PMC7428844_01
Front view. Slight facial erythrosis.
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The extraoral examination showed slight facial erythrosis (Figure 1).
Intraoral view: inner side of the labial mucosa in different stages of the treatment. (a, b) Widespread redness with erosive lesions. (c, d) Disappearance of the erosions with the presence of slight reticular pattern.
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Intraoral examination showed slightly hyperkeratotic erythematous lesions located on the inner side of the labial mucosa (Figure 2).
Intraoral view: inner sides of the cheeks. Widespread redness with erythema, erosions, and some pigmented lesions induced by hydroxyurea.
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The inner sides of the cheeks showed erythematous erosions especially on the right side (Figure 3).
Intraoral view: right lateral edge and ventral side of the tongue in different stages of the treatment. (a) Two painful erosive ulcerations. (b) Improvement of the lesions and disappearance of the ulcerations. We notice the presence of a discrete reticular pattern that characterizes oral lichen planus.
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We noticed also two erosive ulcerations as well as hyperkeratotic lesions at the right lateral edge and the ventral side of the tongue forming a discrete reticular network (Figure 4).
Histological examination leading to the diagnosis of oral lichen planus (OLP). The mucosa was covered with a squamous epithelium taking on a flattened appearance with slight acanthosis and hyperkeratosis (essentially orthokeratosis and some focal parakeratosis). The basement membrane was vacuolated with the presence of Civatte apoptotic bodies (b). The underlying tissue is the seat of a dense linear infiltrate surrounding the nerve nets in places; it is mainly made of lymphocytes with rare cells of a histiocytic nature. This lymphocytic band infiltrate (a) at the level of the chorion attacks and gradually destroys the keratinocytes of the basal and deep seat of the epithelium. No signs of malignancy were noted.
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The result was oral lichen planus (Figure 5).