Oral Lesions and Oral Health-Related Quality of Life in Adult Patients with Psoriasis: A Retrospective Chart Review

Abstract

Psoriasis is a widespread chronic inflammatory skin disease, that negatively affects physical and emotional well-being and quality of life, as shown by the generally low Dermatology Life Quality Index (DLQI). Psoriasis is burdened by associated comorbidities and some patients manifest concurrent oral lesions, although the existence of oral psoriasis remains controversial. Psoriasis-specific and nonspecific oral lesions and Oral Health-Related Quality of Life (OHRQoL), self-assessed using the Oral Health Impact Profile-14 (OHIP-14) questionnaire, were retrospectively reviewed in adult untreated psoriasis patients with ≥15 teeth, who were non-smokers and had no dental or periodontal infections. Sample (age, gender, comorbidities) and descriptive variables (Body Surface Area-BSA, Psoriasis Area and Severity Index-PASI, Dermatology Life Quality Index-DLQI, severity of psoriasis, distribution of lesions and predominant involvement, years since diagnosis) were correlated with DLQI and OHIP-14 and compared by baseline DLQI and OHRQoL classes. Charts from 90 participants were included. No oral lesions were detected, and excellent/good OHRQoL was found in 94% of the participants. DLQI scores displayed positive significant associations with PASI and BSA, while OHIP-14 with hypertension and IMID, and age. PASI and BSA were significantly higher in participants with DLQI > 10 and also differed significantly among OHQRoL ranks, as well as mucosal involvement and comorbidities. Specifically, among subjects revealing an Excellent OHQRoL, 92.6% were non-IMID, 75% non-hypertensive, 89.7% non-diabetic subjects, 86.8% of non CVD-subjects.

Keywords: mouth; oral health; oral lesions; oral manifestations; psoriasis; quality of life; skin diseases.

Figure 1

Participants’ comorbidities on the x axis, the comorbidities investigated (diabetes, hypertension, dyslipidemia, cardiovascular events, and IMID); on the y axis, the number of participants.

Figure 2

Participants’ psoriasis lesions distribution on the body and prevailing involvement.

Figure 3

DLQI trend by age classes was stratified for males and females. For the construction of these plots, the age variable was categorized in four classes divided by quartiles: the point represents the mean of DLQI score for both gender and age class, and the upper/lower band represents the confidence interval at 95%.

Figure 4

DLQI trend by age classes was stratified for males and females. For the construction of these plots, the age variable was categorized into four classes divided by quartiles: the point represents the mean of OHIP-14 score for both gender and age class, and the upper/lower band represents the confidence interval at 95%.