title: Clinical diagnosis of oral erosive lichen planus by direct oral microscopy.
abstract: BACKGROUND
  Direct oral microscopy is a novel, non-invasive diagnostic technique that aids clinical examination of the oral cavity. The basic principles of this method derive from colposcopy and dermoscopy. The principle is to reveal precancerous lesions of oral mucosae in their subclinical phase in order to begin their treatment as early as possible and prevent malignant transformation. Oral lichen planus (OLP) is an autoimmune, inflammatory, chronic disease affecting oral mucous membranes. Buccal mucosae are most often affected.
  
  
  OBJECTIVE
  To describe the in vivo picture of erosive OLP in direct oral microscopy in terms of the pattern and density of subepithelial blood vessels, surface texture, color, transparency and borders of the lesions. The study also demonstrates the utility of the method in the selection of the most appropriate biopsy site.
  
  
  METHODS
  A total of 30 patients with erosive OLP were examined. Clinical examination of the oral cavity with the naked eye was performed, followed by direct oral microscopy. The most appropriate biopsy sites based on both examinations were chosen for every individual and biopsies were taken for histopathological evaluation.
  
  
  RESULTS
  Biopsies obtained based on direct oral microscopy revealed dysplasia in 16 patients (53.3%). Biopsies obtained based on clinical examination with the naked eye revealed dysplasia in 3 cases (10%).
  
  
  CONCLUSIONS
  Direct oral microscopy makes it possible to obtain a repeated picture of erosive OLP and constitutes an alternative to the clinical examination with the naked eye in election of the most appropriate biopsy site. Thus, introduction of the most accurate and early therapy is possible.
authors.affiliation: Chair and Department of Oral and Maxillofacial Surgery, Medical University of Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD ; Department of Otolaryngology, Ward of Maxillofacial Surgery, University Clinical Center, Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD.
authors.forename: Barbara
authors.initials: B
authors.lastname: Drogoszewska
authors.affiliation: Chair and Department of Oral and Maxillofacial Surgery, Medical University of Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD ; Department of Otolaryngology, Ward of Maxillofacial Surgery, University Clinical Center, Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD.
authors.forename: Piotr
authors.initials: P
authors.lastname: Chomik
authors.affiliation: Department of Otolaryngology, Ward of Maxillofacial Surgery, University Clinical Center, Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD.
authors.forename: Adam
authors.initials: A
authors.lastname: Polcyn
authors.affiliation: Chair and Department of Oral and Maxillofacial Surgery, Medical University of Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD ; Department of Otolaryngology, Ward of Maxillofacial Surgery, University Clinical Center, Gdansk, Poland. Head of Department: Prof. Adam Włodarkiewicz MD, DMD, PhD.
authors.forename: Adam
authors.initials: A
authors.lastname: Michcik
keywords: colposcopy; diagnosis; direct microscopy; lichen planus; oral cavity