Lip/oral psoriasis?

Posted Tue 21 Jan 2020 22.03 by Xiong mao

I'm completely new to forums and to psoriasis. In fact I'm not sure if my diagnosis is 100% correct and wonder if anyone else has experienced my symptoms. I went to my GP at the end of November 2019 as I had a few small flat red spots on my chest and arms which weren't going away (started Sept '19) Iinitially the GP diagnosed a fungal skin infection as it started to appear after a hot sunny holiday abroad. I was prescribed Daktacort cream for 10 days. This made the spots itch and they didn't fade or get any better. In that 10 day period I had 3 lumps appear in my bottom lip which kind of blossomed into whitish patches on my lip. At the same time I had some small white spots appear in clusters on the inside of my cheeks. Back to see another doctor who prescribed Terbinafine for my skin and said I had dry skin on my lips and dismissed oral spots. Same itchy reaction t o Terbinafine. Couldn't get another appointment due to christmas and New year but was seen again by same original GP early January. By this time the skin had had many more spots/patches appearing and was generally itchy. The white spots inside my mouth had spread so there were new clusters particularly on my jaw hinge. The GP got a 2nd opinion and both diagnosed Guttate Psoriasis stating that the newer patches on my lip was the infection site which triggered the whole thing????? And that I have thrush in my mouth. I was prescribed Betnovate cream for my skin and Nystatin for my mouth. While I'm living with all of this and have obviously read alot on the subject I can agree that I probably have Guttate Psoriasis. However, I haven't had strep throat or any kind of infection for years and years so my lip patches cannot be the trigger. And i'm not susceptible to thrush at all (my nurse friend says it doesn't look like thrush) The Nystatin has made no difference whatsoever and while a few of the skin spots are healing, most aren't. New ones are appearing daily and some of the larger ones itch like mad and sting if accidentally rubbed on something. I have another GP appointment at the end of January and my nurse friend is coming with me but I feel like I'm not being taken very seriously, particularly in regards to whatever's going on in my mouth and on my lips. I can't find anything on this forum with regards to lip/mouth symptoms but I know that lips can be affected (not sure about inside mouth) and just wondered if anyone had any similar experience?

Posted Wed 29 Jan 2020 10.48 by PsoAdminMod

Hi Xiong, Sorry to hear you are having difficulty with your skin at the moment, it does sounds as though the advice from your GP has been a little confusing and i can understand your frustration. Whilst is is very rare, it is possible to get psoriasis on the lips and inside the mouth. If you do have psoriasis on your lips, your GP may be able to prescribe a mild topical (applied to skin) treatment to try to help control it. Guttate psoriasis does normally reach a 'peak' before it starts to improve, so as your symptoms have been persistent since your first appointment 5 months ago, it would be advisable to ask your GP for a referral to dermatology if your current treatments are not working. A dermatologist may offer you light treatment which can help to reduce inflammation in the skin. You can find more information about UVB therapy here: https://www.psoriasis-association.org.uk/psoriasis-and-treatments/treatments/from-a-dermatologist. I hope this helps and best of luck with your GP appointment. Best Wishes, Amber, Psoriasis Association

Posted Sun 2 Feb 2020 23.14 by Xiong mao

Hi Amber Thank you so much for replying and explaining more than I knew about Psoriasis and it’s presentation and treatment. I saw my GP again last Thursday and she has now changed her opinion of my condition to Lichen Planus, I think because she FINALLY had a good examination of my lip and mouth instead of the cursory glance on my previous visit. I’ve been prescribed a stronger steroid cream for my skin (Dermovate) which is working amazingly well already and advised to buy a pure Lanolin cream for my lip (it’s sold as a nipple cream for breast feeding moms, expensive at £10 but has already made such a difference) My mouth is still affected, nothing was prescribed or advised other than no alcohol or mouthwash, but I’m just so relieved that other symptoms are easing I can deal with the sore/burning mouth in due course. Hope this may help someone who’s getting stuck on diagnosis, I know Guttate and Lichen Planus are often difficult to differentiate.

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