Mucoscopic features of oral potentially malignant disorders and oral squamous cell carcinoma: A systematic review

Early detection of oral potentially malignant disorders (OPMDs) and their progression to oral squamous cell carcinoma (OSCC) remains challenging due to subtle clinical presentation. Mucoscopy, a non-invasive extension of dermoscopy for oral mucosa, allows real-time visualization of vascular and surface patterns, but its diagnostic features are not well established.

This systematic review aimed to synthesize mucoscopic features of healthy oral mucosa, OPMDs, and OSCC. The review followed PRISMA guidelines and was registered in PROSPERO (CRD420251007205). PubMed, Scopus, and ScienceDirect were searched up to January 2026. Eligible studies reported mucoscopic or dermoscopic findings in human OPMDs or OSCC. Studies of healthy oral mucosa were included as a reference for comparison. Data on vascular morphology, surface architecture, and color patterns were qualitatively analyzed.

Healthy mucosa showed organized hairpin, dot, and glomerular vessels on a pale-rosy background. OPMDs exhibited disrupted vascular patterns and epithelial irregularities, with lesion-specific features such as white structureless areas in leukoplakia, scaling and pigmentation in actinic cheilitis, and Wickham striae in oral lichen planus. OSCC demonstrated polymorphous vascularity, ulceration, keratinization, and extensive structureless areas.

Mucoscopy identifies consistent vascular and structural patterns that may aid differentiation between benign, premalignant, and malignant oral lesions. Standardized criteria are needed to improve diagnostic accuracy and support early detection.