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.

Determinants of geographic tongue in patients with asthma

The study was conducted on 72 patients with asthma who attended the Asthma follow-up Clinic in King Abdel-Aziz University Hospital during one month. Diagnosis of bronchial asthma was confirmed through medical history, nature of the episodic attacks, complaints during attacks, chest X-ray, and lung function measurements before and after salbutamol inhalation. Total IgE level was determined for all patients. Detailed personal and clinical information were obtained on each patient. The presence of geographic tongue was checked through intraoral examination. The study showed high prevalence of geographic tongue [18%] among the asthmatic patients. Geographic tongue lesions were encountered more frequently among young patients, with no sex predilection. There was no significant tendency of occurrence of geographic tongue in patients with raised IgE levels, nor in those with known allergic disorders. Of interest, was the finding that geographic tongue was exclusively detected in patients with mild and episodic asthma, while no tongue lesions were detected in those with severe and chronic asthma