Psoriasis of the lips: an unusual localization

Psoriasis of the Lips: A Case Report with Review of the Literature

Psoriasis is a chronic inflammatory dermatosis, which progresses by relapses-remissions, of a multifactorial etiology which involves genetic, immunological, and environmental factors. Skin lesions are mainly localized in areas of friction: elbows, knees, pre-tibial, lumbosacral regions, scalp, and nails. Although the appearance of the skin lesions is sufficient for a diagnosis, diagnostic difficulties may be found in case of unusual topography. We report a case of a 45-year-old female patient with psoriatic cheilitis with a review of the literature.

Diseases of the lips

Heath care providers should be comfortable with normal as well as pathologic findings in the lips, because the lips are highly visible and may display clinical manifestations of local, as well as systemic inflammatory, allergic, irritant, and neoplastic alterations. Fortunately, the lips are easily accessible. The evaluation should include a careful history and physical examination, including visual inspection, as well as palpation of the lips and an examination of associated cervical, submandibular, and submental nodes. Pathologic and microscopic studies, as well as a review of medications, allergies, and habits, may further highlight possible etiologies. Many lip conditions, including premalignant changes, are relatively easy to treat, when the abnormalities are detected early; however, advanced disease and malignancies are challenging for both the patient and clinician. Treatment should be focused on eliminating potential irritants or allergens and treatment of the primary dermatosis. In this paper we review physiologic variants as well as pathologic conditions of the lips.

Oral Psoriasis: An Overlooked Enigma

Although cutaneous psoriasis is common, the existence of its manifestations in the oral cavity has been questioned. The definitive diagnosis of oral psoriasis can be challenging due to the variability of presentations, and overlapping clinical and histological features with a number of other conditions as well as the lack of consensus. We review oral psoriasis, noting its variable clinical appearance, delineate the differential diagnosis, and discuss management strategies.

Oral psoriasis-a diagnostic dilemma: a report of two cases and a review of the literature

Whether psoriasis can manifest itself in the oral mucosa has been a matter of debate for many years. If an oral version of psoriasis exists, most researchers regard this manifestation as rare. The present report describes two patients who presented with lesions possibly related to cutaneous psoriasis. One patient had patchy erythematous lesions on the gingiva, and one had serpiginous lesions in the hard palate. We discuss these cases in relation to the existing literature, with special emphasis on the clinical and histopathologic criteria for the diagnosis of oral psoriasis.

In search of oral psoriasis

Even though psoriasis is a common skin disorder, reports of it involving the oral cavity are exceedingly rare, with less than 100 publications in the literature. Biopsy-proven oral psoriasis has been reported in the oral medical literature, but the commonest oral mucosal findings in most studies are associated non-specific features including fissured and geographic tongue. Case series on this entity have not provided any definitive data to support its existence. From the evidence available to date, it is still unclear if oral psoriasis is a distinct entity or if, indeed, it exists.

Psoriasis of the lips

BACKGROUND

Psoriasis is a frequently occurring disorder with a chronic and relapsing course. Common sites of involvement are the extremities, trunk, scalp and nails. The disease may occasionally involve genitalia and the anus. Although cutaneous lesions are generally sufficiently distinct to make a diagnosis, diagnostic difficulties can be found in cases of unusual involvement.

MAIN OBSERVATIONS

We report a 38-year-old man who presented scaling and cracking of the lips without intraoral involvement as a first manifestation of psoriasis. Three years later he developed erythematous plaques with desquamation on fingers, characteristic of psoriasis.

CONCLUSION

Psoriasis should be considered in the differential diagnosis of chronic or recurrent labial lesions.