Prevalence of Oral Mucosal Lesions and Their Association with Severity of Psoriasis among Psoriatic Patients Referred To Dermatology Clinic: A Cross-Sectional Study in Kashan/Iran

Abstract

BACKGROUND:Psoriasis is a common inflammatory papulosquamous disease of the skin with unknown aetiology that may be associated with the abnormal T-cell function.AIM:This study was aimed to determine the prevalence of oral mucosal lesions and their associations with severity of psoriasis in psoriatic patients attending the dermatologic clinic of Shahid Beheshti Teaching Hospital at Kashan, Iran.METHODS:In this cross-sectional descriptive analytic study, all consecutive patients with psoriasis who referred to the dermatologic clinic at the Shahid Beheshti Hospital of Kashan University of Medical Sciences in Kashan City/ Iran were enrolled. All patients were examined for the presence of oral lesions, and the clinical and epidemiological features of the disease were recorded in a questionnaire for each patient. A biopsy was taken from atypical suspected patients with oral lesions by an expert dermatologist. Data were analysed using the Statistical Package for Social Science (Version 18). Descriptive statistics tests; Cross tabulation and Chi-square with Fisher’s exact test were used.RESULTS:Of total 177 psoriatic patients, 62 cases (35%) of patients were male, and 115 cases (65%) were female. Mean age of patients was 31.71 years. The oral lesion was seen in 83 cases (46.9%). Fissure tongue (28.2%) and geographic tongue (4.5%) were the most common oral lesions. The prevalence of oral lesions in patients with psoriasis significantly was associated with age, history of oral lesions, and with the onset of the oral lesions (P < 0.05). The most common form of psoriasis was chronic plaque form (Psoriasis Vulgaris) observed in 147 cases (83.1). The majority of patients (67.2%) were suffering from a mild form of the disease. Psoriasis Area and Severity Index (PASI) score of most patients was mild.CONCLUSIONS:The prevalence of oral lesions such as Fissure tongue and geographic tongue is higher in psoriatic patients suggests further studies for approving the clinical importance of these apparently nonspecific lesions as possible predictors or markers of the severity of the cases suspected to Psoriasis disease.

Oral mucosal lesions in psoriatic patients based on disease severity and treatment approach

“…The oral manifestations of psoriasis remain controversial, although this has been supported by some recent reports mostly from Asian and South American researchers. [12][13][14][15][16][17] In this study, the frequency of oral lesions in patients with psoriasis treated with different therapeutic approaches was investigated. A possible association between oral lesions prevalence and the severity of the disease assessed with PASI scale and DLQI questionnaire was also examined.…”

“…Life Quality Index (DLQI) questionnaire, which categorizes the effect of the disease on the quality of life as none (score 0-1), small (2-5), moderate (6-10), very large (11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and extremely large (21-30). 10 The Psoriasis Area and Severity Index (PASI) score was also used to assess the severity of the disease as remission (score 0), mild (<10), moderate (10)(11)(12)(13)(14)(15)(16)(17)(18), or severe (>18) course. 10 The patients were also classified according to the type of treatment, which included topical, systemic, and biological option.…”

Oral Psoriasis of the Tongue: A Case Report

“…The most common form of psoriasis is the plaque type, also known as psoriasis vulgaris, which accounts for approximately 90% of occurrences. The most common anatomical presentations of these lesions occur on the elbows, knees, scalp, fingernails, and toenails [1][2][3][4][5].…”

“…The association of psoriasis with both fissured tongue and BMG (also known as geographic tongue) is well documented. The prevalence of fissured tongue ranges between 9.8-47%, and the prevalence of BMG ranges between 5.6-8.1% in patients with cutaneous psoriasis [2,9]. The prevalence of BMG overall is between 1-2% of the population [10].…”

Letter Regarding “Fissured Tongue: A Case Report”

“…There are considerable controversies about the correlation between prevalence of FT and severity of psoriasis [4, [7][8][9]. Some investigators state that GT may be a more useful indicator of psoriasis severity than FT. Multicentric, well designed, controlled studies with large sample sizes are warranted to investigate this relationship.…”