10th August 2020

A 63-year-old lady has come to see you due to a white patch on the inside of her mouth

A 63-year-old lady has come to see you due to a white patch on the inside of her mouth. She denies any pain or itching, and states that it is always present, and that it has not grown since she noticed it. On examination, she has a white plaque that is irregularly shaped on the inside of her left cheek. It appears slightly raised. There is a fine reticular like pattern on the rest of the buccal mucosa. There are no palpable cervical lymph nodes and she denies any weight loss or trouble swallowing. She has never smoked and does not drink alcohol. She has a past medical history of ischaemic heart disease, type 2 diabetes and chronic obstructive pulmonary disease, but she states she is currently fit and well and has no new complaints. 

Which of the following is the most likely cause? 

Select the SINGLE most appropriate option from the list below. Select ONE option only.