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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Candidiasis – The plaques of candidiasis usually wipe off more easily than the keratotic tags of cheek chewing.
• Leukoplakia – This condition usually does not have a ragged surface and is more sharply demarcated than cheek chewing.
• Leukoedema – This condition is characterized by a smooth white surface of the buccal mucosa, and the lesion tends to disappear when the mucosa is stretched or everted.
• Lichen planus – While lichen planus often affects the buccal mucosa, the surface of this process is not as ragged, and even the more papular forms often have areas of reticular striae.
• White sponge nevus – The lesions of white sponge nevus tend to be more diffuse and affect areas of the mucosa that cannot be reached by the teeth.
• Squamous cell carcinoma

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References

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