Oral Discoid Lupus Erythematosus : Histopathologic Diagnosis at the Light Microscopic Level

Abstract

Lupus erythematosus (LE) may be seen in one of two well-recognized forms, systemic (acute) lupus erythematosus (SLE) and discoid (chronic) lupus erythematosus (DLE), both of which may have oral manifestations. Oral discoid lesions may be observed in patients with SLE. A number of studies have established a set of histopathologic criteria that would distinguish between oral mucosal LE and lichen planus. We report herein a case of LE that exhibited the following characteristics : patchy periodic acid-Schiff stain-positive deposits subepithelially, periodic acid-Schiff stain-positive thickening of blood vessel walls, and the presence of a severe inflammatory cell infiltrate. Several other less significant alterations were also identified. The present case report suggests that oral DLE in most cases is characteristic enough to provide a definitive diagnosis at the light microscopic level.