A 17-year-old girl notices a small, sensitive, gray-white area forming along the lateral border of her tongue 2 days before the end of her final examinations. On examination by the physician's assistant, the girl is afebrile. There is a shallow, ulcerated, 0.3-cm lesion with an erythematous rim. No specific therapy is given, and the lesion disappears within 2 weeks. The history shows that the girl does not use tobacco or alcohol. Which of the following is the most probable diagnosis?
Aphthous ulcer
Herpes simplex stomatitis
Leukoplakia
Oral thrush
An aphthous ulcer is a common lesion that also is known as a canker sore. The lesions are never large, but are annoying and tend to occur during periods of stress. Aphthous ulcers are not infectious; they probably have an autoimmune origin. Herpetic lesions are typically vesicles that can rupture. Leukoplakia appears as white patches of thicker mucosa from hyperkeratosis. It may be a precursor to squamous cell carcinoma in a few cases. The temperance ditty mentioned in the history is a cautionary note for all young people. Oral thrush is a superficial candidal infection that occurs in diabetic, neutropenic, and immunocompromised patients. Inflammation of a salivary gland (sialadenitis), typically a minor salivary gland in the oral cavity, may produce a localized, tender nodule.
Head & Neck