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Chronic Kidney Disease Oral Manifestations — MFDS Part 1 MCQ

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ModerateHuman DiseaseChronic Kidney Disease Oral ManifestationsMFDS Part 1

A 58-year-old man with advanced chronic kidney disease and marked uraemia develops painful, non-wipeable grey-white plaques with shallow ulceration on the lateral tongue and buccal mucosa. Fungal culture is negative, and the lesions improve markedly after initiation of haemodialysis. What is the most likely diagnosis?

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Correct answer: D — Uraemic stomatitis

The diagnosis is **uraemic stomatitis**, an uncommon oral complication associated principally with marked uraemia in advanced or inadequately treated kidney disease. It may produce painful grey-white plaques, crusting or ulceration, often involving the tongue and buccal mucosa. Improvement after haemodialysis strongly supports the diagnosis. Oral candidosis usually produces wipeable pseudomembranes and would be supported by fungal investigation. Erosive oral lichen planus typically has bilateral erythema or ulceration with peripheral reticular white striae and is not corrected by dialysis. Leukoplakia is a persistent white plaque rather than an acute painful uraemia-associated eruption. Geographic tongue causes migrating depapillated erythematous areas with pale borders, not diffuse plaques and ulceration.

Reference: Arruda JAA et al. Uremic Stomatitis: A Latin American Case Series and Literature Review. Head and Neck Pathology. 2024;18(1):54. https://pubmed.ncbi.nlm.nih.gov/38896178/