Differentials

Oral hairy leukoplakia (hairy tongue)

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

Painless white plaques along the lateral tongue borders. History of HIV or immunosuppression.[24]

INVESTIGATIONS

Tongue biopsy with immunostaining of the specimen for Epstein-Barr virus, the causative agent for oral hairy leukoplakia.

Acute pseudomembranous candidiasis (hairy/geographic tongue)

SIGNS / SYMPTOMS
INVESTIGATIONS
SIGNS / SYMPTOMS

White patches resemble milk curds and when wiped off reveal a raw erythematous and sometimes bleeding base.

INVESTIGATIONS

The diagnosis is clinical. Demonstrating the presence of candidal growth with a nonquantitative investigation (e.g., swab for culture) may simply reflect candidal carriage, as these organisms are oral commensals.

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