Case Report: Dermoscopic features of oral lichen planus - the evolution of mucoscopy

Sidharth Sonthalia, Sangeeta Varma, Abhijeet Kumar Jha, Deepak Jakhar, Feroze Kaliyadan
2018 F1000Research  
Dermoscopy, a non-invasive technique for cutaneous diagnosis is being increasingly studied in various disorders of the skin, nails and scalp. However, it has been under-utilized for the diagnosis and characterization of mucosal disorders. The dermoscopic characterization of cutaneous lichen planus and its variants has been well documented with Wickham's striae constituting the hallmark of the condition. However, the dermoscopic features of oral lichen planus with hand-held or videodermoscopy
more » ... ain to be elucidated. We present the case of a young adult man who presented with asymptomatic white lacy lesions over a bluish-black background over the tongue, patchy hyperpigmentation of the buccal mucosae and gingivae, and longitudinal melanonychia involving some nails. History of intake of any drugs preceding the lesions, smoking, chewing of betel nut and dental implants was negative. Family history was non-contributory. There were no cutaneous lesions suggestive of lichen planus. Mucoscopy (dermoscopy of the mucosa, oral in this case) and onychoscopy were done followed by biopsy from the tongue that confirmed the diagnosis of lichen planus. Oral mucoscopy of the tongue revealed a tri-colored pattern with structureless veil-like grey-white areas (modified Wickham's striae), well-demarcated red glossy erosions, and violaceous-to-brown clods. Additionally, vascular pattern of dotted and linear to curved vessels along the borders of leukoplakia-like areas and erosions were observed. Onychoscopy confirmed lichen planus-associated melanonychia. Dermoscopy also proved useful in conveniently ruling out other disorders typified by mucosal and nail pigmentation such as Laugier Hunziker syndrome and drug-induced changes. Although direct oral microscopy has been used in defining features of oral lichen planus, to the best of our knowledge this case is the first report on mucoscopy or dermoscopy of oral lichen planus PubMed Abstract | Publisher Full Text 2. Vázquez-López F, Manjón-Haces JA, Maldonado-Seral C, et al.: Dermoscopic features of plaque psoriasis and lichen planus: new observations. Dermatology. 2003; 207(2): 151-6. PubMed Abstract | Publisher Full Text 3. Zalaudek I, Argenziano G: Dermoscopy subpatterns of inflammatory skin disorders. Arch Dermatol. 2006; 142(6): 808. PubMed Abstract | Publisher Full Text 4. Vazquez-Lopez F, Palacios-Garcia L, Gomez-Diez S, et al.: Dermoscopy for discriminating between lichenoid sarcoidosis and lichen planus. Arch Dermatol. 2011; 147(6): 1130. PubMed Abstract | Publisher Full Text 5. Lallas A, Kyrgidis A, Tzellos TG, et al.: Accuracy of dermoscopic criteria for the diagnosis of psoriasis, dermatitis, lichen planus and pityriasis rosea. Br J Dermatol. 2012; 166(6): 1198-205. PubMed Abstract | Publisher Full Text 6. Boyd AS, Neldner KH: Lichen planus. J Am Acad Dermatol. 1991; 25(4): 593-619. PubMed Abstract | Publisher Full Text 7. Pindborg JJ, Mehta FS, Daftary DK, et al.: Prevalence of oral lichen planus among 7639 Indian villagers in Kerala, South India. Acta Derm Venereol. 1972; 52(3): 216-220. PubMed Abstract 8. Bhonsle RB, Pindborg JJ, Gupta PC, et al.: Incidence rate of oral lichen planus among Indian villagers. Acta Derm Venereol. 1979; 59(3): 255-257. PubMed Abstract 9. Eisen D: The clinical manifestations and treatment of oral lichen planus. Dermatol Clin. 2003; 21(1): 79-89. PubMed Abstract | Publisher Full Text 10. Friedman P, Sabban EC, Marcucci C, et al.: Dermoscopic findings in different clinical variants of lichen planus. Is dermoscopy useful? Dermatol Pract Concept. 2015; 5(4): 51-5. PubMed Abstract | Publisher Full Text | Free Full Text 11. Yeo IK, Kim HK, Kim DH, et al.: Oral Lichen Planus for Whom Dermoscopy Was Used as an Adjuvant Diagnostic Tool. Korean J Dermatol. 2012; 50(2): 167-170. Reference Source 12. Drogoszewska B, Chomik P, Polcyn A, et al.: Clinical diagnosis of oral erosive lichen planus by direct oral microscopy. Postepy Dermatol Alergol. 2014; 31(4): 222-228. PubMed Abstract | Publisher Full Text | Free Full Text 13. Güngör Ş, Topal IO, Göncü EK: Dermoscopic patterns in active and regressive lichen planus and lichen planus variants: a morphological study. Dermatol Pract Concept. 2015; 5(2): 45-53. PubMed Abstract | Free Full Text 14. Litaiem N, Mansour Y, Jones M, et al.: Dermoscopic signs of lichen planus. BMJ Case Rep. 2016; 2016: pii: bcr2015213923. PubMed Abstract | Publisher Full Text | Free Full Text 15. Borghi A, Corazza M, Minghetti S, et al.: Preliminary study on dermoscopic features of vulvar lichen planus: new insights for diagnosis. J Eur Acad Dermatol Venereol. 2016; 30(6): 1063-1065. PubMed Abstract | Publisher Full Text 16. Jefferson J, Rich P: Melanonychia. Dermatol Res Pract. 2012; 2012: 952186. PubMed Abstract | Publisher Full Text | Free Full Text References
doi:10.12688/f1000research.14134.2 fatcat:stqug322xfdd3aonam647rlveq