Mortazavi et al reported a diagnostic decision tree to aid in the diagnosis of an oral white lesion. The authors are from Shahid Beheshti University of Medical Sciences in Iran.
Patient selection: oral white lesion
Parameters:
(1) congenital vs acquired
(2) scrapability
(3) specific pattern
|
Congenital vs Acquired
|
Can Be Scraped Off
|
Specific Pattern
|
Group
|
|
congenital
|
NA
|
NA
|
1
|
|
acquired
|
Yes
|
NA
|
2
|
|
acquired
|
No
|
Yes
|
3
|
|
acquired
|
No
|
No
|
4
|
Group 1:
(1) leukoedema
(2) white sponge nevus
(3) dyskeratosis congenita
(4) hereditary benign intraepithelial dyskeratosis
Group 2:
(1) superficial oral burn
(2) pseudomembranous candidiasis
(3) pseudomembrane of oral ulcers and materia alba
(4) habitual biting of cheek, lips and tongue (morsicatio)
Group 3:
(1) lichenoid
(1a) oral lichen planus
(1b) lichenoid contact reaction
(1c) drug-induced lichenoid reaction
(1d) graft-vs-host disease (GVHD)
(2) lupus erythematosus
Group 4:
(1) frictional keratosis
(2) oral leukoplakia
(3) oral hairy leukiplakia
(4) proliferative verrucous leukoplakia
(5) oral squamous cell carcinoma
(6) verrucous carcinoma
(7) nicotinic stomatitis
(8) actinic keratitis
(9) candidiasis (chronic mucocutaneous vs chronic hyperplastic)
(10) other
