Diagnosis: Lichen Planus (oral)
Poorly defined annular lesions with lacy-white pattern on the buccal mucosa associated with similar lesions on the dorsal surface of the tongue.
Poorly defined annular lesions with lacy-white pattern on the buccal mucosa associated with similar lesions on the dorsal surface of the tongue.
Submitted by Alaa Saad. Originally posted October 30, 2010.
See case discussion.
• Drug-induced lichenoid eruption • Psoriasis (guttate) • Pityriasis rosea • Secondary syphilis • Eczema • Lichen nitidus • Lichenoid keratosis • Graft-versus-host disease
• Remember the 6 P's: Pruritic, Purple, Polygonal, Planar (flat-topped), Papules, Plaques • Wickham striae (fine white lines on surface) are pathognomonic — best seen with dermoscopy • Koebner phenomenon: lesions at sites of trauma • Oral LP: most common mucosal form — reticular (lacy white striae) vs. erosive • Erosive oral LP has a small risk of SCC transformation — requires monitoring • Hepatitis C association varies geographically — screening recommended • Histology: interface dermatitis with band-like lymphocytic infiltrate, sawtooth rete ridges, Max Joseph spaces (civatte bodies)
Tags: lichen, planus, oral, alaa saad