[Cardiac imaging].

A 20-year-old woman presented to our clinic with a history of fissuring, cracking and scaling of her lips that had been present for about 2 months. The lesions started at the corners of the mouth and insidiously migrated towards the centre, involving both lips completely. She complained of a burning sensation and severe discomfort during eating and speaking. She had been prescribed various medications including emollient creams and topical steroids, with no effective improvement. Dermatological examination revealed diffuse erythema, adherent silvery scales and fissuring on both upper and lower lips, extending beyond the vermilion border (Fig. 1). The oral mucous membranes, palate and tongue appeared normal. Erythema and silvery scales were present also in the external portion of the ears (Fig. 2). She had characteristic psoriatic lesions on her elbows, knees and scalp. Routine laboratory tests were normal. Histopathologic examination of a biopsy taken from the lip revealed features of parakeratosis with neutrophils (Munro’s abscesses), psoriasiform acanthosis, and spongioform pustules. There was mild lymphocytic infiltrate noted in the upper dermis.