Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Int J Dermatol. 2024 Nov;63(11):1503-1512. doi: 10.1111/ijd.17341. Epub 2024 Jun 21.
In dermatology, lichenoid describes lesions with a violaceous hue that is a clinical reflection of basal cell damage in the epithelium and dense mononuclear infiltrate in the sub-epithelium. The violaceous color results from pigment incontinence due to basal cell damage and the Tyndall effect. Although classically described in lichen planus, a lichenoid hue is noted in the oral mucosa in several other disorders that often lead to diagnostic dilemmas. Early and accurate diagnosis is important for the appropriate management of the underlying condition and prognostication. Dermatologists play a central role in managing such patients since, apart from the oral mucosa findings, the cutaneous features also help to significantly differentiate various conditions. Mimickers of oral lichen planus include nicotine stomatitis, oral submucous fibrosis, oral lichenoid lesions, mucosal discoid lupus erythematosus, pemphigus vulgaris, paraneoplastic pemphigus, mucous membrane pemphigoid, fixed drug eruption, plasma cell cheilitis/gingivitis, and erythema multiforme. While a detailed history and clinical examination can help reach a diagnosis in most cases, histopathology, immunofluorescence, and other relevant investigations help establish the diagnosis.
在皮肤病学中，苔藓样描述的病变具有紫红色色调，这是上皮基底层细胞损伤和上皮下致密单核细胞浸润的临床反映。紫红色的颜色是由于基底层细胞损伤和丁达尔效应导致的色素失禁。虽然经典地描述于扁平苔藓中，但在其他几种常导致诊断难题的疾病中也注意到了苔藓样色调。早期和准确的诊断对于适当处理基础疾病和预后很重要。皮肤科医生在管理此类患者中发挥着核心作用，因为除了口腔黏膜表现外，皮肤特征也有助于显著区分各种情况。口腔扁平苔藓的类似物包括尼古丁性口炎、口腔黏膜下纤维化、口腔苔藓样病变、黏膜盘状红斑狼疮、寻常性天疱疮、副肿瘤性天疱疮、黏膜类天疱疮、固定性药物疹、浆细胞性唇炎/牙龈炎和多形性红斑。虽然详细的病史和临床检查可以帮助大多数情况下做出诊断，但组织病理学、免疫荧光和其他相关检查有助于确立诊断。
