Oral lichen planus (OLP) is a common premalignant chronic inflammatory disorder. Optical Coherence Tomography (OCT) provides a real-time, non-invasive, and in-situ optical signature using light of varying wavelengths to examine tissue. Aim of the present study was to assess the possible role of OCT as diagnostic tool for atrophic-erosive OLP by examining OCT scans of healthy buccal mucosa, and comparing their ultrastructural features with those of a buccal mucosa affected by atrophic-erosive OLP, using their histopathological counterparts as the gold standard. Through grayscale (enface scan) and an application in which the vascularization of the tissue is visible (dynamic scan), it was possible to distinguish the healthy from the lichenoid pattern from 20 controls (12 M; 8 F; mean age: 41.32 years) and 20 patients with histologically confirmed atrophic-erosive OLP (7 M; 13 F; mean age: 64.27 years). In detail, mean width of stratified squamous epithelium (EP) and lamina propria (LP) were evaluated. Among controls, EP and LP showed a mean width of 300 (±50) and of 600 (±50) μm respectively; among cases, disruption of membrane basement prevented from any measurement. Furthermore, a differential pattern of EP and LP emerged between the two groups: a light-grayish, hypo-reflective, homogeneous area of EP recurring in controls turned into a hyper-reflective, non-homogeneous area among cases. Dynamic scan showed a differential profile of LP vascularization, varying from a hypo-reflective red area with small blood vessels in the control group, to a hypo/hyper-reflective area, completely overrun by a denser, wider blood flow amid OLP cases. Although histopathological examination remains the gold standard for OLP diagnosis, OCT could be a potentially helpful tool for the clinician and the pathologist, since it allows analysis of the vascularization of the sample without adversely affecting histological processing.

口腔扁平苔藓（OLP）是一种常见的癌前慢性炎症性疾病。光学相干断层扫描（OCT）提供实时，无创且原位光学签名，使用不同波长的光检查组织。本研究的目的是通过检查健康颊黏膜的OCT扫描，并比较它们与受萎缩性侵蚀性OLP影响的颊黏膜的超微结构特征，来评估OCT作为萎缩性侵蚀性OLP诊断工具的可能作用。组织病理学作为金标准。通过灰度（面部扫描）和可见组织血管形成的应用（动态扫描），可以从20个对照（12 M； 8 F；平均年龄：41.32岁）中区分健康与类苔藓样经组织学证实为萎缩性侵蚀性OLP的20例患者（7 M； 13 F；平均年龄：64.27岁）。详细地，评估了分层的鳞状上皮（EP）和固有层（LP）的平均宽度。在对照中，EP和LP的平均宽度分别为300（±50）μm和600（±50）μm。在某些情况下，无法通过任何措施阻止膜基底的破坏。此外，两组之间出现了EP和LP的差异模式：在对照组中，浅灰色的，低反射性的，均质的EP区域在对照组中变成了高反射性，非均匀性区域。动态扫描显示LP血管形成的差异，从对照组中小血管的低反射性红色区域到OLP病例中的低密度/高反射性区域完全被更密集，更宽的血流所覆盖。尽管组织病理学检查仍然是OLP诊断的金标准，但OCT对于临床医生和病理学家可能是潜在的有用工具，