Differential Diagnosis for a White Lesion on the Lateral Surface of the Tongue
- Single most likely diagnosis
- Leukoplakia: This is the most common cause of white lesions on the tongue, often associated with chronic irritation or tobacco use. It presents as a white patch or plaque that cannot be rubbed off and has a high potential for malignant transformation.
- Other Likely diagnoses
- Oral lichen planus: An autoimmune condition that can cause white, lacy patches on the mucous membranes, including the tongue. It may be associated with symptoms like burning or discomfort.
- Oral candidiasis (thrush): A fungal infection that can cause white lesions on the tongue and other parts of the mouth, especially in immunocompromised individuals or those with poor oral hygiene.
- Frictional keratosis: Caused by chronic irritation or trauma, leading to the formation of a white lesion due to hyperkeratosis (thickening of the outer layer of the skin).
- Do Not Miss diagnoses
- Squamous cell carcinoma: Although less common, any persistent white lesion on the tongue should be evaluated for the possibility of oral cancer, especially in individuals with risk factors like tobacco use or excessive alcohol consumption.
- Lymphoma: Though rare, lymphoma can present with oral lesions, including on the tongue, and is critical to diagnose early due to its potential for aggressive behavior.
- Rare diagnoses
- White sponge nevus: A rare, benign condition that affects the mucous membranes, causing white, spongy lesions. It is often inherited and may appear on the tongue.
- Pachyonychia congenita: A rare genetic disorder that can cause a variety of symptoms, including white lesions on the tongue due to oral leukokeratosis.
- Darier's disease: A rare genetic disorder that affects the skin and sometimes the mucous membranes, leading to white or red lesions, including on the tongue.