She attends her ANC regularly. What is the most probable dx?

A 38yo female G4 at 32wks of pregnancy presented with thick white marks on the inside of her

mouth for 3wks. Her mouth including her tongue appeared inflamed on examination. She

smokes 20 cigarettes/day despite advice to quit. She attends her ANC regularly. What is the

most probable dx?

a. Lichen planus

b. Aphthous ulcer

c. Smoking

d. Candidiasis

e. Leukoplakia

Ans. The key is D. Candidiasis. [lichen planus may have lace like appearance and not thick white mark. Aphthous ulcer has yellowish floor and surrounded by erythematous halo. Smoking may cause tongue coating but not like thick white mark on the inside of mouth. Leukoplakia is with raised edges/Bright white patches and sharply defined and cannot be rubbed out like candida patch; here also inflamed tongue points towards infection. So candidiasis is the most probable option].