Oral Psoriasis: Can I Get Psoriasis in My Mouth?
This Q&A is part of a series highlighting frequently asked questions, answered by a healthcare professional in our community.
We asked: “Can I get psoriasis in my mouth?”
Allison Truong, M.D.: Yes, it is possible to get a skin manifestation of psoriasis in the mouth, but it is quite rare. Indeed, oral psoriasis is so rare that not all doctors agree on exactly what the symptoms are. Most severe cases are in people with severe pustular psoriasis flares, where their whole body is covered with pustules, sometimes including in the mouth as well.
Some people have reported symptoms that may be oral psoriasis:
- Mouth sores
- Peeling skin on their gums
- Pain or burning when eating spicy foods
But these symptoms can have other causes too. For example, some people might have psoriasis and Behcet’s syndrome, which is a condition that can also cause recurrent sores in the mouth.
What Else Could It Be?
Oral psoriasis symptoms are most commonly confused with two other conditions: burning mouth and geographic tongue.
Burning mouth is a condition when you feel burning or pain in your mouth without an obvious cause. People also described severe dryness or a weird bitter or metallic taste in the mouth. Spicy foods may worsen the condition. Because nightshade vegetables (tomatoes, peppers, eggplants, and white potatoes) are considered inflammatory foods for some people with nightshade sensitivities, these vegetables might also trigger burning in the mouth. If you find these foods cause you mouth pain, avoiding them might be helpful.
Geographic tongue is when small patches appear on the tongue’s surface, making your tongue look like islands on a map—hence the name geographic mouth. The patches, which have whitish or yellowish borders, can come and go and change frequently. They generally don’t cause symptoms. However, some people may have fissures or cuts in the tongue from where the islands connect. That can create pain or discomfort in those areas.
How Else Can Psoriasis Affect the Mouth?
Psoriasis is a disease of inflammation. And that can include gingivitis, or inflammation of the gingival (the part of your gum around the base of your teeth). Untreated gingivitis can lead to loss of teeth over many years. So if you have psoriasis, it’s especially important that you have regular dental screenings. Your dentist can check for gum disease and make recommendations to help protect your oral health.
How Do I Manage Mouth Symptoms?
If you have oral problems stemming from your psoriasis, your dermatologist can recommend a mouthwash that has a combination of steroids and numbing properties called magic mouthwash. You need a prescription for this mouthwash that has to be compounded at a special pharmacy called a compounding pharmacy. The mouthwash can be made tailored to you based on your level of discomfort or pain.
Your doctor also may recommend a prescription dental paste that you can apply to certain areas of your mouth to help calm down inflammation, such as Kenalog (triamcinolone) in Orabase.
Finally, if symptoms persist or worsen, your dermatologist or primary care doctor can refer you to specialists in oral medicine for more advice.
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