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硬化萎缩苔藓(Lichen sclerosus et atrophicus,LSA)是少见的皮炎,极少累及口腔粘膜。作者报道一例单发于口腔的LSA。病例女,57岁,间歇性舌痛几月,长期患甲亢。临床检查发现皮肤泛发白癜风,双肘轻度湿疹。口腔粘膜广泛萎缩,舌背、舌缘与硬腭弥漫性白斑,表面糜烂;实验室检查表明血液生化常规正常,白念珠菌涂片与培养阴性,抗胃壁细胞抗体阳性,但未发现恶性贫血的证据;舌背白斑活检显示上皮萎缩,过度正角化,棘皮症,基底细胞液化变性,突出的是固有层浅层的胶原纤维透明变性,其下方的单核炎症细胞呈散在间杂带状浸润。因此病理诊断为“舌背粘膜LSA”。
Lichen sclerosus et atrophicus (LSA) is a rare dermatitis that rarely affects the oral mucosa. The authors report a single case of oral LSA. Case female, 57 years old, intermittent tongue pain for a few months, long-term suffering from hyperthyroidism. Clinical examination revealed skin vitiligo, mild eczema on both elbows. Oral mucosa atrophy, tongue back, tongue margin and hard palate diffuse white spot, surface erosion; laboratory tests showed normal blood biochemistry, Candida albicans smear and culture negative, anti gastric parietal antibody positive, but no evidence of pernicious anemia ; Tongue white spot biopsy showed epithelial atrophy, over positive keratosis, acanthosis, basal cell liquefaction degeneration, highlighting the lamina propria of collagen fibers transparent degeneration, below the mononuclear inflammatory cells interspersed with interstitial infiltration. Therefore, the pathological diagnosis of “lingual mucosa LSA”.