What is the cause of perioral (around the mouth) white discoloration?

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Last updated: April 18, 2025View editorial policy

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Differential Diagnosis for Peri-labial White Discoloration

  • Single most likely diagnosis
    • Fordyce spots: These are small, white or yellowish spots on the lips, inside of the cheeks, and sometimes on the genitalia. They are caused by the abnormal presence of sebaceous glands in the mucous membranes and are usually harmless.
  • Other Likely diagnoses
    • Oral candidiasis (thrush): A fungal infection that can cause white patches on the lips, tongue, and inside of the mouth. It is more common in immunocompromised individuals, the elderly, and those with poor oral hygiene.
    • Leukoplakia: A condition characterized by white patches or plaques on the mucous membranes, often associated with chronic irritation or tobacco use. It can be a precursor to oral cancer.
    • Lichen planus: An autoimmune condition that can cause white, lacy patches on the mucous membranes, including the lips.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Squamous cell carcinoma: A type of skin cancer that can present as a white or red patch on the lip. Early detection is crucial for effective treatment.
    • Lupus: An autoimmune disease that can cause a variety of symptoms, including oral ulcers and white patches on the lips and mouth.
  • Rare diagnoses
    • Darier's disease: A rare genetic disorder that affects the skin and mucous membranes, causing white or yellowish patches on the lips and other areas.
    • White sponge nevus: A rare genetic condition that causes white, spongy patches on the mucous membranes, including the lips.

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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