Shreya K, Panwar Hemlata, Asati Dinesh P, Lakshman Amulya M, Verma Priyanka, Denla Young
From the Department of Dermatology and Venereology, AIIMS, Habibganj, Saketnagar, Bhopal, Madhya Pradesh, India.
Department of Pathology and Laboratory Medicine, AIIMS, Habibganj, Saketnagar, Bhopal, Madhya Pradesh, India.
Indian J Dermatol. 2025 Jul-Aug;70(4):177-187. doi: 10.4103/ijd.ijd_1145_23. Epub 2025 Jun 30.
A dermatoscope is a non-invasive diagnostic imaging tool that enables to visualise superficial, deeper structures, pigmentary and vascular patterns of skin, nails, hair and mucosa. Oral mucosal lesions are abnormal alterations in colour, surface, presence of swelling, or loss of integrity of mucosal and semimucosal surface. The use of dermoscopy in the characterisation of mucosal disorder is a grey area and needs further exploration.
To describe clinical and mucoscopic features and correlate histopathologically in oral mucosal diseases.
Single-centre, cross-sectional, observational study presenting to inpatient and outpatient departments of dermatology, and otorhinolaryngology. Patients fulfilling inclusion criteria were dermoscopically evaluated using DermLite DL4, 30 mm lens system and 10× magnification and documented in a prestructured proforma. Then, a mucosal biopsy was taken from the visualized site.
Fordyce spots were observed as white-yellow clods with dots. Median rhomboid glossitis as atrophic filiform papillae at the centre with normal-looking peripheral papillae. Pemphigus vulgaris visualized as a red structureless area, red dots, with violaceous streaks at the periphery. Lichen planus showed a tricolor pattern, Wickham's striae, blunted tips of lingual papillae, discoid lupus erythematosus showed superficial erosions, yellow-white scale, brown pigment spots at the periphery with telangiectasia and follicular plugs at the vermilion border. Aphthous stomatitis characterised by three zones with a central yellowish-white structureless area, a surrounding white area, and a peripheral red structureless area. Actinic cheilitis showed superficial ulceration, polymorphic vessels and white scales. Warts have hyperkeratotic pointed tips with fused bases, with central thrombosed capillaries. showed a central pore-like structure with crown vessels. Vitiligo showed a white structureless area, a diffuse white glow with a scalloped margin. Premalignant conditions such as oral submucosal fibrosis and leukoplakia showed atrophic lingual papillae, chrysalis white structureless area, with telangiectasia and white to pink structureless area, surface corrugation, white clods and dotted vessels. Limitations in our study were a response to therapy could not be assessed and the relation with the disease activity could not be determined. Difficult-to-reach sites such as the palate, and retromolar area were not assessed. Haziness while capturing pictures due to mist formation hindered the quality of images. Not many premalignant and malignant diseases were recruited to provide the mucoscopy features in predicting the risk of conversion.
Mucoscopy helps in delineating various mucosal diseases with subtle features.
皮肤镜是一种非侵入性诊断成像工具，能够可视化皮肤、指甲、毛发和黏膜的浅表、深层结构、色素沉着和血管形态。口腔黏膜病变是指黏膜和半黏膜表面在颜色、表面、肿胀情况或完整性方面出现的异常改变。皮肤镜在黏膜疾病特征描述方面的应用尚属空白领域，需要进一步探索。
描述口腔黏膜疾病的临床和黏膜镜特征，并进行组织病理学相关性分析。
在皮肤科和耳鼻喉科的住院部和门诊部进行单中心、横断面、观察性研究。符合纳入标准的患者使用DermLite DL4、30毫米镜头系统和10倍放大倍数进行皮肤镜评估，并记录在预先设计的表格中。然后，从观察部位取黏膜活检组织。
福代斯斑表现为黄白色的小结节且有小点。正中菱形舌炎表现为中央萎缩的丝状乳头，周边乳头外观正常。寻常型天疱疮表现为红色无结构区域、红点，周边有紫红色条纹。扁平苔藓呈现三色模式、威克姆纹、舌乳头尖端变钝，盘状红斑狼疮表现为浅表糜烂、黄白色鳞屑及周边褐色色素斑，伴有毛细血管扩张和唇红缘的毛囊性丘疹。复发性阿弗他口炎的特征为三个区域，中央为黄白色无结构区域，周围为白色区域，周边为红色无结构区域。光化性唇炎表现为浅表溃疡、多形性血管和白色鳞屑。疣有角化过度且尖端尖锐、基部融合，中央有血栓形成的毛细血管。表现为中央有孔状结构及冠状血管。白癜风表现为白色无结构区域、边缘呈扇贝状的弥漫性白色光晕。口腔黏膜下纤维化和白斑等癌前病变表现为萎缩的舌乳头、茧白色无结构区域，伴有毛细血管扩张以及白色至粉红色无结构区域、表面有皱纹、白色小结节和点状血管。本研究的局限性在于无法评估治疗反应，也无法确定与疾病活动的关系。腭部和磨牙后区等难以触及的部位未进行评估。因形成雾气导致拍摄照片时图像模糊，影响了图像质量。纳入的癌前和恶性疾病数量不多，无法提供预测转化风险的黏膜镜特征。
黏膜镜有助于鉴别具有细微特征的各种黏膜疾病。
