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Decision Tree for Oral Mucosa Lesions

(Revised 3/08)

Epithelial thickening Candidosis Surface debris Burn White Subepithelial Congenital keratotic cysts Scar Fordyce granules Hemangioma Varix Kaposi’s sarcoma Hematoma Ecchymosis Petechiae Oral melanotic macule Nevus Hereditary Melanoma Ephelis Viral Autoimmune Idiopathic Mycotic

Geographic tongue (erythema migrans) Hairy tongue Leukoedema White sponge nevus Hairy leukoplakia Lichen planus Nicotinic stomatitis Hyperkeratosis Epithelial dysplasia Carcinoma-in-situ Squamous cell carcinoma

Surface Lesions of Oral Mucosa Localized

Intravascular Extravasated blood Melanocytic Tattoo Pigmented

Epidermolysis bullosa Herpes simplex Herpangina Hand, foot and mouth disease Herpes zoster Infectious mononucleosis Varicella (Chickenpox) Primary herpes Recurrent herpes

Generalized Clinical Impression

Hereditary Addison’s disease Heavy metal ingestion Peutz-Jeghers syndrome Neurofibromatosis Polyostotic fibrous dysplasia Pregnancy Medication Smoker’s melanosis

Aphthous ulcers Erythema multiforme Erythroplasia (erythroplakia) Medication-Induced mucositis Contact stomatitis Candidosis Papilloma Verruca vulgaris Condyloma acuminatum

Erosive lichen planus Mucous membrane pemphigoid Pemphigus vulgaris Bullous pemphigoid Lupus erythematosus Epithelial dysplasia Carcinoma in situ Squamous cell carcinoma

Vesicular-ulceratederythematous Reactive

Parulis/sinus track Periodontal abscess Mucocele (mucous extravasation phenomenon) Fibrous hyperplasia Inflammatory papillary hyperplasia Necrotizing sialometaplasia Epithelial Mesenchymal Salivary gland Gingival cyst of adult Lymphoepithelial cyst Epidermoid/dermoid cyst Thyroglossal tract cyst

Soft Tissue Enlargements


Tumor or Neoplasm



Squamous cell carcinoma Verrucous carcinoma Lymphoma Metastatic carcinoma Melanoma Sarcoma Salivary gland adenocarcinoma

Pleomorphic adenoma Papillary cystadenoma lymphomatosum Adenoid cystic carcinoma Acinic cell adenocarcinoma Mucoepidermoid carcinoma, low grade Polymorphous low-grade adenocarcinoma Monomorphic adenoma

Adenoid cystic carcinoma Mucoepidermoid carcinoma Polymorphous low-grade adenocarcinoma Acinic cell adenocarcinoma

Fibroma Peripheral ossifying fibroma Leiomyoma Rhabdomyoma Peripheral giant cell granuloma Hemangioma Lymphangioma Pyogenic granuloma Lipoma Neuroma Neurofibroma Schwannoma Granular cell tumor Congenital epulis

Irritation fibroma Epulis fissuratum

©2008 University of Iowa, College of Dentistry