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Quintessence Publishing: Journals: QI
Quintessence International

Edited by Eli Eliav

ISSN 0033-6572 (print) • ISSN 1936-7163 (online)

June 2015
Volume 46 , Issue 6

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Periodontal management of a patient with severe psoriasis: A case report

Romano, Federica / Manavella, Valeria / Ercoli, Elena / Aimetti, Mario

Pages: 531-538
PMID: 25941679
DOI: 10.3290/j.qi.a33991

Psoriasis is a common, disfiguring and stigmatizing skin disease associated with impaired quality of life. In patients with severe psoriasis unresponsive to other treatments, cyclosporine can induce a rapid remission. Although drug-induced gingival overgrowth (GO) is a frequent side effect, in the guidelines for the use of cyclosporine for psoriasis regular dental examinations were not mentioned as an essential part of monitoring of these patients.
Case Report: A 59-year-old man with GO involving almost all the interdental papillae (Seymour’s grading score 1-5) reported difficulties in mastication and gingival swelling. The medical history revealed severe recalcitrant psoriasis treated by oral cyclosporine. The periodontal treatment consisted of strict oral hygiene instructions, scaling, root surface instrumentation, and a 2-month interval periodontal supportive treatment. At 12 months an almost complete regression of GO was observed. A careful nonsurgical periodontal treatment combined with meticulous self-performed oral hygiene may avoid the need for surgical intervention, even in advanced cases.

Keywords: cyclosporine, gingival overgrowth, nonsurgical periodontal therapy, psoriasis

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