Clinicopathologic Correlation of Oral Lichen Planus and Oral Lichenoid Lesions: A Preliminary Study

Table 1

Histopathological criteria distinctive of OLP and OLL.

Diagnosis	Epithelium	Subepithelium	Authors
OLP	Bilateral presentation of lesions; Hyperkeratosis; Reduced epithelial thickness; Liquefactive degeneration; of the basal cell layer	Well-defined subepithelial band of chronic inflammatory infiltrate composed predominantly of lymphocytes; Absence of eosinophils and neutrophils	Juneja et al., 2006 [14]
		Band shaped inflammatory infiltrate in some or all areas	Thornhill et al., 2006 [1]
	Normal stratification and maturation; Basal cell liquefaction is always present; Atypia absent	Dense band of inflammatory components, chiefly lymphocytes, in the juxtaepithelium; Dyskeratotic epithelial cells; Civatte bodies are usually found in subepithelial area, at the junction of the lamina propria and epithelial layer	Ismail et al. 2007 [22]
	Compact hyperorthokeratosis, seldom a moderate degree of parakeratosis; Thickened stratum granulosum at acrosyringia and acrotrichia, irregular saw-tooth-like epidermal layers	Mostly a superficial dermal inflammatory infiltrate; seldom eosinophils; acanthosis, necrotic keratinocytes in the lower epidermal layers	Ziemer, 2014 [17]
	OLL	Unilateral presentation of lesions	Poorly differentiated lower border of the subepithelial inflammatory zone; Presence of a substantial number of plasma cells in the lymphocytic infiltrate; Perivascular infiltrate; Increased number of colloid bodies; Presence of acute inflammatory cells, such as eosinophils and neutrophils	Juneja et al., 2006 [14]
		Focal parakeratosis, cytoid bodies in the cornified layer; Thickened stratum granulosum possible, however, with focal interruption of the granular layer, cytoid bodies in the granular layer, necrotic keratinocytes scattered in all epidermal layers	More often a deep dermal infiltrate, especially in nonphotodistributed lichenoid drug eruption; admixture of eosinophils and plasma cells possible (presence of plasma cells is a regular finding in biopsies from mucous membranes independently of the origin of dermatosis)	Ziemer, 2014 [17]
		OLL related with amalgam filling		Inflammatory infiltrate located deep to superficial infiltrate in some or all areas; Focal perivascular infiltrate; Plasma cells, eosinophils, and neutrophils in the connective tissue	Thornhill et al., 2006 [1]
Normal stratification basal cell liquefaction may or may not be present; Atypia absent	Lymphoid follicle formations, with mixed inflammatory cells consisting of plasma cells and neutrophils		Ismail et al. 2007 [22]
Basal cell liquefaction may not be present	Predominant formation of lymphoid follicles chiefly consisting of plasma cells and neutrophils; Dense inflammatory cells in the stroma		Hiremath et al., 2011 [2]
OLL related with drugs	Extensive degeneration in the lower prickle cell layer, prompting spongiotic vesicle formation; Basal cell liquefaction is usually present; Atypia absent; Apoptotic and colloid body formation are evident		Infiltrate is not band-like but extends to the deeper stroma inflammatory cells predominated by plasma cells and eosinophils; Perivascular cuffing of inflammatory cells is evident	Ismail et al. 2007 [22]
			Infiltrate is often not band-like but extends to the deeper stroma, with plasma cells and eosinophils which predominate the inflammatory component	Hiremath et al., 2011 [2]

OLP: oral lichen planus; OLL: oral lichenoid lesions.