A parent may present with an infant with white patches in the mouth, or an older patient—classically with either poor oral hygiene, diabetes, a hematologic malignancy, an immunodeficiency, or on antibiotic, cytotoxic, or steroid therapy—may complain of a sore mouth and sensitivity to foods that are spicy or acidic. On physical examination, painless white patches are found in the mouth and on the tongue. The patches wipe off easily with a swab, leaving an erythematous base that may bleed. There also may be intense, dark red inflammation throughout the oral cavity (see Fig. 53.1).