Table 1. White Surface Lesions of Oral Mucosa
|EPITHELIAL THICKENING WHITE LESIONS
Asymptomatic; rough to palpation; fixed to the surface (won’t rub off)
|Multiple areas of mucosa involved; bilateral distribution; white plaques arranged in striated pattern associated with erythema; ulcers may be present; skin lesions may be present.
|Nicotine (nicotinic) stomatitis
|Hard palate; mainly in pipe or cigar smokers.
|Dorsum of tongue.
|Lateral surface of tongue; patient is immunocompromised, e.g. AIDS.
|White sponge nevus
|Multiple lesions affecting broad areas of mucosa; familial history; present from early age; genital & rectal mucosa may be affected.
|Bilateral on buccal mucosa. Disappears when tissue is stretched.
|Erythema migrans (geographic tongue, benign migratory glossitis)
|Multiple red patches with irregular yellow-white border; dorsal lateral tongue; lesions migrate; usually asymptomatic.
|May resolve spontaneously.
Superficially invasive squamous cell carcinoma
|Persistent; usually asymptomatic; more common as red lesion or mixed red and white lesion.
|SURFACE DEBRIS WHITE LESIONS
Pain or burning; rubs off; submucosal erythema
|History of antibiotic therapy, immunosuppression; xerostomia; nail and/or vaginal lesions may be present
|Burn (thermal or chemical)
|History of burn.
|Dried, thick saliva
|Removed with wet gauze.
|SUBEPITHELIAL WHITE LESIONS
Asymptomatic; smooth to palpation; surface is translucent.
|Small cysts of oral mucosa can appear white. Examples are congenital keratotic cyst and lymphoepithelial cyst.
|Fordyce granules (ectopic sebaceous glands)
|Yellow, circumscribed, in clusters; most commonly located on buccal mucosa and upper lip.
|History of injury or surgery; usually poorly defined.