Clinicopathologic Review: Synchronous White Lesions of the Lateral Tongue and Cheek
CONCLUSION
A contact reaction to cinnamon-flavored candy should be
considered in patients who present with multiple, white,
somewhat shaggy-appearing lesions that are specifically
located in areas of contact with a candy held in the mouth.
This includes the central buccal mucosa (uni- or bilaterally) as
well as the lateral tongue. Presence of a burning sensation is
a particularly useful clue, since it is not associated with any of
the other pathologies discussed above. It is also important to
note that intraoral contact reactions may manifest in other
ways, including presentation as a lichenoid lesion. Careful
examination of the lesion(s) and consideration of the location
or distribution are important in order to achieve the correct
diagnosis. If a contact reaction is suspected, the patient
should be questioned about any habits, like frequent
consumption of cinnamon-flavored candies. If the history
suggests a contact reaction, the patient should be directed to
stop using or consuming the suspected allergen for a period
of two weeks, and then the tissue should be re-evaluated.
Resolution of the lesion(s) after discontinuation of the candy,
food, or oral hygiene product helps confirm the diagnosis
and no further treatment is necessary. However, if the lesion
persists after discontinuation of the offending agent, a biopsy
is indicated to rule out other possible conditions, such as
dysplasia or lichen planus.
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