Oral pathology: leukoplakia and erythroplakia: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Oral pathology: leukoplakia and erythroplakia

Sample item

A 52-year-old tobacco chewer has a persistent flat red velvety patch on the floor of the mouth that cannot be scraped off or attributed to another disease. What is the most appropriate next step?

AReassurance and review in one yearBTopical antifungal therapy for 2 weeksCIncisional biopsy because malignant potential is highDPrescribing vitamin B12 supplements

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Incisional biopsy because malignant potential is high

Erythroplakia is a red patch that cannot be characterised as any other condition and carries a much higher risk of dysplasia or carcinoma in situ than leukoplakia, so biopsy is mandatory. Leukoplakia is a white patch that cannot be scraped off and also needs biopsy of suspicious areas. In India tobacco and areca nut are the main risk factors.

Option by option

A. Reassurance and review in one year
Observation delays diagnosis of a high-risk lesion.
B. Topical antifungal therapy for 2 weeks
A scrapable white plaque suggests candidiasis; this red lesion does not.
C. Incisional biopsy because malignant potential is high (correct)
Erythroplakia is often already dysplastic or malignant, so tissue diagnosis is needed.
D. Prescribing vitamin B12 supplements
B12 deficiency causes glossitis and not a localised floor-of-mouth patch.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Incisional biopsy because malignant potential is high. Erythroplakia is a red patch that cannot be characterised as any other condition and carries a much higher risk of dysplasia or carcinoma in situ than leukoplakia, so biopsy is mandatory.

Why is "Reassurance and review in one year" not the answer?

Observation delays diagnosis of a high-risk lesion.

Why is "Topical antifungal therapy for 2 weeks" not the answer?

A scrapable white plaque suggests candidiasis; this red lesion does not.

Why is "Prescribing vitamin B12 supplements" not the answer?

B12 deficiency causes glossitis and not a localised floor-of-mouth patch.

What concept does this question test?

It tests Oral pathology: leukoplakia and erythroplakia in Pathology. Leukoplakia is a white patch that cannot be scraped off and also needs biopsy of suspicious areas. In India tobacco and areca nut are the main risk factors.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral pathology: leukoplakia and erythroplakia?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.