Diagnosis of oral lesions is based on an accurate history and clinical examination, as well as further investigations. The toluidine blue test, cytological examination and biopsy are the most common. The now obsolete toluidine blue test looks for the presence of atypical, nucleic acid-rich cells that strongly absorb the dye. Cytological examination, or exfoliative cytology, is performed on a sample obtained by scraping epithelial cells spread out on a slide. This easy-to-perform technique is indicated for lesions such as candidiasis or bullous lesions, but not for precancerous lesions, due to the many false negatives. Only biopsy, which provides a histopathological study of the tissue removed for diagnostic purposes, remains the reference examination.
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