A report describes a case of a 32-year-old male who was a mason by occupation and presented with complaints of itchy scaly lesions on hands and lips for 4 years and 6 months, respectively, and pain over the small joints of the hands for 6 months. He gave a history of winter exacerbation with symptomatic relief from using topical steroids.

Examination showed well-defined erythematous plaques with silvery-white scaling on the dorsum and palmar aspect of both hands. Both the lips showed erythematous plaques with fissuring and scaling, extending onto the vermilion border. Examination of the oral cavity revealed fissuring of the tongue. The fifth digit of both hands showed deformities.

Histopathology from the lip showed psoriasiform acanthosis, parakeratosis, hypogranulosis and suprapapillary thinning with dilated blood vessels in the superficial dermis, indicating psoriasis.

Hence, the physicians gave him the final diagnosis of chronic plaque psoriasis with psoriatic arthritis and oral psoriasis and initiated methotrexate and topical corticosteroids. The cutaneous and lip lesions received symptomatic treatment, while the fissured tongue received conservative management.

Source: Lobo C, Dominic S, Bhat I. Oral psoriasis - A rare entity. Indian J Dermatol. 2022;67(2):209.