Isolated lip involvement in psoriasis: an uncommon aspect of a common dermatologic condition

Abstract

Introduction: Psoriasis is a chronic inflammatory skin disease that typically affects the extremities, trunk, scalp, and nails. Psoriatic cheilitis as an exclusive presentation is very rare and to our knowledge, only 6 cases have been reported to date. The absence of cutaneous lesions causes diagnostic difficulties that can result in misdiagnosis and inadequate treatment. Observation: We reported the case of a 21-year-old woman with a seven years history of scaly plaques of the vermillion of the lips as the only disease manifestation. Her cheilitis was associated with significant psychiatric morbidity. Oral biopsy showed a psoriasiform pattern. Local applications of betamethasone was proposed. Discussion: Although lip psoriasis is extremely rare, it can be the sole presentation of psoriasis even in the absence of accompanying skin lesions, other oral manifestations or a family history of psoriasis. Conclusion: Lip psoriasis should be considered in the differential diagnosis of chronic or recurrent treatment-resistant labial lesions.

Single-plaque psoriasis: a single-clue diagnostic challenge

“…The involvement of psoriasis regarding the oral mucosa is typically limited to a fissured, geographic tongue; however, histopathological analysis revealed a diagnosis of psoriasis in a 21 year old female patient presenting with recurrent, spontaneously remitting fissures of the vermillion and lower lip [9].…”

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

“…Ten of the cases were female and 5 male, the mean age of the patients was 28.86 years (13–65 years), extra-labial involvement was found in 6 patients with typical skin lesions in 4 cases, vulva involvement in one case, nail involvement in one case and scalp involvement in 2 cases. Only the case reported by Migliari et al had intraoral involvement [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ] (Table 1 ).…”

“…Specifically, the white color of psoriatic scales is of particular value for the diagnosis of psoriasis compared with the yellow scales or crusts that are usually suggestive of dermatitis [ 15 ]. Several treatments have been used in the literature: topical strong to very strong topical steroid, calcipotriol, tacrolimus, vitamin A derivatives, salicylic acid, and methotrexate with good outcome in most cases [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Severe Xerostomia Induced by Multiple Systemic Diseases in a Patient with Psoriasis Vulgaris: A Case Report and Literature Review

“…13 Oral psoriasis findings, such as geographic tongue, fissure tongue, and localized psoriasis plaques. 4,5,[13][14][15][16][17][18][19] Oral psoriasis is usually asymptomatic, The oral management of the patient was to apply a thin layer of petroleum jelly on the lips three times a day for exfoliative cheilitis, gargle with chlorine dioxide mouthwash three times a day for xerostomia, apply 2% miconazole cream two times a day for angular cheilitis, and suck benzydamine HCl lozenges three times a day for painful swallows. On the fifth day of his hospitalization, the patient developed respiratory distress and was diagnosed with hospitalacquired pneumonia (HAP).…”

“…The main clinical features most commonly seen in psoriasis patients are a fissured tongue and a geographic tongue. 10,12,13,[16][17][18][19]36,[38][39][40] The diagnosis of oral psoriasis is made when the clinical course of skin lesions coincides with oral lesions, which should preferably be confirmed histopathologically. 15,16,19,40 The manifestations of oral psoriasis in this patient were severe xerostomia, diffuse-type fissured tongue, exfoliative cheilitis, angular cheilitis, gingivitis, and periodontitis.…”