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Oral lichen planus — NDEB AFK MCQ

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ModerateOral PathologyOral lichen planusNDEB AFK

A 46-year-old woman reports intermittent burning of the buccal mucosa. Examination shows bilateral reticular white striae with erythematous areas on the posterior buccal mucosa. The lesions do not wipe off. What is the most likely diagnosis?

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Correct answer: B — Oral lichen planus

Bilateral reticular white striae on buccal mucosa with burning are typical of oral lichen planus. Candidiasis usually wipes off or presents with erythematous candidal patterns rather than fixed Wickham-like striae. The clinical pearl is that erosive or symptomatic lesions may need biopsy and monitoring because several lichenoid disorders can mimic one another.

Reference: NDEB released item style; Canadian oral medicine reference texts