It is a rare inflammatory disease that affects the skin and mucous membranes of the mouth. It affects middle-aged adults and is less common in children.
Its origin is unknown, although it may be related to an allergic or immune reaction. There are risk factors that may predispose to its appearance, such as stress, exposure to certain drugs, dyes and other chemicals, and diseases such as hepatitis C.
The lesions in the mouth are characterised by being painful, located on the sides of the tongue, inside the cheeks or on the gums, in the form of pimples or white and bluish patches that gradually increase in size and sometimes form painful ulcers. Skin lesions are located on the inside of the wrist, legs, torso or genitals, are itchy, may be covered with thin white lines or linear scratch marks, are shiny or scaly, dark purple in colour and may form blisters or ulcers. Other symptoms may include a dry mouth, hair loss, a metallic taste in the mouth and/or ridges or flakes on the nails.
The diagnosis is made by a medical history and physical examination. It is confirmed by a biopsy of the skin or mouth lesion.
Treatment is based on symptom control. Commonly prescribed medications include antihistamines, lidocaine mouthwashes, topical, oral or intralesional corticosteroids, cream or oral vitamin A, immunosuppressive drugs and/or ultraviolet light therapy.
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