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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

• Sebaceous hyperplasia is another condition due to a proliferation of sebaceous glands and appears as a larger papule or plaque.
• Lipomas are generally larger, exophytic, unilateral, and soft in texture.
• Oral lymphoepithelial cysts are usually solitary, exophytic, unilateral, and larger. They occur in the floor of the mouth and posterior lateral tongue, not the usual sites for Fordyce spots.
• Granular cell tumors are solitary, larger, firm in consistency, and are usually within the substance of the tongue.
• Candidal plaques have an acute onset, a "stuck-on" appearance, and are not found within the mucosa.
• Small fibromas and areas of scarring have an indurated texture.
• Lichen planus of the oral mucosa can present with lacy white reticulated plaques.

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