confused with conditions that are removable.
- Do Not Miss Diagnoses
- Syphilitic mucous patches: In secondary syphilis, mucous patches can appear on the tongue and oral mucosa. These can sometimes be wiped off and are a critical diagnosis not to miss due to the implications of untreated syphilis.
- Tuberculosis: Oral tuberculosis can very rarely present with white patches or ulcers on the tongue. Although extremely uncommon, missing this diagnosis could have significant consequences.
- Rare Diagnoses
- Histoplasmosis: This is a fungal infection that can cause oral lesions, including on the tongue, especially in immunocompromised individuals. It's rare but could present with white patches.
- Cryptococcosis: Another fungal infection that can cause oral lesions, including white patches on the tongue, primarily in immunocompromised patients. It is relatively rare but important to consider in the right clinical context.