Pathology · single question
A patient presents with a WIPEABLE white lesion. Which of the following would NOT be in the differential diagnosis?
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Correct answer: C. Leukoplakia
- A. A chemical burn (aspirin burn, phenol, hydrogen peroxide) produces a white necrotic slough that can be wiped away, exposing raw connective tissue.
- B. Materia alba and food debris wipe away readily and leave normal mucosa beneath.
- C. CORRECT — this would NOT be in the differential. LEUKOPLAKIA is by definition a white patch that CANNOT be wiped off and cannot be attributed to any other condition. It is a clinical diagnosis of exclusion with definite malignant potential and requires biopsy. If the lesion wipes away, it is not leukoplakia.
- D. Pseudomembranous candidiasis (thrush) is the classic WIPEABLE white lesion, leaving an erythematous, sometimes bleeding base.
Note: The single most useful chairside test for a white lesion: try to wipe it. Wipes off = infection, burn, or debris. Does not wipe off = keratosis, biopsy required.