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Oral Candidiasis — ORE Part 1 MCQ

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EasyOral MedicineOral CandidiasisORE Part 1

A 62-year-old man on long-term systemic corticosteroids for COPD presents with white plaques on his palate that can be wiped off to reveal an erythematous base. What is the most likely diagnosis?

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Correct answer: EPseudomembranous candidiasis

Explanation lettering: D = shown as A · C = shown as B · B = shown as C · E = shown as D · A = shown as E

The correct answer is A (Pseudomembranous candidiasis). The clinical presentation—white plaques on the palate that are easily wiped away to reveal an erythematous base—is pathognomonic for pseudomembranous candidiasis (oral thrush). This presentation is typical in patients on long-term systemic corticosteroids, which suppress local and systemic immunity. The removability of the plaques is the key discriminating sign. Leukoplakia (B), oral lichen planus (C), chemical burn (D), and frictional keratosis (E) are all non-removable white lesions or disorders without the characteristic erythematous base revealed by gentle wiping. Lichen planus presents with adherent reticular patterns; leukoplakia is dysplastic and adherent; chemical burn and frictional keratosis are associated with different aetiologies and are not scrapable.

Reference: RCS England Faculty Dental Journal, 'Oral white lesions: who, what, where, when, how and why?', 2024. https://publishing.rcseng.ac.uk/doi/10.1308/rcsfdj.2024.10