Pathology · patient case question
What is the diagnosis?
Patient case: Woman with white striae on the buccal mucosa
Patient: Female, 50 years old
Chief complaint: Rough, occasionally sore areas inside the cheeks.
Background: No relevant medical history reported.
Current findings: Bilateral white striae on the buccal mucosa that cannot be wiped away.
Show answer and explanation
Correct answer: C. Oral lichen planus
- A. Leukoplakia is usually a solitary homogeneous patch, not bilateral symmetrical striae.
- B. Candidal plaques WIPE OFF, and are typically not symmetrical striae.
- C. CORRECT. Bilateral, symmetrical white striae on the buccal mucosa that do not rub off are WICKHAM STRIAE, the hallmark of reticular ORAL LICHEN PLANUS. It is a T-cell mediated condition targeting the basal keratinocytes, and histology shows a band-like lymphocytic infiltrate at the interface with basal cell degeneration.
- D. Lupus lesions can resemble lichen planus but are typically asymmetrical, with radiating striae around a central erythematous zone.