Psoriasis is an autoimmune disease that can affect the skin and, more rarely, the mucous membranes. Although it is an infrequent localization, the lips can be affected by this pathology with considerable discomfort for patients, given the visibility of the manifestations and the annoying symptoms associated with them. Due to its rarity, lip psoriasis is often confused with other pathologies, most frequently found here: allergic or irritative dermatitis of the lips, cold sores or lesions of the lips associated with autoimmune diseases such as lupus.

The diagnosis must be made on the basis of clinical manifestations as biopsy samples are not indicated here, except in very rare cases. The main clinical element that distinguishes lip psoriasis from other conditions is the white and silvery scales that form on a reddened and inflamed background, in the absence of vesicles arranged in clusters (typical of cold sores) and without association with the application of lipsticks, lip balms or toothpastes (as occurs in the eczema of the lips from allergic causes ). Other elements that can guide the dermatologist in the diagnosis are the presence of psoriasis in other locations such as elbows, knees and scalp, as well as a family history of psoriasis.

Treating this type of psoriasis involves a series of pharmacological and behavioral measures. First of all it is essential to keep the lips well hydrated: emollient balms can also be applied several times throughout the day, relieving the dryness and flaking typical of labial psoriasis. Avoid repeated injuries, how the habit of continually biting or licking the lips is equally important as it is known that the autoimmune process typical of psoriasis is stimulated by traumatic stimuli. To this are added the pharmacological aids which can be local or, in the most serious and disabling cases, include the administration of systemic drugs. Among the drugs to be applied locally there are creams based on derivatives of vitamin D (calcipotriol) and corticosteroids, very useful in controlling itching and inflammation.
It is important to remember that topical corticosteroids they should be prescribed by a specialist who will choose, from the various available, the most suitable type for the lip site, more predisposed to the development of side effects such as atrophy (thinning of the skin) and will prescribe application schemes capable of preventing this problem. Topical tacrolimus is another option: it is a molecule that is used for the treatment of eczema, but due to its anti-inflammatory and immunomodulatory properties it is also used in labial psoriasis. Finally, in the most severe forms, one can opt for systemic immunosuppressants such as methotrexate.
In conclusion, lip psoriasis can be an annoying obstacle to the relational life of some patients, but contact a competent specialist and following their directions can make a difference.