Noninvasive Imaging Techniques as Modern Diagnostic Tools in Desquamative Gingivitis: Focus on RCM, OCT, and LC-OCT

Sep 30, 2026

Uploaded by Aran

Desquamative gingivitis presents with erythema, blisters, and erosions in the gingiva and may reflect oral lichen planus or autoimmune bullous disorders, including pemphigus vulgaris and mucous membrane pemphigoid. Cause identification typically combines clinical assessment with histopathology and immunopathology. This review evaluates how noninvasive imaging—reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and line-field confocal optical coherence tomography (LC-OCT)—supports differential diagnosis. Literature searching of PubMed, Scopus, and Wiley up to January 2025 indicates characteristic imaging patterns across underlying diseases, aiding clinical decision-making, biopsy targeting, and long-term monitoring.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Background

Clinical features and differential causes

Materials and Methods

Literature search strategy

Results

Diagnostic patterns by disease (RCM, OCT, LC-OCT)

Conclusion

Support for clinical decisions, biopsy targeting, and monitoring

Skin Research and Technology REVIEW Noninvasive Imaging Techniques as Modern Diagnostic Tools in Desquamative Gingivitis: Focus on RCM, OCT, and LC-OCT Urszula Fałkowska1 Aneta Durmaj1 Carolyn Szwed1 Marta Kurzeja1 Joanna Czuwara1 Dorota Olczak-Kowalczyk2 Lidia Rudnicka1 Małgorzata Olszewska1 1 Department of Dermatology, Medical University of Warsaw, Warsaw, Poland 2 Department of Paediatric Dentistry, Medical University of Warsaw, Warsaw, Poland Correspondence: Małgorzata Olszewska ([malgorzata.olszewska@wum.edu.pl](malgorzata.olszewska@wum.edu.pl)) Received: 28 January 2025 Revised: 30 July 2025 Accepted: 5 September 2025 Keywords: desquamative gingivitis | mucosal involvement | mucous membrane pemphigoid | optical coherence tomography | oral lichen planus | pemphigus vulgaris | reflectance confocal microscopy ABSTRACT Background: Desquamative gingivitis is a clinical condition characterized by erythema, blisters, and erosions within the gingiva. It may be a manifestation of oral lichen planus or autoimmune bullous diseases, such as pemphigus vulgaris and mucous membrane pemphigoid. The identification of the cause of desquamative gingivitis typically involves the analysis of clinical manifestations, histopathology, and immunopathology evaluation. This article reviews available data on the application of noninvasive imaging techniques (reflectance confocal microscopy, optical coherence tomography, and line-field confocal optical coherence tomography) in identifying the cause of desquamative gingivitis. Materials and Methods: The review of the literature for desquamative gingivitis was performed by searching the PubMed, Scopus, and Wiley databases up to January 2025 . Results: This study aimed to evaluate the applicability of noninvasive imaging techniques, including RCM, OCT, and LC-OCT, in the differential diagnosis of desquamative gingivitis. Findings suggest these modalities offer characteristic diagnostic patterns across underlying diseases. In oral lichen planus, RCM typically shows disrupted connective tissue papillae, obscured basement membranes, and inflammatory cell infiltrates. In pemphigus vulgaris, the key findings are acantholytic keratinocytes and intraepithelial clefts, while mucous membrane pemphigoid displays subepithelial clefts and signs of hemorrhage. OCT findings in desquamative gingivitis associated with oral lichen planus include maintained epithelial thickness in the erosive forms and multilocular blisters in the bullous variants of the disease. In pemphigus vulgaris, OCT reveals intraepithelial cleftsand thinning of the epithelium, while mucous membrane pemphigoid is marked by subepithelial blister formation and fluid accumulation. Conclusion: New noninvasive imaging techniques, such as reflectance confocal microscopy and optical coherence tomography, may support clinical decision-making, improve biopsy targeting, and enhance long-term monitoring of desquamative gingivitis. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2026 The Author(s) . Skin Research and Technology published by John Wiley & Sons Ltd. Skin Research and Technology, 2026; 32:e70236 1 of 12 [https://doi.org/10.1111/srt.70236](https://doi.org/10.1111/srt.70236) 1 Introduction Desquamative gingivitis is a clinical symptom characterized byerythema, desquamation, erosions, and blistering of the gingival epithelium [1] . Several diseases may present with desquamative gingivitis. The clinical criteria for diagnosing desquamative gingivitis were first established by Nisengard in 1995 . These criteria included the presence of erythema not associated with plaque and desquamation of the gingiva, along with additional oral or extraoral lesions and sensa

FAQs

What is desquamative gingivitis and what conditions can it indicate?

Desquamative gingivitis is characterized by gingival erythema, blisters, and erosions. It can manifest oral lichen planus or autoimmune bullous diseases such as pemphigus vulgaris and mucous membrane pemphigoid.

Which noninvasive imaging techniques are reviewed for diagnosis?

The review evaluates reflectance confocal microscopy (RCM), optical coherence tomography (OCT), and line-field confocal optical coherence tomography (LC-OCT) for identifying the cause and supporting differential diagnosis.

What diagnostic imaging patterns are described for oral lichen planus, pemphigus vulgaris, and mucous membrane pemphigoid?

RCM may show disrupted connective tissue papillae and obscured basement membranes in oral lichen planus, acantholytic keratinocytes and intraepithelial clefts in pemphigus vulgaris, and subepithelial clefts with hemorrhage signs in mucous membrane pemphigoid. OCT findings include maintained epithelial thickness in erosive lichen planus and multilocular blisters in bullous variants, intraepithelial clefts and epithelium thinning in pemphigus vulgaris, and subepithelial blister formation with fluid accumulation in mucous membrane pemphigoid.

Sep 30, 2026

Uploaded by Aran