Severe Xerostomia Induced by Multiple Systemic Diseases in a Patient with Psoriasis Vulgaris: A Case Report and Literature Review

Abstract

Introduction

Psoriasis is a complex autoimmune disease associated with chronic systemic keratinization and inflammation, which can affect the skin, joints, and oral cavity. Xerostomia is a subjective feeling of oral dryness that impairs patient comfort and lowers the quality of life. The aim of this case report is to describe the clinical mechanism of xerostomia in a psoriasis patient with multiple systemic diseases.

Case Report

A 51-year-old inpatient man with psoriasis vulgaris was referred to the Oral Medicine Department with complaints of difficulty swallowing due to a sore throat and dry tongue since last week. The patient had psoriasis vulgaris 15 years ago, chronic adrenal insufficiency, psoriatic arthritis, acute circulatory collapse, anemia of inflammation, acute kidney injury, dehydration, gastritis, urinary tract infections, and malnutrition. A complete anamnesis and oral examination were done. The patient was diagnosed with severe xerostomia, a fissured tongue, exfoliative cheilitis, angular cheilitis, and gingivitis by the Oral Medicine Department.

Case Management

The patient was treated with petroleum jelly, chlorine dioxide mouthwash, miconazole cream, and benzydamine HCl lozenges.

Conclusion

Based on case reports and reviews, multiple systemic diseases may not only increase the risk of xerostomia but also aggravate its severity.

Keywords:

• acute kidney injury
• inflammation
• nitrogen oxide
• psoriasis arthritis
• SXI-ID

Acknowledgments

The authors would like to express our sincere gratitude to our patient and his family for their consent and those who have worked and helped us at Dr. Hasan Sadikin Hospital Bandung. The Universitas Padjadjaran directorate of research and community service is also gratefully acknowledged by the authors for its financial support.

Disclosure

The authors report no conflicts of interest in this work.