An asthmatic patient who uses a corticosteroid inhaler presents with a wipeable white plaque on the palate that leaves a raw, erythematous surface when removed. What is the most likely diagnosis?

Corticosteroid inhalers suppress local immunity in the oral cavity and pharynx, creating an environment favorable for overgrowth of Candida albicans. The resulting pseudomembranous candidiasis (oral thrush) presents as white, wipeable plaques that leave a raw, erythematous, or bleeding surface when removed — a key distinguishing feature. This distinguishes candidiasis from leukoplakia and lichen planus, which cannot be wiped away. Patients using inhaled corticosteroids should be instructed to rinse their mouth with water and gargle after each use to reduce oropharyngeal deposition of the steroid. Treatment is with topical antifungal agents (clotrimazole troches or nystatin oral rinse).