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The diagnostic challenges of separating chronic ulcerative stomatitis from oral lichen planus
Hiba Qari1, Carmen Villasante1, Jordan Richert1
1Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA.
Objective:
To attempt to establish criteria to differentiate between chronic ulcerative stomatitis (CUS) and oral lichen planus (OLP) with hematoxylin and eosin (H&E) staining alone.
Study Design:
Ten confirmed cases of CUS were reviewed from the Stomatology Clinic at the Texas A&M University Baylor College of Dentistry.
Results:
The original diagnosis on H&E evaluation was OLP, chronic mucositis, or mucositis with lichenoid features, but subsequent direct immunofluorescence (DIF) revealed a positive speckled intranuclear deposition of immunoglobulin G (IgG) in the basal and parabasal layers of the epithelium, confirming a diagnosis of CUS.
Conclusions:
No consistent histopathologic features were present that would allow recognition of CUS from H&E analysis alone. DIF remains the gold standard for diagnosis.
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