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d Leukoedema
d White Sponge Nevus
d Hereditary Benign Intraepithelial Dyskeratosis
d Dyskeratosis Congenita
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d Linea Alba (White Line)
d Frictional (Traumatic) Keratosis
d Cheek Chewing
d Chemical Injuries of the Oral Mucosa
d Actinic Keratosis (Cheilitis)
d Smokeless TobaccoȂInduced Keratosis
d Nicotine Stomatitis
d Sanguinaria-Induced Leukoplakia
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d Oral Hairy Leukoplakia

d Candidiasis
d Mucous Patches
d Parulis
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d IDIOPATHIC DzTRUEdz LEUKOPLAKIA
d BOWENǯS DISEASE
d ERYTHROPLAKIA
d ORAL LICHEN PLANUS
d LICHENOID REACTIONS
d LUPUS ERYTHEMATOSUS (SYSTEMIC AN DISCOID)
d DEVELOPMENTAL WHITE LESIONS: ECTOPIC
LYMPHOID TISSUE
d FORDYCEǯS GRANULES
d GINGIVAL AND PALATAL CYSTS OF THE
NEWBORN AND ADULT
d MISCELLANEOUS LESIONS
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d Diffuse grayish-white
milky appearance of
the buccal mucosa
d Appearance will
disappear when cheek
is everted and
stretched
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d No treatment is indicated for leukoedema since it is a

variation of the normal condition.
d No malignant change has been reported
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d White sponge nevus (WSN) is a rare autosomal
dominant disorder.
d With a high degree of penetrance and variable
expressivity.
d It predominantly affects noncornified stratified
squamous epithelium.
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d Presents as bilateral symmetric white, soft, Dzspongy,dz
or velvety thick plaques of the buccal mucosa.
d Other sites in the oral cavity may be involved,
including the ventral tongue, floor of the mouth,
labial mucosa, soft palate, and alveolar mucosa.
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d No treatment is indicated for this benign and

asymptomatic condition.
d if the condition is symptomatic Patients may require
palliative treatment.

   

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d Is a horizontal streak
on the buccal mucosa
at the level of the
occlusal plane.
d It is a very common
finding most likely
associated with
pressure, frictional
irritation, or sucking
trauma from the
facial surfaces of the
teeth.
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d Is defined as a white plaque with a rough and frayed
surface that is clearly related to an identifiable source
of mechanical irritation
d Usually resolve on elimination of the irritant.
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d Upon removal of the offending agent, the lesion

should resolve.
d within 2 weeks. Biopsies should be performed on
lesions that do not heal to rule out a dysplastic lesion.
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d Ragged, irregular white tissue of the buccal
mucosa in the line of occlusion
d May be ulcerated
d Due to chewing or biting the cheeks
d May also be seen on labial mucosa
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d Since the lesions result from an unconscious and/or

nervous habit, no treatment is indicated.
d For those desiring treatment and unable to stop the
chewing habit, a plastic occlusal night guard may be
fabricated.
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d Transient nonkeratotic white lesions of the oral
mucosa .
d Are often a result of chemical injuries caused by a
variety of caustic agents retained in the mouth for
long periods of time.
d such as aspirin, silver nitrate, formocresol, sodium
hypochlorite, paraformaldehyde, dental cavity
varnishes, acid etching materials, and hydrogen
peroxide.


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d The white lesions are attributable to the formation of a
superficial pseudomembrane composed of a necrotic
surface tissue and an inflammatory exudates.


   
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d Actinic (or solar) keratosis is a premalignant epithelial

lesion directly related to long-term sun exposure
d classically found on the vermilion border of the
d lower lip as well as on other sun-exposed areas of the
skin.
d A small percentage of these lesions will transform into
squamous cell carcinoma.

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d Palate initially becomes diffusely erythematous and
eventually turns grayish white secondary to
hyperkeratosis
d multiple keratotic papules with depressed red
centers correspond to dilated and inflamed
excretory duct openings of the minor salivary
glands
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d Nicotine stomatitis is completely reversible once the

habit is discontinued.
d The lesions usually resolve within 2 weeks of cessation
of smoking.
d Biopsy of nicotine stomatitis is rarely indicated except
to reassure the patient.
d biopsy should be performed on any white lesion of
d the palatal mucosa that persists after month of
discontinuation of smoking habit

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d Occurs in persons with poorly controlled diabetes,
pregnancy, hormone imbalance, those receiving
broad spectrum antibiotics, long term steroid
treatment, cancer therapy and other
immunocompromised individuals
d Oral lesions may be erythematous,
pseudomembranous, hyperplastic or angular
cheilitis
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d Pseudomembranous
d Atrophic (erythematous)
d Antibiotic stomatitis
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Atrophic
d Denture sore mouth
d Angular cheilitis
d Median rhomboid glossitis
d Hypertrophic/hyperplastic
d Candidal leukoplakia
d Papillary hyperplasia of the palate (see denture sore
mouth)
d Median rhomboid glossitis (nodular)
d Multifocal
d 
d Syndrome associated
d Familial +/Ȃ endocrine candidiasis syndrome
d Myositis (thymoma associated)
d Localized
d Generalized (diffuse)
d Immunocompromise (HIV) associated
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d Denture sore mouth
d Angular cheilitis
d Median rhomboid glossitis
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d Denture stomatitis is a common form of oral

candidiasis111
d Manifests as a diffuse inflammation of the maxillary
denture-bearing areas .
d and that is o
d Often associated with angular cheilitis.





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d Angular cheilitis is the term used for an infection
involving the lip commissures.
d The majority of cases are w
    



promptly to antifungal therapy.
d There is frequently a coexistent denture stomatitis.
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d Other possible etiologic cofactors include
d reduced vertical dimension
d nutritional deficiency (iron deficiency anemia and
vitamin B or folic acid deficiency) sometimes referred
to as perlèche;
d diabetes, neutropenia, and AIDS.
d co-infection with á 
   



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d Erythematous patches of atrophic papillae located in
the central area of the dorsum of the tongue
d Considered a form of chronic atrophic candidiasis
d These lesions were originally thought to be
developmental in nature but are now considered to be
a manifestation of chronic candidiasis.
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d Candidal leukoplakia
d Papillary hyperplasia of the palate (denture sore
mouth)
d Median rhomboid glossitis (nodular)
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d Superficial infection of the oral mucosa
by the fungus Candida albicans and
less common species of mthe same
genus.
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Predisposing factors,
d poor oral hygiene,
d xerostomia,
d recent antibiotic treatment,
d dental appliance
d Compromised Immune
system.
d early infancy
d AIDS
d Corticosteroid
d anemia,
d diabetes mellitus
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d Syndrome associated
Familial +/Ȃ endocrine candidiasis syndrome
Myositis (thymoma associated)
d Localized
d Generalized (diffuse
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d Mild to Moderate- Topical Therapies
d Nystatin (suspension 100KU/mL, or 1% cream),
Clotrimazole (troche, 10mg)

Moderate to Sever- Systemic Therapies

Fluconazole (100mg/day), Itraconzole (oral suspension
10mg/mL)
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d Topical therapy with nystatin or clotrimazole is
effective. Treatment length is usually 10-14 days, follow
up

Clotrimazole 10mg, 1 tab 5x/day, dissolve slowly and

swallow, 10 day treatment
d Systemic treatment with fluconazole 100 mg/day for 10
days for oropharyngeal/esophageal disease, follow up

Burketǯs Oral Medicine ,Diagnosis & Treatment
2003 BC Decker Inc Tenth Editionm
d George Laskaris, Pocket Atlas of Oral Diseases, 2nd
edition, 2006, Stuttgart · New York