Author: Kim Gear, Oral Medicine Trainee, Auckland, New Zealand, 2007.
Oral or intraoral psoriasis is psoriasis affecting the inside the mouth.
Psoriasis is a chronic inflammatory 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 chronic plaque psoriasis, in which there are persistent or recurring scaly plaques (thickened patches of skin). The extent of psoriasis varies from a few localised plaques on the elbows, knees, lower back and scalp to the 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.
The diagnosis of oral psoriasis is usually made from the clinical appearance, in a patient who has known psoriasis. A biopsy can help to confirm the diagnosis.
Under the microscope, psoriasis is characterised by thickened epithelium with long rete ridges and chronic inflammation. Small collections of lymphocytes form microabscesses within the epithelium along with migrating polymorphonuclear leukocytes.
Psoriasis may be managed using a variety of topical and systemic treatments.
Treatment for oral psoriasis may include:
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