Author: Kim Gear, Oral Medicine Trainee, Auckland, New Zealand, 2007.
What is oral psoriasis?
Oral or intraoral psoriasis is psoriasis affecting the inside the mouth.
Psoriasis is a chronicinflammatory skin disorder affecting 1-3% of the world population. It most often starts in the second and third decades of life. It affects males and females equally.
There are several ways psoriasis may present. The most frequent is psoriasis vulgaris or chronicplaque psoriasis, in which there are persistent or recurring scalyplaques (thickened patches of skin). The extent of psoriasis varies from a few localisedplaques on the elbows, knees, lower back and scalp to involvement of the skin of the whole body. A pustular form of psoriasis may also occur.
Psoriasis inside the mouth is relatively uncommon. It is more likely to develop in those with the more severe forms of psoriasis, especially pustular psoriasis. There are several types of oral lesion.
Irregular red patches with raised yellow or white borders, similar to geographic tongue. This is the most common.
Redness of the oral mucosa
Peeling gums, called desquamative gingivitis
Pustules (in pustular psoriasis)
How is the diagnosis made?
The diagnosis is usually made from the clinical appearance, in a patient who has known psoriasis. Biopsy can help to confirm the diagnosis.
Under the microscope, psoriasis is characterized by thickened epithelium with long rete ridges and chronicinflammation. Small collections of lymphocytes form microabscesses within the epithelium along with migrating polymorphonuclearleukocytes.
Psoriasis may be managed using a variety of topical and systemic treatments.