Differential Diagnosis for White Coat on Tongue
- Single most likely diagnosis
- Oral thrush (candidiasis): This is the most common cause of a white coat on the tongue, especially in immunocompromised individuals, those with poor oral hygiene, or after antibiotic use. The white patches are usually accompanied by redness and soreness.
- Other Likely diagnoses
- Leukoplakia: A condition characterized by white patches on the mucous membranes, including the tongue, 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 tongue and inside the mouth, often accompanied by redness and discomfort.
- Geographic tongue: A benign condition where areas of the tongue appear white or red due to the loss of papillae, giving it a map-like appearance.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Oral cancer: Although less common, a white coat on the tongue could be an early sign of oral cancer, especially if it's persistent, growing, or accompanied by other symptoms like difficulty swallowing or a lump in the neck.
- Syphilis: In its secondary stage, syphilis can cause a variety of oral manifestations, including white patches on the tongue.
- Rare diagnoses
- Pemphigus vulgaris: A rare autoimmune disease that can cause blistering of the skin and mucous membranes, including the tongue, which might appear white due to the formation of blisters or erosions.
- Histoplasmosis: A fungal infection that can cause oral lesions, including white patches on the tongue, especially in immunocompromised individuals.