What is the likely diagnosis for a white lesion present on the buccal mucosa?

• A. Leukoedema
• B. Cheek biting
• C. Lichen planus
• D. Squamous cell carcinoma

Answer: (C)

The presence of a white lesion on the buccal mucosa, particularly if it has a specific appearance described as reticular or striated, is most indicative of lichen planus. Lichen planus is a chronic inflammatory condition that affects the mucous membranes and can present as white, lacy lines known as Wickham's striae. It may also appear as plaque-like lesions, making it a common consideration when assessing white lesions in the oral cavity.

In contrast, while leukoedema can cause a diffuse white appearance in the buccal mucosa, it typically occurs bilaterally and is associated with a specific mucosal texture that does not resemble the appearance of lichen planus. Cheek biting may result in trauma and can present as ulcerations or localized erythema rather than a distinctly white lesion. Squamous cell carcinoma could present as a white lesion, but it is usually accompanied by other alarming features such as induration, ulceration, or a change in the surface characteristics and often involves a history of risk factors like tobacco use. These distinctions help clarify why lichen planus is the most likely diagnosis for a white lesion on the buccal mucosa.