white/gray patch on lower lip

I've had a noticeable white/gray patch on the exterior of my lower lip. It looks like dried skin, but it's resistant to exfoliation. Lip balms including Carmex don't help. I was referred to an ENT, and he says it's not cancer or an infection, but he recommends an excision biopsy. The ENT thinks I may have a blocked salivary gland, and he said the surgery would remove the entire area and my lip would be stitched closed with minor scarring. I am reluctant to undergo this procedure. In the meantime, he prescribed Kenalog Orabase to apply to the area. I am concerned this may be something "simple" and an excision biopsy too extreme. What could cause this discoloration on my lower lip? I am 46 year old male, in good health.

[Bhupinder Kaur, MD]

Hello,
I cannot confirm anything without examination but it can be leukoplakia, lichen planus or vitiligo. Leukoplakia is a white lesion that can't be removed simply by rubbing the mucosal surface. It may occur in response to chronic irritation from dentures or from tobacco use or pipe smoking, or it may represent dysplasia.

I agree with your doctor because biopsy is required to confirm the diagnosis.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.