Müller Susan
Professor Emeritus, Emory University School of Medicine: Atlanta Oral Pathology, Decatur, GA, USA.
Mod Pathol. 2017 Jan;30(s1):S54-S67. doi: 10.1038/modpathol.2016.121.
Oral lichen planus is a chronic inflammatory disease of unknown etiology or pathogenesis with varied disease severity that waxes and wanes over a long period of time. Although a common oral mucosal disease, accurate diagnosis is often challenging due to the overlapping clinical and histopathological features of oral lichen planus and other mucosal diseases. Other immune-mediated mucocutaneous diseases can exhibit lichenoid features including mucous membrane pemphigoid, chronic graft-versus-host disease, and discoid lupus erythematosus. Reactive changes to dental materials or to systemic medications can mimic oral lichen planus both clinically and histologically. In these situations the clinical presentation can be useful, as oral lichen planus presents as a multifocal process and is usually symmetrical and bilateral. Dysplasia of the oral cavity can exhibit a lichenoid histology, which may mask the potentially premalignant features. Proliferative verrucous leukoplakia, an unusual clinical disease, can often mimic oral lichen planus clinically, requiring careful correlation of the clinical and pathologic features.
口腔扁平苔藓是一种病因和发病机制不明的慢性炎症性疾病，疾病严重程度各异，病程漫长，病情有起伏。尽管它是一种常见的口腔黏膜疾病，但由于口腔扁平苔藓与其他黏膜疾病在临床和组织病理学特征上存在重叠，准确诊断往往具有挑战性。其他免疫介导的黏膜皮肤疾病可表现出苔藓样特征，包括黏膜类天疱疮、慢性移植物抗宿主病和盘状红斑狼疮。对牙科材料或全身性药物的反应性改变在临床和组织学上都可能酷似口腔扁平苔藓。在这些情况下，临床表现可能会有所帮助，因为口腔扁平苔藓表现为多灶性病变，通常对称且双侧发病。口腔发育异常可呈现苔藓样组织学表现，这可能掩盖潜在的癌前特征。增殖性疣状白斑是一种不常见的临床疾病，在临床上常可酷似口腔扁平苔藓，需要仔细对比临床和病理特征。
