Study of the oral mucosa in 200 consecutive patients with psoriasis

Abstract

Hietanen J, Salo OP, Kanerva L, Juvakoski T: Study of the oral mucosa in 200 consecutive patients with psoriasis. Scand J Dent Res 1984; 92: 50-4.Abstract -The oral cavities of 200 consecutive psoriasis patients, most of them with widespread disease on the skin, were examined (man/woman ratio 1.63:1, mean age ofthe patients 43.7 yr). The average duration ofthe disease at time of examination was 15.8 yr. When questioned, 16% of the patients reported changes in the joints, which, according to them, had been verified by radiography. 72.5% of the patients reported on nail involvement at some time during their disease. Fissured tongue was present in 9.5% ofthe patients, and geographic tongue and smooth tongue each in 1 % ofthe patients. Angular cheilitis was found in 3.5% ofthe patients. In 20 out of 200 cases, the oral mucosa showed changes and biopsy was taken. Four out of 20 patients showed histoiogic features typical of psoriasis, including accumulations of leukocytes in the upper layers of the epithelium, all with widespread psoriasis skin involvement. Areas of oral mucosa were most often deep red in color, the buccal mucosa and tongue being the two most common sites. Two out of these lour patients had a fissured tongue and one had a geographic tongue.

Clinical Aspects of the Oral Cavity in Patients with Psoriasis: An Initial Study and a Proposal of a New Evaluation Method

“…Although a proportional clinical correlation between the degree of severity (PASI average 17) of skin lesion and the frequency of geographic tongue could be seen as reported in the literature (10), we did not correlate cutaneous PASI with severity level of mucosal lesions. The severity score for the oral mucosa was performed during the clinical visit via photographic evaluation and the OPASI was also calculated.…”

“…Hernandez Perez and collaborators observed that the frequency of geographic tongue and fissured tongue is higher in affected psoriatic patients (13) (16) show a high incidence of geographic tongue and fissured tongue in patients with psoriasis. In addition, Hietaten (17), detected the presence of angular cheilitis in patients with psoriasis. However, epidemiological studies indicate that the frequency of angular cheilitis is similar in the normal population (3.8%) because of the variable aetiology of this condition (full denture irritation, lack of iron or vitamin B complex , candidiasis, etc.…”

“…Although these lesions were shown to exhibit histopathological similarities with psoriasis, they have not been linked to the severity of dermatologic manifestations of the disease (17). Different papers have reported the highest prevalence ofthese entities in patients with psoriasis compared to general population.…”

Oral psoriasis: an atypical case

“…However, their link with psoriasis remains unproven [7]. Their histologic features are similar to those of a cutaneous psoriasis [3,9,[13][14][15], but the histological distinction between psoriasis and isolated geographic/fissurated tongue cannot be made [11].…”

“…Oral psoriasis is a rare entity and remains a subject of controversy [3,4]. In this paper, we report a case of oral psoriasis revealed by a geographic stomatitis.…”