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

Abstract

Aims: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.Objectives: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.Materials and Methods: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.Statistical Analysis Used:The lesions were diagnosed on the histopathological criteria given by Gisslen et al. and was statistically analyzed using the Chi square test.Results: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.Conclusions: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.

Clinical and dermoscopic spectrum of discoid lupus erythematosus: novel observations from lips and oral mucosa

“…Furthermore, in the presented work, we have illustrated the first dermoscopic findings of labial DLE which may include telangiectasia, brown pigment spots, scales, white structureless areas, bleeding spots, and erosions. On the other hand, clinically DLE affecting the vermilion surface or labial DLE presents as typical cutaneous DLE plaques or diffuse cheilitis, especially on the more sun‐exposed lower lip . Also, we observed different patterns of telangiectasia in labial DLE under dermoscopy including hairpin and storiform patterns (Fig.…”

Discoid lupus erythematosus with epithelial dysplasia: a case report

“…WHO (1978) reported PAS-positive deposits juxtaepithelially, which resembles a thickening of the basement membrane. 4 PAS Staining in the above reported case also demonstrated thickened basement membrane.…”

Discoid lupus erythematosus at the vermilion border of the lip: A rare clinical presentation

“…[12] Granular pattern or shaggy pattern of IgG, IgM, IgA, and C3 in the basement membrane or in the dermal epidermal junction positive in active lesions at least 6-week-old granular deposits of IgG (>IgM) at the dermoepidermal junction. [13] This is known as lupus band test (LBT) and is positive in 90% of active lesions not recently treated with topical corticosteroids but negative in burnt out or scarred lesions and in the normal skin both sun exposed and non-exposed. SLE in contrast, has positive LBT in lesional as well as both normal (70-80%) and non-exposed (50%) skin.…”

“…<5% of the cases may convert into SLE, relationship between DLE and SLE 5% of the patients presenting with classic DLE lesions subsequently develop unequivocal evidence of SLE. [6][7][8]13] The patients with generalized DLE have somewhat higher risk for progressing to SLE, and a higher risk for developing more severe manifestations of SLE than patients with localized DLE. The following have been suggested as risk factors for the development of SLE than DLE: Diffuse non scarring alopecia, generalized phenomenon, sub-acute, or acute cutaneous lupus erythematosus skin lesions.…”