Psoriasis is a chronic autoimmune condition that causes a person’s skin to grow faster than average, causing red patches.
Psoriasis can affect different parts of the body, such as the scalp, the skin on the knees and elbows and even the nails. Less common and often overlooked is oral psoriasis, which affects the tongue, the inside of the cheeks and less commonly the gums.
It is not a serious medical problem, but it can cause discomfort to the affected person, and the correct diagnosis is difficult to obtain because it can easily be confused with other oral problems.
Psoriasis can cause visible changes in the color and texture of the tongue. For example, people with psoriasis are more likely to develop an inflammatory condition called geographic tongue or erythema migrans. These conditions occur as a result of a problem with the immune system. This causes the skin cells of the tongue to grow and break at irregular intervals.
Oral psoriasis can manifest as four types of lesions:
(1) well-defined yellow-white, round, oval lesions that are independent of cutaneous psoriasis;
(2) White, scalloped, circinate lesions on the mucosa and tongue, which are related to psoriasis-specific lesions elsewhere on the body;
(3) erythema or redness of the entire oral mucosa associated with acute exacerbation of psoriasis;
(4) geographic tongue, seen more commonly in patients with cutaneous psoriasis,
Oral psoriasis is a very rare entity and may be confused with other dermatoses of the oral mucous membrane.
Differential diagnosis of oral psoriasis requires the presence of cutaneous lesions along with oral lesions that can be identified histopathological by biopsy.
To develop psoriasis, a person must have at least one of the relevant genes and be exposed to trigger factors. These could be stress, certain medications, an infection or trauma to the skin.
Psoriasis can affect one or several areas of the body and can occur in different places. Regardless of where it is localized, psoriasis is not contagious, so one person cannot spread the disease to others.
Most people diagnosed with oral psoriasis do not require treatment because they do not feel any discomfort, but if the patches in the oral cavity start to hurt, the following can be done: stop smoking, avoid spicy foods, use topical medication, and for a severe condition, systemic treatment is indicated. It is advisable to talk to your doctor about your symptoms and he or she can guide you through the correct and effective treatment.
It has been shown that psoriasis is a chronic, immunologically mediated inflammatory disease, which can act as a model for understanding other diseases of this genus.
However, there are gaps in the basic understanding of specific psoriasis related to phenotypes and the natural history of the disease. From the evidence available to date, it is still unclear whether oral psoriasis is a distinct entity or whether it does indeed exist, making diagnosis difficult.
This type of psoriasis can be uncomfortable and unattractive, but with consistent management, problems in the oral cavity should be minimal. Whenever you encounter a problem, seek treatment from qualified personnel for the best possible results.
