Leukoedema Diagnosis — ORE Part 1 MCQ
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Correct answer: D — Leukoedema
The correct answer is Leukoedema. The pathognomonic clinical sign—disappearance of white patches on mucosal stretching—definitively identifies leukoedema. Option C (oral lichen planus) typically presents with symptomatic lesions that do not blanch on stretching and often include erosive or reticular patterns. Option A (leukoplakia) is a potentially malignant diagnosis of exclusion that cannot be removed by stretching. Option E (white sponge naevus) is a genetic disorder presenting as diffuse, spongy, thickened plaques that cannot be removed by stretching; it is associated with keratin gene mutations. Option B (oral candidiasis) presents as removable pseudomembranes and typically occurs in immunocompromised patients or those on broad-spectrum antibiotics. The bilateral symmetry, buccal location, asymptomatic course, and reversibility on stretching confirm leukoedema as a benign, idiopathic finding requiring only reassurance and observation.
Reference: Mortazavi H, Safi Y, Baharvand M, et al. Oral White Lesions: An Updated Clinical Diagnostic Decision Tree. Journal of Dentistry (Tehran). 2019. https://pubmed.ncbi.nlm.nih.gov/30736423/; 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