I have a white patch under the tongue. What is your opinion on it?

Hello,

Welcome to icliniq.com.

I understand your concern and saw your clinical pictures. (attachment removed to protect patient identity).

These pictures look a little blurred and a clearer picture will make the diagnosis easier. It could be a drug-induced lichenoid reaction or lichen planus probably caused by Losartan. Generally, anti-hypertensive drugs such as this are known to cause lichenoid reactions and lichen planus when medicines are taken for longer periods. Please look for skin lesions also.

And visit the dentist, if required the doctors may advise you to go for a biopsy procedure. On clinical examination and with biopsy, it is easier to diagnose and the cause can be determined. If it is drug-induced, the offending drug will be stopped and will be replaced by another one. If the cause is idiopathic (of unknown origin), then it can be managed with a topical corticosteroid cream.

I hope this helps.

Hello,

Welcome back to icliniq.com.

Your pictures are much better. (attachment removed to protect patient identity).

Yes, it seems to be a lichenoid reaction or a lichen planus. Clinically the presenting features for lichen planus, lichenoid reaction and leukoplakia are very similar. The only difference between these are their causative factors and it can also be differentiated by biopsy and palpation (touch and feel examination). Hypertensive drugs predominantly cause these white lesions in our mouth. Please do note that, a through clinical examination and biopsy are required to determine a correct diagnosis.

Hello,

Welcome back to icliniq.com.

The chances of this being oral cancer is very minimal. Since a history of pain, bleeding from ulcers in that area, burning sensation, smoking or other drug usage is not included, I practically neglected the chances of oral cancer. However, a normal benign white lesion like leukoplakia when left untreated and combined with smoking or other aggravating factors could turn into a cancerous one.

After treatment planning and management, this lesion should be constantly monitored at regular intervals for regression. If it regresses, the chances of it becoming cancer becomes nil. This looks a lot like a benign (non- cancerous) lesion. But you have to get it biopsied at once and start treatment immediately.

I hope this helps.