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PLAB03-049

Xander is a five month old boy who has been brought to the GP by his mother. Xander was born at term, normal vaginal delivery after an uneventful pregnancy. His mother is concerned about a white plaque on the roof of his mouth which has developed over the last 48 hours. She informs you that he is otherwise feeding well, wetting nappies and hasn’t had any temperatures or diarrhoea/vomiting.

On examination, Xander is alert, systems examination including observations are normal except for a 3 by 3cm white plaque on the roof of his mouth which sloughs off with pressure from a cotton bud.

What is the most appropriate first line treatment?

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