Pathology · single question
A patient taking prolonged antibiotics develops white lesions on the palate that CAN BE WIPED OFF. What is the most likely diagnosis?
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Correct answer: C. Pseudomembranous Candidiasis
Pseudomembranous Candidiasis (C) — 'Thrush'. The classic presentation: white plaques/lesions on oral mucosa/palate that WIPE OFF with gauze, revealing a red/bleeding base underneath. Caused by Candida albicans overgrowth after broad-spectrum antibiotics destroy commensal bacteria.
• Erythematous Candidiasis (A): red (not white), often seen under dentures or as central papillary atrophy — cannot be wiped off.
• Hyperplastic Candidiasis (B): white plaques that CANNOT be wiped off — firm, leukoplakia-like. Usually on buccal mucosa (commisures).
• Oral Hairy Leukoplakia: white corrugated lesion on LATERAL tongue; cannot be wiped off; caused by EBV in immunocompromised patients.
• Key distinguishing feature: wipes off = pseudomembranous; cannot wipe off = hyperplastic or OHL.
• Erythematous Candidiasis (A): red (not white), often seen under dentures or as central papillary atrophy — cannot be wiped off.
• Hyperplastic Candidiasis (B): white plaques that CANNOT be wiped off — firm, leukoplakia-like. Usually on buccal mucosa (commisures).
• Oral Hairy Leukoplakia: white corrugated lesion on LATERAL tongue; cannot be wiped off; caused by EBV in immunocompromised patients.
• Key distinguishing feature: wipes off = pseudomembranous; cannot wipe off = hyperplastic or OHL.