Dr. Walter Liszewski highlights his lecture From Mucosal Dermatology: Oral & Genital Cases at the 2nd Annual Elevate-Derm Alliance Summer Conference in Park City, Utah at the Grand Hyatt Deer Valley.

In this video

In conversation with dermatology PA Boochi Nita, Dr. Liszewski explains why mucosal disease so often falls through the cracks: dentists and ENT doctors don't want to manage oral lesions, urologists and OB physicians don't want to manage genital ones, and patients are left "suffering" with no one willing to "step up to the plate." Since disorders like pemphigus, bullous pemphigoid, and lichen planus frequently show prominent mucosal involvement alongside cutaneous disease, he argues dermatology should take ownership. He notes lichen planus can be a tough call — "almost any biopsy in the mouth is going to show a lichenoid reaction" — so symptoms like pain with crunchy, spicy, or acidic food help point toward the diagnosis.

On cheilitis, Dr. Liszewski counsels clinicians to be "at peace" with the fact that not every case can be cured, since it blends irritant and allergic drivers. His approach centers on a good barrier — Vaseline twice daily before eating and toothbrushing — plus non-steroidal topical anti-inflammatories, which he favors over steroids for a chronic process. For the genital exam, he urges making it a routine, appropriately offered part of the visit with a chaperone present, and explaining the medical rationale — noting that roughly 1 in 100 to 1 in 200 melanomas appear on genital skin and often present at advanced, potentially fatal stages, and that psoriasis, lichen planus, and vitiligo commonly involve the area.

  • Mucosal disease often has no owner across specialties — dermatology should take responsibility for oral and genital lesions rather than passing the buck.
  • Oral lichen planus is easy to over-call since most mouth biopsies show a lichenoid reaction; pain with crunchy, spicy, or acidic foods supports the diagnosis.
  • Not every cheilitis will be cured; rely on a barrier like Vaseline twice daily before eating and brushing, plus non-steroidal anti-inflammatories for a chronic process.
  • Offer the genital exam as a standard, medically appropriate part of the visit, with a chaperone, and name the specific reason — e.g., "examine the genital area for skin cancer."
  • About 1 in 100 to 1 in 200 melanomas occur on genital skin and present at advanced, sometimes fatal stages; asking permission opens the door to catching psoriasis, lichen planus, and vitiligo that would otherwise go untreated.