Oral health status of psoriatic patients managed with modern biological therapy

Introduction
Psoriasis is a chronic multifactorial dermatosis with an autoimmune and genetic background, with characteristic periods of remission and exacerbation, affecting up to 3% of the population; it is currently regarded as a systemic disease.

Aim
The aim of the study was to investigate the oral health status, including oral mucosal lesion frequency and prosthetic treatment requirements, in psoriatic patients managed with biological therapies.

Material and methods
Forty-two patients diagnosed with psoriasis and managed with biologics were enrolled in this study. All subjects completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The disease severity was assessed using the Psoriasis Area and Severity Index (PASI) scale and a DLQI questionnaire. To evaluate the oral health status, the following techniques were used: Approximal Plaque Index (API), the Community Periodontal Index (CPI), and the Decayed, Missing, and Filled Teeth (DMFT) index. The oral mucosa evaluation was based on the clinical appearance, location, and morphology of the lesions.

Results
The most common oral lesions in patients with psoriasis were found to be fissured tongue and white coated tongue. Thirteen patients (31%) presented with clinically healthy oral mucosa. Type II (diffuse type) denture stomatitis (DS) was most common amongst psoriatic patients wearing acrylic removable dentures. Most of the subjects required prosthetic treatment (57.1 %) and the removal of calculus (40.5%); however, no one required surgical treatment.

Conclusions
Fissured tongue seemed to be associated with skin lesions in psoriatic patients managed with biological therapies. The need for dental treatment was observed in 71.4% of the patients, with most subjects requiring prosthetic treatment. The study indicated that the diffuse type of DS occurred amongst subjects with psoriasis, who were wearers of acrylic removable dentures.