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Erythematous LP lesions on the gingiva are often indistinguishable from other diseases presenting as desquamative gingivitis such as mucous membrane pemphigoid, hypersensitivity reaction, or plasma cell gingivitis

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However, these differences are not statistically significant

According to IKDSG guidelines, KD use is strictly contraindicated in patients with a deficiency of carnitine (primary), carnitine palmitoyltransferase (CPT) 1 or 2, carnitine translocase, pyruvate carboxylase, medium-chain acyl-coenzyme A (CoA) dehydrogenase (MCAD), long-chain acyl-CoA dehydrogenase (LCAD), short-chain acyl-CoA dehydrogenase (SCAD), and disorders of fatty acid -oxidation and porphyria