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PRACTICE: Ray Jobling Psoriasis BMJ 2007; 334: 953-954 [Full text]

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Psoriasis. Can oral lesions be a common sign of the disease?

Eduardo E. Castillo-Betancourt MDD, Eduardo M. Curbeira-Hernández. MDD, Moisés A. Santos-Peña MD, Susana Garcia-Buchaca. MsC   (8 May 2007)

Psoriasis. Can oral lesions be a common sign of the disease? 8 May 2007
Eduardo E. Castillo-Betancourt MDD, Dentistry and epidemiology Department Gustavo Aldereguía Lima University Hospital. Cienfuegos, Cuba, Eduardo M. Curbeira-Hernández. MDD, Moisés A. Santos-Peña MD, Susana Garcia-Buchaca. MsC Send response to journal: Re: Psoriasis. Can oral lesions be a common sign of the disease?	The article “Psoriasis” published by BMJ1 has been of great interest for our staff. The skin is, according to Noman Wrong, an organ for expressing feelings such as anger, fear, resentment and shame. This characteristic of the skin has turned it into a mirror in which emotions can be exhibited through out lesions. Numerous clinical observations have confirmed that psoriasis is a sort of disease that appears in patients subjected to nervous strain. 2 Psoriasis has been defined as a chronic inflammatory skin disease characterised by well demarcated arythematous scaly patches on the extensor surfaces of the body and scalp. The lesion may itch, sting, and occasionally bleed. Dystrophic nail changes are found in more than a third of people with chronic plaque psoriasis, and psoriasis arthropathy occurs in 1-3%, it is know to affect mortality. Psoriasis may substantialy affect quality of life.3 Oral manifestations of this condition have been described and there seems to be high incidence of migratory mucositis, fissured tongue and angular cheilitis. 2 During the year 2006, twelve patients in the 27-71 age group with a clinical and histopathological diagnosis of psoriasis were examined in our clinic and all of them presented with buccal manifestations characteristic of the disease. Clinical signs included migratory mucositis, fissure tongue, angle cheilitis, filiform papillae elongation, and leucoplasia. Out of all cases, 41.7% presented with more than a lesion. Our experience shows how detailed oral exam may contribute to the early diagnosis of systemic disease which release buccal manifestations. Referencias: 1. Jobling R. Psoriasis. BMJ 2007; 334: 953-4 2. López S. et al. Manifestaciones orales de la Psoriasis. Rev Científica Bogotá 1998; 4(2):52-63. 3. Naldi L, Rzany B. Chronic plaque psoriasis. Clinical Evidence BMJ Publishing Group 2001; 5: 1150-64. Competing interests: None declared