MedComic

Leukoplakia vs. Oral Candidiasis

Jorge Muniz ·
Educational medical illustration comparing oral leukoplakia (flat white lesion that cannot be brushed off, associated with squamous cell carcinoma), oral candidiasis/thrush (creamy white plaque caused by Candida albicans that brushes off), and oral hairy leukoplakia (Epstein-Barr virus, lateral tongue, vertical striations)
Illustrated guide comparing three oral mucosal conditions: leukoplakia (premalignant), oral candidiasis (thrush), and oral hairy leukoplakia (EBV-associated) — including clinical features, risk factors, and management. Proprietary medical illustration by Jorge Muniz, PA-C.

Oral Leukoplakia

  • Flat, white lesions that cannot be brushed from the oral mucosa
  • Typically painless
  • Associated with tobacco and alcohol use
  • Associated with squamous cell carcinoma
  • Erythroplakia: similar lesions, but with a red appearance
    • Carry a higher risk of dysplasia or carcinoma
  • Malignant potential warrants biopsy
  • Management: alcohol and smoking cessation, consider surgical removal

Oral Candidiasis (Thrush)

  • Caused by Candida albicans
  • White, creamy plaque that easily brushes off, with underlying erythema
  • Typically associated with throat or mouth pain
  • Risk factors for infection
    • Immunocompromised states
    • HIV
    • Radiation or chemotherapy
    • Diabetes
    • Systemic or inhaled corticosteroid use
    • Broad-spectrum antibiotics
    • Dentures
  • KOH preparation demonstrates budding yeasts, hyphae, or pseudohyphae
  • Treatment is with antifungals
    • Nystatin liquid
    • Oral fluconazole
    • Clotrimazole troches
Educational medical illustration of oral hairy leukoplakia caused by Epstein-Barr virus (EBV), showing white hyperkeratotic plaques with vertical striations along the lateral border of the tongue, commonly associated with immunocompromised states including HIV
Illustrated guide to oral hairy leukoplakia — an EBV-associated condition of the lateral tongue seen in immunocompromised patients. Proprietary medical illustration by Jorge Muniz, PA-C.

Oral Hairy Leukoplakia

  • Caused by Epstein-Barr virus (human herpesvirus 4)
  • Most commonly affects immunocompromised patients (e.g. HIV)
  • White, hyperkeratotic plaque that cannot be brushed off
  • Usually distributed along the lateral border of the tongue
  • Vertical white striations may appear "hairy"
  • Lesions are typically painless and benign
  • Treatment for lesions not usually required; antivirals may be considered

Master ECG Interpretation with Sparkson

Get instant digital access to the complete Sparkson ECG guide, the full MedComic library, and educational games. One-time purchase.

Get Instant Access for $49