Pathology · single question
A whitish opalescent lesion is noted bilaterally on the buccal mucosa. When you stretch the cheek, the lesion disappears. What is the most likely diagnosis?
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Correct answer: B. Leukoedema
Leukoedema presents as a diffuse, bilateral, grayish-white opalescent lesion on buccal mucosa. Its HALLMARK diagnostic feature is that it disappears (or diminishes) when the cheek is stretched — the diascopic phenomenon. This distinguishes it from all other white lesions.
- A. White sponge nevus is hereditary and bilateral but the lesions do NOT disappear on stretching.
- B. CORRECT. Leukoedema disappears when the cheek is stretched — this is its pathognomonic feature (diascopic phenomenon). Benign normal variant, no treatment needed.
- C. Morsicatio buccarum (cheek biting) produces a shredded white surface that does not disappear on stretching.
- D. Leukoplakia is a white patch that CANNOT be rubbed off and does NOT disappear when stretched. It has malignant potential.