Head and neck tumours: oral lichen planus: practice question

A ENT 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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ENT · Head and neck tumours: oral lichen planus

Sample item

A 50-year-old woman has bilateral lacy white striae on the buccal mucosa, with painful erosions in some areas. What is the diagnosis and its significance?

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

The answer and the reasoning

D. Oral lichen planus, needing long-term follow-up

Bilateral lacy (Wickham) striae with erosions are typical of oral lichen planus, an immune-mediated disease. The erosive form carries a small risk of malignant transformation, so patients are followed up long term and any non-healing area is biopsied.

Option by option

  • A. Pemphigus vulgaris, with a high risk of carcinoma

    Pemphigus causes blisters and erosions without lacy striae and is not strongly linked to oral cancer.

  • B. Leukoedema, a normal variant needing no follow-up

    Leukoedema is a faint greyish-white change of the buccal mucosa without erosions.

  • C. Oral candidiasis, with no malignant risk

    Candidiasis presents with wipe-off plaques, not lacy striae.

  • D. Oral lichen planus, needing long-term follow-up (correct)

    Correct. Lacy striae with erosions indicate lichen planus, which warrants surveillance.

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.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Oral lichen planus, needing long-term follow-up. Bilateral lacy (Wickham) striae with erosions are typical of oral lichen planus, an immune-mediated disease.

Why is "Pemphigus vulgaris, with a high risk of carcinoma" not the answer?

Pemphigus causes blisters and erosions without lacy striae and is not strongly linked to oral cancer.

Why is "Leukoedema, a normal variant needing no follow-up" not the answer?

Leukoedema is a faint greyish-white change of the buccal mucosa without erosions.

Why is "Oral candidiasis, with no malignant risk" not the answer?

Candidiasis presents with wipe-off plaques, not lacy striae.

What concept does this question test?

It tests Head and neck tumours: oral lichen planus in ENT. The erosive form carries a small risk of malignant transformation, so patients are followed up long term and any non-healing area is biopsied.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Head and neck tumours: oral lichen planus?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT 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.