Measles Oral Features — MFDS Part 1 MCQ
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Correct answer: D — Koplik spots on the buccal mucosa
Koplik spots on the buccal mucosa are the oral finding most characteristic of measles. They are small white or bluish-white lesions on an erythematous base and commonly occur around the onset of the rash, often approximately one day beforehand. Although strongly suggestive, UKHSA cautions that suspected Koplik spots can be confused with other oral lesions and should not be treated as an infallible diagnostic marker. Strawberry tongue is associated particularly with scarlet fever and Kawasaki disease. Oral hairy leukoplakia is an Epstein–Barr virus-associated lesion seen mainly with immunosuppression. Target lesions involving the lips suggest erythema multiforme, while a ranula is a mucus extravasation phenomenon arising in the floor of the mouth.
Reference: UK Health Security Agency. National measles guidelines, version 8, section 1.3.2: Clinical presentation of primary measles infection. July 2026. https://assets.publishing.service.gov.uk/media/66a0ce1449b9c0597fdb03a6/20240704_national-measles-guidelines-July-2024.pdf