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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes a white patch on buccal mucosa and palpebral fissure?

While interviewing and examining a 17-year-old male, you discover a white patch on his buccal mucosa and slanting palpebral fissures in his eyes. He also states during the interview that he plays baseball and is hoping to earn an athletic scholarship to college. What do you suspect? What kind of client teaching is appropriate in this situation? When would slanting palpebral fissures be normal? While performing a retinal examination on this patient, you discover that the margins of the optic disc become blurred and indistinct. What further testing would be required? Why? What is the foremost cause of this clinical finding?
Sat, 21 Nov 2020
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General & Family Physician 's  Response
Hello,

White patch on the buccal mucosa is commonly indicative of leucoplakia resulting from poor oral hygiene, repeated cheek or tongue biting or due to chewing certain nuts or leaves. He is suggested to maintain better oral hygiene, brushing teeth after every meal, rinsing the mouth and gargle with warm water with a pinch of salt at least three times a day. He should avoid addictions if any. Not all white patch are harmful some may be caused by friction of the teeth against the skin in the mouth.However, some can be pre-cancerous.

Slanting palpebral fissure is commonly due to genetic or congenital disorder. He is suggested to clinically examined by an ENT to assess the type of white patch. He will be recommended to get few routine blood tests, urinalysis or biopsy if required to be done. He will be treated according to the severity of the symptoms and pathology detected. He may be referred to an Eye specialist for further investigations.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Nupur K., General & Family Physician
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What causes a white patch on buccal mucosa and palpebral fissure?

Hello, White patch on the buccal mucosa is commonly indicative of leucoplakia resulting from poor oral hygiene, repeated cheek or tongue biting or due to chewing certain nuts or leaves. He is suggested to maintain better oral hygiene, brushing teeth after every meal, rinsing the mouth and gargle with warm water with a pinch of salt at least three times a day. He should avoid addictions if any. Not all white patch are harmful some may be caused by friction of the teeth against the skin in the mouth.However, some can be pre-cancerous. Slanting palpebral fissure is commonly due to genetic or congenital disorder. He is suggested to clinically examined by an ENT to assess the type of white patch. He will be recommended to get few routine blood tests, urinalysis or biopsy if required to be done. He will be treated according to the severity of the symptoms and pathology detected. He may be referred to an Eye specialist for further investigations. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician