Abstract
Diagnosis of oral white lesions might be quite challenging. This review article aimed to introduce a decision tree for oral white lesions according to their clinical features. General search engines and specialized databases including PubMed, PubMed Central, EBSCO, Science Direct, Scopus, Embase, and authenticated textbooks were used to find relevant topics by means of MeSH keywords such as “mouth disease”, “oral keratosis”, “oral leukokeratosis”, and “oral leukoplakia”. Related English-language articles published since 2000 to 2017, including reviews, meta-analyses, and original papers (randomized or nonrandomized clinical trials; prospective or retrospective cohort studies), case reports, and case series about oral diseases were appraised. Upon compilation of data, oral white lesions were categorized into two major groups according to their nature of development: Congenital or acquired lesions and four subgroups: Lesions which can be scraped off or not and lesions with the special pattern or not. In total, more than 20 entities were organized in the form of a decision tree in order to help clinicians establish a logical diagnosis by a stepwise progression method.
Highlights
Diagnosis of oral white lesions might be quite challenging
Recent studies have noticed the relationship between Oral lichen planus (OLP) and hepatitis C virus in some populations such as Central and Eastern Asia, Middle East, North Africa with high prevalence, South Asia, sub-Saharan Africa, Central and Latin America, the Caribbean, Oceania, Australia, Central and Eastern Europe, Western Europe with medium prevalence (1.5–3.5%), and North
Discoid oral lesions appear as whitish steriae generally radiating from the central erythematous area (“brush border” pattern), which makes it difficult to distinguish them from oral candidiasis or OLP if there is no systemic or cutaneous findings [4]
Summary
Diagnosis of oral white lesions might be quite challenging. These lesions represent a wide spectrum of lesions with different etiology and various prognoses. Oral white lesions can be caused by a thickened keratotic layer or an accumulation of non-keratotic material. A superficial non-keratotic layer such as pseudomembranes, most commonly of non-keratotic when a clinician a white area on the oral mucosa, caused by fungal material. Out of more including than 140 reviews,articles meta-analyses, originalfive papers (randomized non-randomized clinical trials; reviews, prospective relevant and textbooks, textbooks, and 45orpapers were selected including caseor retrospective cohort studies), case reports, andWe casedescribed series were. Oral white lesions were categorized into two major groups of congenital andor case series, and original. Patterned or oral white lesions were categorized into two major groups of congenital and acquired origin and four non-pattern lesions (Figure 1).
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