The diagnosis can typically be made from the clinical appearance alone, but not always. As<unk>  can be variable in appearance, and present with white, red or combined white and red lesions, the differential diagnosis can be extensive. In pseudomembraneous<unk> , the membranous slough can be wiped away to reveal an erythematous surface underneath. This is helpful in distinguishing pseudomembraneous<unk>  from other white lesions in the mouth that cannot be wiped away, such as lichen planus,<unk>  hairy leukoplakia. Erythematous<unk>  can mimic geographic tongue. Erythematous<unk>  usually has a diffuse border that helps distinguish it from erythroplakia, which normally has a sharply defined border. Special investigations to detect the presence of candida species include<unk>  swabs,<unk>  rinse or<unk>  smears. Smears are collected by gentle scraping of the lesion with a spatula or tongue blade and the resulting debris directly applied to a glass slide.<unk>  swabs are taken if culture is required. Some recommend that swabs be taken from 3 different<unk>  sites.<unk>  rinse involves rinsing the mouth with phosphate-buffered saline for 1 minute and then spitting the solution into a vessel that examined in a pathology laboratory.<unk>  rinse technique can distinguish between commensal candidal carriage and<unk> . If candidal leukoplakia is suspected, a biopsy may be indicated. Smears and biopsies are usually stained with periodic acid-Schiff, which stains carbohydrates in fungal cell walls in magenta. Gram staining is also used as Candida stains are strongly Gram positive. Sometimes an underlying medical condition is sought, and this may include blood tests for full blood count and hematinics. If a biopsy is taken, the histopathologic appearance can be variable depending upon the clinical type of<unk> . Pseudomembranous<unk>  shows hyperplastic epithelium with a superficial parakeratotic desquamating (i.e., separating) layer. Hyphae penetrate to the depth of the stratum spinosum, and appear as weakly basophilic structures. Polymorphonuclear cells also infiltrate the epithelium, and chronic inflammatory cells infiltrate the lamina propria. Atrophic<unk>  appears as thin, atrophic epithelium, which is non-keratinized. Hyphae are sparse, and inflammatory cell infiltration of the epithelium and the lamina propria. In essence, atrophic<unk>  appears like pseudomembranous<unk>  without the superficial desquamating layer. Hyperplastic<unk>  is variable. Usually there is hyperplastic and acanthotic epithelium with parakeratosis. There is an inflammatory cell infiltrate and hyphae are visible. Unlike other forms of<unk> , hyperplastic<unk>  may show dysplasia.
Oral candidiasis
Geographic tongue
Denture-related stomatitis
Leukoplakia
Contact stomatitis
Aphthous stomatitis
Caviar tongue
Head lice infestation