Mucosal lichen sclerosus/lichen planus overlap syndromes

Area of Science:

• Dermatology
• Oral Medicine
• Pathology

Background:

• Lichen sclerosus and lichen planus are distinct skin conditions, but differentiating them on mucosal surfaces can be difficult.
• Histopathological examination is often crucial for diagnosis when clinical signs are ambiguous.

Observation:

• This study examined seven patients with concurrent vulval lichen sclerosus and oral lichenoid lesions.
• Vulval biopsies confirmed lichen sclerosus in all patients.
• Oral biopsies predominantly showed features of lichen planus, though oral lichen sclerosus is rarely reported.

Findings:

• Two patients developed vulval intraepithelial neoplasia, and one progressed to squamous cell carcinoma.
• The oral lesions in these patients might represent oral lichen sclerosus, a condition with variable histopathological descriptions.
• These patients may constitute a unique group requiring identification and monitoring due to unknown dysplasia risks.

Implications:

• The potential for oral lichen sclerosus necessitates careful histopathological evaluation and long-term patient follow-up.
• Identifying patients with coexisting vulval lichen sclerosus and oral lichenoid lesions is critical for assessing oral dysplasia risk.
• Further research is needed to understand the behavior and malignant potential of these oral lesions.