Interconnected pathophysiology: Psoriatic lesions bridging the skin and oral mucosa in an elderly patient

Psoriasis is a chronic inflammatory skin condition that can present in various forms, including oral lesions, which are less frequently reported. This case highlights the challenges posed by the absence of histopathological confirmation through biopsy in diagnosing oral psoriasis, relying instead on clinical correlation and exclusion of other conditions. We present a case of a 61-year-old male patient with a long-standing history of skin psoriasis who developed significant oral lesions. A clinical diagnosis of oral psoriasis was made based on the clinical features, exclusion of other conditions, and the patient's history, despite the lack of an oral biopsy. After 3 months of treatment with topical corticosteroids and systemic methotrexate, the patient showed significant improvement, with reduced oral lesions and substantial clearance of skin plaques. This case underscores the interconnected nature of skin and oral psoriasis, emphasizing the need for histopathological confirmation in ambiguous cases. However, clinical correlation can be an effective diagnostic approach when histopathology is unavailable. A multidisciplinary approach is essential for managing such complex cases.