I have constant sore throat with red patch on epiglottis. Could this be a premalignant lesion?

Hello doctor,

I am a 33-year-old male, normal weight, ex-smoker, and occasional drinker.

I have a constant sore throat, which started approximately 1 year ago. I feel the symptoms mostly on the right side of my throat, above Adam's apple. I am feeling a burning like I have a wound inside my throat. I feel it worse when swallowing my own saliva. I feel these symptoms mostly on the right side of my throat between the base of the tongue and Adam's apple.

On throat endoscopy, they see nothing wrong except some mild lingual tonsils hypertrophy. Neck CT scan showed nothing wrong except some mild lingual tonsils hypertrophy. Gastric endoscopy showed some reflux and a small 0.39 inches hiatus hernia. My complete blood count is normal except for a mild low MCV. CRP, calcium, magnesium, and iron are normal.

I took proton pump inhibitors twice daily for a couple of months without any improvement in my symptoms. I have been told that I might have laryngopharyngeal reflux despite I have no hoarse voice, no cough, no signs of reflux on throat endoscopy inside my throat.

I had tried some antifungal treatments like Fluconazole, Nystatin, and Itraconazole in the hope that I might have some fungal infection, but with in success on improving my symptoms. Tried different types of throat lozenges and sprays with no improvement. Tried lifestyle changes and diet with no success. Now, I want to ask you to look at a picture which I took with my phone and a dental mirror.

There seems to be some red patch on my epiglottis, which I see it there for at least three months (not sure if it was there prior to me observing it). No doctor has seen it, because I had my last doctor visit 7 or 8 months ago. Could my symptoms be from there? I am afraid of being it some premalignant lesions like erythroplakia.

I am not expecting a diagnosis from you, but some opinion on what most likely looks like that redness on my epiglottis, and what you think about my whole situation. I do not know what to do with my symptoms and what direction should I take?

Thank you doctor,

I had tried with Nexium (Esomeprazole) 40 mg twice daily for at least three months, but I did not see any improvement in my symptoms. On the dietary side, I really do not know from my observations which foods make my symptoms worse or better. I cannot associate my symptoms with consumption of any specific foods, but I might feel a change in regarding the quantity of food because I might feel a little worse when I do not eat enough.