White spots on tongue

If white spots appear on the mouth and tongue, they cannot be ignored. Although the clinical symptoms of this disease are not so obvious, if it is not treated in time, it will affect the patient's normal life and make it impossible for the patient to eat normally. In addition, white spots on the mouth and tongue are likely caused by oral ulcers. However, the specific cause of the disease can only be known after going to the hospital for a detailed examination, so that the right medicine can be prescribed.

Clinical manifestations

1. Plaque

White or grayish white homogeneous hard plaques appear on the oral mucosa, with a dense texture, varying lesion shapes and areas, and slight elevations or unevenness. It is worth noting that there is no parallel relationship between the size of the lesion and the possibility of cancer. Sometimes cancer can occur even when the lesion is only the size of a grain of rice.

2. Granular

Also known as granular-nodular leukoplakia, it is more common in the mucosa of the corners of the mouth. The lesions are often triangular in shape, with the base located at the corner of the mouth; the lesions are a mixture of red and white, with the red area being an atrophic erythema; the surface of the erythema is "dotted" with nodular or granular white spots. This type of leukoplakia can be found in most cases of Candida albicans infection.

3. Crumpled paper

It is often seen on the floor of the mouth and the tongue, and is also known as leukoplakia of the floor of the mouth and sublingual keratosis. This disease can occur on the floor of the mouth and the ventral tongue at the same time, or it can occur on the floor of the mouth or the ventral tongue alone, or cross-wise on the floor of the mouth and the ventral tongue. The area of ​​damage varies and may even involve the lingual gums. The surface is undulating like white crumpled paper, the base is soft, and crumpled-paper-like "peaks" are visible. Except for the rough and uncomfortable feeling, there are no obvious subjective symptoms at the beginning.

4. Verrucous

The lesions are raised, with an uneven surface, accompanied by papillary or burr-like protrusions, and are slightly hard to palpate. Except for those located on the gums or palate, there are no obvious nodules on the base, the affected area feels rough, and pain usually occurs due to ulcer formation.

The above types can be called "ulcer type" when ulcers occur. Ulcers are essentially precancerous lesions; secondly, the clinical diagnosis of each type must be verified by pathological examination as a basis for selecting a treatment method.

The most common sites for leukoplakia are the oral mucosa of the cheeks, back of the tongue, ventral tongue, lips, palate, floor of the mouth, gums, etc., but it can sometimes occur in other parts of the body. Some types have more specific locations: granular leukoplakia are mostly seen on the buccal mucosa at the corners of the mouth; wrinkled paper-like leukoplakia are mostly seen on the floor of the mouth and tongue; and warty leukoplakia are mostly seen on the gums. The site of vitiligo and the common area of ​​white keratosis are different, and they have nothing in common in shape and texture. Vitiligo and white keratosis can be distinguished by the site of onset, the texture of the lesions, and the clarity of the lesion boundaries. In addition to microabscesses and abnormal epithelial proliferation, the presence of pathogens in tissues can be confirmed by periodic acid-Schiff staining or culture, and histological examination is more definitive.