Oral discoid lupus erythematosus: A study of twenty-one cases

This study was undertaken to analyze the histopathological findings of oral discoid lupus erythematosus with conventional light microscopy for early diagnosis of the oral lesions that would aid in prompt treatment.

To find out the predominant age, sex, site and clinical features of oral discoid lupus erythematosus. To study the histopathological features of oral discoid lupus erythematosus. To study the alterations of basement membrane changes of oral discoid lupus erythematosus.

Our study consisted 21 cases of diagnosed DLE with oral lesions. A detailed clinical proforma was used for thorough clinical examination and light microscopy was used for histopathological study of the incisional biopsy specimens.

The lesions were diagnosed on the histopathological criteria given by Gisslen et al. and was statistically analyzed using the Chi square test.

In the present study 9.52% patients had only oral lesions, while 90.47% patients had oral lesions along with skin lesions with the most common site of oral involvement being labial mucosa (76.19%), vermillion border (71.42%) and buccal mucosa (42.85%). On clinical examination, white spots were present in 28.6%, ulcers in 19% and central erythema in 52.4% lesions. Histopathologically, atrophy was observed in 66.66% cases, acanthosis in 66.66% and acanthosis alternating with atrophy in 33.33% cases along with the basement membrane appearing thin and homogenous in 66.7% and partially destroyed in 81% cases with Periodic Acid Schiff stain.

Thus, from this study it was found that a diagnosis of oral discoid lupus erythematosus was based on the combination of clinical and histopathological findings. Thus the dentist may be in an important position to establish the diagnosis with the aid of clinical and histopathological findings before the cutaneous lesions become apparent.