Patient with a lesion that appears and disappears, described with a 'velvety' texture. Diagnosis:

Correct answer: C. Candidiasis (erythematous/velvety)

• A. Lichen planus classically presents with white reticular striae (Wickham's striae), not a velvety erythematous texture.
• B. White sponge nevus is a persistent, congenital white, corrugated/spongy lesion, not an intermittent velvety erythematous lesion.
• C. Correct. Erythematous (atrophic) candidiasis classically presents with a red, smooth-to-velvety texture, and can wax and wane with factors like denture wear, antibiotic use, or immune status.
• D. Hereditary keratosis presents as persistent white keratotic lesions, not an intermittent velvety erythematous presentation.

Note: The key descriptive word in this question is 'VELVETY' — a clue pointing to erythematous candidiasis rather than a white lesion.