Pathology · single question

A 45-year-old female presents with bilateral white lacy lines (Wickham's striae) on the buccal mucosa with a burning sensation. What is the MOST likely diagnosis?

  1. Lichen planus
  2. Candidiasis
  3. Leukoplakia
  4. Mucous membrane pemphigoid
Show answer and explanation

Correct answer: A. Lichen planus

Wickham's striae (bilateral white lacy/reticular pattern) on buccal mucosa are pathognomonic for oral lichen planus. Candidiasis appears as white plaques that wipe off and lacks the lacy pattern. Leukoplakia is a risk-based diagnosis (rule out other causes). MMP causes blistering, not striae.

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