Rare Symptoms of Psoriasis on the Tongue and Lips - Verywell Health

Psoriasis is an autoimmune skin disease that develops when an overactive immune system speeds up skin cell growth. It leads to inflammation and a buildup of skin cells.

Psoriasis causes red and scaly patches of skin, most commonly on the elbows, knees, and scalp. In rare cases, psoriasis can affect the tongue and mouth. This type of psoriasis is known as oral psoriasis.

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Symptoms 

Symptoms that appear in a case of oral psoriasis can include: 

• Small, round lesions (areas of abnormal tissue) that are gray to yellowish-white in color
• Circular, white, and elevated patches or lesions on the moist membrane of the inside of the mouth, such as the inside of the cheeks and the gums
• Extreme redness of the skin inside the mouth accompanied by red, scaly patches
• Geographic tongue—red, bald spots of skin that are surrounded by an irregular white border
• Fissured tongue—deep or shallow grooves on the top of the tongue
• A rash on the inside of the mouth
• Bleeding of the mouth or gums
• Plaque buildup in the mouth
• Sores in the mouth
• Loss of taste
• Pain

How Do I Know If I Have Oral Psoriasis?

It can be difficult to diagnose psoriasis on the tongue because its symptoms are similar to those of other conditions and some medical professionals don't believe oral psoriasis is a type of psoriasis. Also, no clinical criteria have been established to diagnose psoriasis of the tongue. Your doctor will likely diagnose you with oral psoriasis by ruling out other conditions that could be causing your symptoms.

Causes

Oral psoriasis is an incredibly rare form of the skin condition, and researchers aren't sure how some people develop it on the tongue while others don't.

Researchers believe that certain factors may contribute to oral psoriasis, including:

• Genetics: Researchers believe that psoriasis has a genetic component and that some people with specific genes are more likely to inherit the condition. However, people without a family history of the disease can still develop it.
• Immune system: Since medical professionals believe psoriasis is driven by an overactive immune system, the function of the immune system plays a role in its development.

Diagnosis

The diagnosis of oral psoriasis is usually made in a physical exam. Your doctor will be able to determine if you have oral psoriasis by looking at your symptoms.

A biopsy, where a small sample of tissue is taken and sent to a lab for analysis, can help confirm the diagnosis.

When to See a Doctor

If you notice any type of lesions or abnormal patches of skin in your mouth, with or without pain, you should see your doctor. This is especially true if you developed psoriasis on other areas of your body. Any changes in the texture or feeling of the inside of your mouth or tongue could be indicative of a health condition that may require treatment and should prompt you to see your doctor.

Treatment

If the flare-up occurs because of irritants, you will likely have to get rid of them. Some irritants include spicy foods, smoking, and dentures.

In the event that your oral psoriasis isn't driven by any irritant, treatment is focused on relieving the symptoms, because there is no cure for the condition.

Psoriasis on the tongue is often treated with antiseptic mouthwash. Corticosteroids, which can help reduce inflammation, may also be used to help treat oral psoriasis.

Psoriasis that flares up on other parts of the body as well as the tongue may require a different treatment approach, such as the use of anti-TNF agents. Anti-TNF agents suppress inflammation in the body which can trigger psoriasis flare-ups.

Psoriasis Doctor Discussion Guide

Summary

Psoriasis is an autoimmune disease that speeds up skin cell growth and causes a buildup of cells on the skin. These cells form plaques, which are red, scaly patches of skin. Rarely, psoriasis can affect your tongue and the inside of your mouth. When it does, it can cause symptoms like geographic tongue, which consists of irregular red patches with raised yellow or white borders, redness on the inside of your mouth, and sores.

A Word From Verywell

Having psoriasis in your mouth can be difficult to cope with. Even though the condition has no cure, it is not contagious, so you cannot pass it on.

The best way to stay ahead of flare-ups is by avoiding certain triggers. You can identify your triggers by keeping a journal to track certain activities, foods, or experiences that may happen prior to a flare-up.

Psoriasis, in general, can be tough on your mental health, but with the right tools and management practices, you can lead a happy and healthy life with the condition.

Frequently Asked Questions

• Typically, treatment of psoriasis in the mouth will be done using antiseptic mouthwash and corticosteroids. If psoriasis of the mouth is severe, typical treatments for psoriasis on other parts of the body, such as anti-TNF agents, may be used in the hopes that treating the entire body will also help heal the mouth.

• Geographic tongue and oral psoriasis are not the same thing, but the two conditions do present in similar ways. Geographic tongue is generally benign and does not cause any long-term health problems. Some people may feel a burning or stinging sensation on their tongue, but otherwise have no symptoms. Oral psoriasis, on the other hand, is an autoimmune condition. It can cause geographic tongue, but geographic tongue cannot cause psoriasis. 

• Mouth sores caused by psoriasis are incredibly rare, and the rate at which people develop oral psoriasis isn't well known. One study that looked at the prevalence of psoriasis mouth sores on the tongue in children with the condition on other parts of the body found that only 7.7% had the typical sores and symptoms in their mouths.