Oral Psoriasis—An Overlooked Entity: Current Paradigms and Future Perspectives

Psoriasis is a chronic, genetically determined, scaly, and inflammatory disease of the skin. Pathogenesis is multi-factorial, involving dysregulated inflammation and genetic associations. Cutaneous lesions are characterized as thick, erythematous, all-around defined plaques covered with a silvery white scale. Commonly affected areas include the elbows, knees, sacral area, and scalp. One of the factors that may result in the appearance of psoriatic lesions may be the oral cavity lesions. Aim of the present article was to review the effects of psoriasis on oral cavity, histopathological investigations, and etiopathogenesis and diagnosis of oral psoriasis. Recently, many therapies for oral psoriasis are observed and some are in development, or under investigation. Regular non-biologic therapeutic options for psoriasis like cyclosporine, methotrexate, and acitretin are usually not recommended for long-term use due to their adverse safety profiles. More recently, biomarkers present in the oral fluids have been tested as diagnostic tool for psoriasis using gingival crevicular fluid. In this review article, we have provided an insight vision to the etiopathogenesis, clinical features, diagnostic criteria, and treatment of oral psoriasis. Apart from this, a strong emphasis is given to the oral manifestations presented by psoriatic patients, its association with geographic tongue, and salivary changes seen in psoriasis.