Evaluation of the Th17 pathway in psoriasis and geographic tongue

Abstract Background: Psoriasis is a skin-articular disease with unclear etiopathogenesis. It has been suggested that the disease is immune-mediated by T-lymphocytes, predominantly Th17 cells. Similar to psoriasis, geographic tongue is an inflammatory disease with participation of Th17 cells and direct correlation with psoriasis. Objective: To investigate and compare the inflammatory responses and the Th17 pathway in psoriasis and geographic tongue. Methods: This was a cross-sectional study with 46 participants that were categorized into three groups: (A) patients with psoriasis vulgaris; (B) patients with geographic tongue and psoriasis; (C) patients with geographic tongue without psoriasis. All patients underwent physical examination, and a skin and oral biopsy for histopathological examination and immunohistochemical analysis with anti-IL6, anti-IL17, and anti-IL23 antibodies. Results: Histological analysis of all lesions showed mononuclear inflammatory infiltrate. However, moderate intensity was prevalent for the patients with geographic tongue and psoriasis and geographic tongue groups. Immunopositivity for the antibodies anti-IL6, anti-IL17, and anti-IL23 revealed cytoplasmic staining, mainly basal and parabasal, in both psoriasis and geographic tongue. Regarding IL-6, in patients with geographic tongue and psoriasis cases the staining was stronger than in patients with geographic tongue without psoriasis cases. IL-17 evidenced more pronounced and extensive staining when compared to the other analyzed interleukins. IL-23 presented similar immunopositivity for both geographic tongue and psoriasis, demonstrating that the neutrophils recruited into the epithelium were stained. Study limitation: This study was limited by the number of cases. Conclusion: The inflammatory process and immunostaining of IL-6, IL-17, and IL-23 were similar in geographic tongue and psoriasis, suggesting the existence of a type of geographic tongue that represents an oral manifestation of psoriasis.

Geographic stomatitis with palate involvement

Abstract: Benign migratory glossitis or geographic tongue is a benign condition that usually manifests as asymptomatic erythematous and migratory circinate patches, involving the lateral and dorsal aspects of the tongue. Extra-lingual lesions uncommonly occur and are mainly located on labial and buccal mucosae, lips and floor of the mouth. The present report describes one patient with a geographic lesion on the hard palate associated with lingual lesions and another patient who had multiple geographic lesions both in the hard and soft palate without lingual lesions. We found 64 cases in the English literature of ectopic locations with 22 palate involvement. No case of simultaneous involvement of the hard and the soft palate was found.

Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review

Abstract: Geographic tongue is a chronic, inflammatory, and immune-mediated oral lesion of unknown etiology. It is characterized by serpiginous white areas around the atrophic mucosa, which alternation between activity, remission and reactivation at various locations gave the names benign migratory glossitis and wandering rash of the tongue. Psoriasis is a chronic inflammatory disease with frequent cutaneous involvement and an immunogenetic basis of great importance in clinical practice. The association between geographic tongue and psoriasis has been demonstrated in various studies, based on observation of its fundamental lesions, microscopic similarity between the two conditions and the presence of a common genetic marker, human leukocyte antigen (HLA) HLA-C*06. The difficulty however in accepting the diagnosis of geographic tongue as oral psoriasis is the fact that not all patients with geographic tongue present psoriasis. Some authors believe that the prevalence of geographic tongue would be much greater if psoriatic patients underwent thorough oral examination. This study aimed to develop a literature review performed between 1980 and 2014, in which consultation of theses, dissertations and selected scientific articles were conducted through search in Scielo and Bireme databases, from Medline and Lilacs sources, relating the common characteristics between geographic tongue and psoriasis. We observed that the frequency of oral lesions is relatively common, but to establish a correct diagnosis of oral psoriasis, immunohistochemical and genetic histopathological analyzes are necessary, thus highlighting the importance of oral examination in psoriatic patients and cutaneous examination in patients with geographic tongue.

Psoríase e suas manifestações bucais / Psoriasis and its oral manifestations

O presente estudo teve por objetivo investigar a rela‡Æo entre psor¡ase e algumas manifesta‡ães bucais consideradas comuns, principalmente a l¡ngua geogr fica. Foi realizado um estudo epidemiol¢gico, caracterizado como uma pesquisa transversal observacional anal¡tica. Foram examinados clinicamente 39 pacientes, subdivididos em dois grupos, sendo os portadores de l¡ngua geogr fica (Grupo 1) e psor¡ase (Grupo 2). Os resultados foram analisados por meio de an lise estat¡stica descritiva. A partir da amostra analisada, p“de-se concluir que uma rela‡Æo entre a l¡ngua geogr fica e o aparecimento da psor¡ase ‚ incerta. Por outro lado, observou-se que a prevalˆncia da l¡ngua geogr fica em pacientes com psor¡ase foi consideravelmente maior que numa popula‡Æo normal

This epidemiological study has investigated the association of psoriasis to common oral conditions, especially geographic tongue. Thirty-nine patients were examined in this crosssectional analytical observational research. The patients were divided into two groups: patients presenting geographic tongue (Group 1) and patients affected by psoriasis (Group 2). The results were analyzed using descriptive statistics. An unclear association between geographic tongue and the occurrence of psoriasis was observed in this study. However, the prevalence of geographic tongue in patients with psoriasis was significantly higher than its frequency in a normal population

Relação entre língua geográfica e psoríase / Geographic tongue and psoriasis relationship

A língua geográfica ou eritema migratório benigno é uma alteração, na maioria das vezes, assintomática que requer tratamento exclusivamente quando há sensação de queimação ou ardência da língua. Por outro lado, a psoríase, que é uma doença crônica tipicamente cutânea, raramente apresenta manifestação intrabucal. Esta tem sido associada ao eritema migratório benigno da língua, pois as características estomatológicas da psoríase são semelhantes às demonstradas pela língua geográfica. Desta forma, este artigo apresenta as manifestações bucais de ambas, enfatizando junto aos profissionais da área médica (dermatologistas) e odontológica (estomatologistas) a importância do exame bucal nos pacientes psoriáticos e do exame cutâneo nos pacientes com língua geográfica

Patología blanca de la mucosa oral / White lesions of the oral mucosa

La patología blanca de la mucosa oral comprende una constelación de enfermedades cuyos cuadros clínicos se asemejan mucho entre sí y se caracterizan por la presentación de una lesión de aspecto blanquesino en la cavidad bucal. Con el fin de remarcar las diferencias entre cada afección, sus diversas evoluciones y pronósticos y alertar sobre aquellas con tendencia cancerígena y pronóstico más ominoso es que se realiza este trabajo. Es también nuestro interés señalar que no debemos olvidar a la cavidad bucal en el examen dermatológico de rutina

Alteraçöes dos tecidos moles da boca. Parte 2: lesöes brancas e vermelho-azuis / Alterations of bucal soft tissues. Part 2: white and red-blue lesions

Os autores dao continuidade ao desenvolvimento do tema Alteraçoes dos tecidos moles da boca, fornecendo informaçoes sobre as principais lesoes brancas e vermelho-azuis.