The diagnostic challenges of separating chronic ulcerative stomatitis from oral lichen planus.
OBJECTIVE
To attempt to establish criteria to differentiate between chronic ulcerative stomatitis (CUS) and oral lichen planus (OLP) with hematoxylin and eosin (H&E) staining alone.


METHODS
Ten confirmed cases of CUS were reviewed from the Stomatology Clinic at the Texas A&M University Baylor College of Dentistry.


RESULTS
The original diagnosis on H&E evaluation was OLP, chronic mucositis, or mucositis with lichenoid features, but subsequent direct immunofluorescence (DIF) revealed a positive speckled intranuclear deposition of immunoglobulin G (IgG) in the basal and parabasal layers of the epithelium, confirming a diagnosis of CUS.


CONCLUSIONS
No consistent histopathologic features were present that would allow recognition of CUS from H&E analysis alone. DIF remains the gold standard for diagnosis.
Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA. Electronic address: Hqari@bcd.tamhsc.edu.
Hiba
H
Qari
Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA.
Carmen
C
Villasante
Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA.
Jordan
J
Richert
Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA.
Terry
T
Rees
Texas A&M University, Baylor College of Dentistry, Dallas, Texas, USA.
Harvey
H
Kessler
D000328:Adult; D000368:Aged; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D005892:Gingivitis, Necrotizing Ulcerative / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D017676:Lichen Planus, Oral / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D013194:Staining and Labeling; D013781:Texas