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Short Communication | DOI: https://doi.org/10.31579/2578-8949/173
Senior Professor & Head Daswani Dental College, affiliated with Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
*Corresponding Author: Ashish Pandey, Senior Professor & Head Daswani Dental College, affiliated with Rajasthan University of Health Sciences, Jaipur, Rajasthan, India.
Citation: Ashish Pandey, (2024), Exploring the Intersection of Dentistry and Dermatology: Oral Manifestations in Dermatological Conditions and Implications for Diagnosis and Treatment, Dermatology and Dermatitis, 11(2); DOI:10.31579/2578-8949/173
Copyright: © 2024, Ashish Pandey. This is an open-access article distributed under the terms of The Creative Commons. Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 18 September 2024 | Accepted: 30 September 2024 | Published: 11 November 2024
Keywords: oral manifestations; dermatology; dentistry; dermatitis; lichen planus; pemphigus vulgaris; interdisciplinary collaboration; inflammatory pathways; novel treatments
Dermatological conditions frequently present with oral symptoms, making the collaboration between dermatology and dentistry crucial. Oral manifestations are often an early sign of systemic dermatological conditions, necessitating the involvement of dentists in both diagnosis and management. This article explores the intersection of dermatology and dentistry, focusing on recent advancements in the treatment of oral lesions associated with dermatological diseases, including dermatitis and autoimmune conditions.
A variety of dermatological diseases, such as lichen planus, pemphigus vulgaris, and systemic lupus erythematosus, present oral manifestations. These conditions can significantly impact a patient’s oral health and overall quality of life, often requiring a combined dermatological and dental approach to care. For example, oral lichen planus presents as white, reticular lesions and is associated with a chronic inflammatory response that affects the mucosa. Early diagnosis by dental professionals is key to managing these lesions and preventing further complications. Pemphigus vulgaris, an autoimmune condition that causes painful blisters and erosions, is another example where oral symptoms may precede skin involvement, highlighting the dentist's role in early detection and referral to dermatologists for further treatment [1].
The treatment landscape for oral manifestations of dermatological diseases has expanded significantly in recent years. Biopharmaceutical therapies targeting specific inflammatory pathways have shown promise in managing conditions such as lichen planus and pemphigus vulgaris. Monoclonal antibodies and small molecules targeting tumor necrosis factor (TNF), interleukin-6 (IL-6), and interleukin-17 (IL-17) are particularly effective in reducing both oral and cutaneous symptoms [2]. For instance, biologics like rituximab and infliximab have been investigated for their efficacy in treating autoimmune diseases affecting both the skin and oral mucosa. These advancements represent a significant step forward in managing oral lesions, although more research is needed to determine the long-term safety of these therapies in the oral cavity [3].
In addition to biopharmaceuticals, treatments traditionally used in dermatology are finding applications in managing oral manifestations. Narrowband ultraviolet B (NB-UVB) phototherapy, commonly used to treat psoriasis and lichen planus, has shown potential in treating oral lichen planus as well. Recent studies have reported promising results with NB-UVB therapy for oral lesions, though more clinical trials are necessary to confirm these findings [4]. Similarly, laser therapies used in dermatology for skin lesions have been explored for their effectiveness in treating oral lesions, particularly those related to autoimmune conditions [5]. These emerging treatment modalities highlight the growing need for interdisciplinary collaboration between dermatologists and dentists.
Dermatitis, particularly atopic dermatitis, can also present oral health challenges. Patients with atopic dermatitis are more susceptible to xerostomia and secondary oral infections. Dupilumab, a monoclonal antibody targeting the interleukin-4 receptor, has recently been approved for the treatment of moderate to severe atopic dermatitis. Clinical trials have demonstrated that dupilumab improves both cutaneous and oral symptoms in affected patients [6]. This is especially important for individuals with atopic dermatitis who exhibit oral manifestations, as managing both skin and oral symptoms can significantly improve their quality of life.
While these advancements offer new avenues for treatment, they also raise important ethical and regulatory concerns. The use of biopharmaceuticals in dentistry is still in its early stages, and there are concerns regarding off-label use of these drugs for oral conditions. Regulatory compliance is essential to ensure that treatments are used safely and effectively, and ethical considerations must be addressed when using novel therapies in a clinical setting. Patients should be fully informed of the potential risks and benefits of new treatments, and clinicians must adhere to the highest standards of patient care [7]. Furthermore, global standards for the use of biopharmaceuticals in treating both dermatological and dental conditions must be clearly defined to prevent misuse and ensure patient safety [8].
The future of interdisciplinary collaboration between dentistry and dermatology is promising. As new treatments continue to emerge, dentists and dermatologists will need to work closely to optimize patient outcomes. Early diagnosis of dermatological conditions presenting in the oral cavity can lead to more effective treatment and improve overall patient care. Dentists must remain informed about the latest advancements in dermatological therapies, particularly those that affect oral health. Similarly, dermatologists should be aware of the potential oral implications of systemic treatments used in their field. By working together, these professionals can ensure that patients receive comprehensive care that addresses both their oral and dermatological health [9].
In conclusion, the integration of dentistry and dermatology is essential for managing patients with oral manifestations of dermatological conditions. Recent advancements in biopharmaceuticals, phototherapy, and laser treatments offer new possibilities for treatment, but also raise important ethical and regulatory concerns. As the fields of dentistry and dermatology continue to evolve, collaboration between these disciplines will be key to advancing patient care and improving outcomes for individuals with complex dermatological conditions.
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