Lingual Pustular Psoriasis and Acrodermatitis Continua of Hallopeau Successfully Treated with Adalimumab: A Rare Case Report and Review of Oral Psoriasis
Bibliographic record
Abstract
Psoriasis is a common skin disease with various cutaneous manifestations and is classified into two clinical groups: non-pustular and pustular. Pustular psoriasis is less common than non-pustular forms of psoriasis and is particularly resistant to treatment. Studies of the rarer variants of acrodermatitis continua of Hallopeau and pustular psoriasis of the tongue remain scant. The subtypes of psoriasis can present all over the body, including in uncommon locations, such as the oral cavity; however, there are limited presentations and data regarding oral involvement in psoriasis and its subsequent management. Although cases involving oral psoriasis are rare, with <100 publications in the literature, and generally asymptomatic, recent studies have suggested that it is more prevalent than once thought. In contrast, presentation and subsequent management of lingual pustular psoriasis have not been reported. Presented and discussed in this review is a rare case of symptomatic, painful lingual pustular psoriasis and acrodermatitis continua of Hallopeau with complete remission after the use of adalimumab, followed by a thorough review of the histopathology, diagnosis, and clinical management of oral psoriasis. The use of biologics for conditions involving the oral mucosa, particularly in the setting of cutaneous psoriasis, is a novel concept with potential application in the fields of dermatology, oral medicine, and rheumatology.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".