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Pathology · single question

A patient using an albuterol inhaler for asthma has a white patch on the palate that can be wiped off. What should you tell the patient?

  1. This is nicotinic stomatitis; stop smoking
  2. Rinse your mouth with water after every inhaler use to prevent candidiasis
  3. Discontinue the inhaler immediately
  4. This requires biopsy for leukoplakia
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Correct answer: B. Rinse your mouth with water after every inhaler use to prevent candidiasis

  • A. Incorrect. Nicotinic stomatitis is from smoking, not inhalers.
  • B. Correct. Corticosteroid inhaler particles deposit in the oral cavity, suppressing local immunity and promoting Candida overgrowth (pseudomembranous candidiasis) — white plaque that wipes off. Prevention: rinse and spit with water immediately after every inhaler use.
  • C. Incorrect. The inhaler should not be discontinued — preventive rinsing is the solution.
  • D. Incorrect. Leukoplakia does NOT wipe off. This wiped-off lesion is classic candidiasis.

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