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Zisis V, Theodoridou A, Anagnostou E, Poulopoulos A, Andreadis D. An Unusual Case of Psoriatic Arthritis With Secondary Lingual Lesions, Resembling Geographic Tongue. Cureus 2024; 16:e63439. [PMID: 39077241 PMCID: PMC11284735 DOI: 10.7759/cureus.63439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2024] [Indexed: 07/31/2024] Open
Abstract
Psoriatic arthritis (PsA) is a chronic inflammatory condition that impacts a significant proportion of individuals diagnosed with psoriasis. This report presents a rare case of a patient diagnosed with PsA who never had active psoriatic skin lesions but only a family history of psoriasis, with secondary lingual lesions, resembling geographic tongue (GT). A male patient, 24 years old, was referred with two painless erythematous areas resembling (without whitish borders, as in GT) rounded atrophic lesions on the dorsal surface of the tongue, resistant to any kind of antimicrobial/antifungal treatment for more than six months. The patient was diagnosed with PsA two years ago fulfilling the CASPAR (ClASsification for Psoriatic ARthritis) criteria. The patient never had active psoriatic skin lesions, but his father had psoriasis. The biopsy of lingual lesions showed moderate hyperkeratosis, spongiosis, and diffuse inflammatory infiltration of lymphocytes and neutrophils in the lamina propria as well as in the stratified squamous epithelium forming Munro's microabscesses at the superficial layers. The manifestation of the atypical psoriasiform, GT-like lingual lesions was considered as part of psoriasis manifestations and the patient was advised to follow regular checkups so that any major exacerbation of the systematic symptoms could be preemptively avoided. Not only GT but also atypical lingual GT-like reddish oral lesions may be considered as transient forms of psoriasis supporting an early diagnosis and monitoring of psoriasis/PsA.
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Affiliation(s)
- Vasileios Zisis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | | | | | - Dimitrios Andreadis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
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2
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Altemir A, Melé-Ninot G, Lázaro-Simó A, Iglesias-Sancho M, Quintana-Codina M, Arandes J, Carrera-Morodo M, Salleras-Redonnet M. Manifestaciones orales en pacientes con psoriasis. Prevalencia y asociación con sus características clínicas y epidemiológicas. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:459-466. [DOI: 10.1016/j.ad.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/20/2021] [Accepted: 01/07/2022] [Indexed: 10/19/2022] Open
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3
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[Translated article] Oral Lesions in Patients With Psoriasis: Prevalence and Association With Its Clinical and Epidemiological Characteristics. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2022.01.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Monshi B, Grabovac S, Gulz L, Ellersdorfer C, Vujic M, Richter L, Kivaranovic D, Rappersberger K, Vujic I. Psoriasis ist mit Lingua plicata jedoch nicht mit Lingua geographica assoziiert: eine prospektive Fall‐Kontroll‐Studie. J Dtsch Dermatol Ges 2021; 19:1170-1177. [PMID: 34390146 DOI: 10.1111/ddg.14451_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Babak Monshi
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich
| | - Sofia Grabovac
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich
| | - Lilli Gulz
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich
| | - Christina Ellersdorfer
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich
| | - Marin Vujic
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich
| | - Leo Richter
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich
| | - Danijel Kivaranovic
- Institut für Statistik und Operations Research, Universität Wien, Österreich
| | - Klemens Rappersberger
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich.,Fakultät für Medizin, Sigmund Freud-Privatuniversität Wien, Österreich
| | - Igor Vujic
- Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Österreich.,Fakultät für Medizin, Sigmund Freud-Privatuniversität Wien, Österreich
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Monshi B, Grabovac S, Gulz L, Ellersdorfer C, Vujic M, Richter L, Kivaranovic D, Rappersberger K, Vujic I. Psoriasis is associated with fissured tongue but not geographic tongue: a prospective, cross-sectional, case-control study. J Dtsch Dermatol Ges 2021; 19:1170-1176. [PMID: 34114338 DOI: 10.1111/ddg.14451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES It has been postulated that psoriasis is associated with tongue lesions and geographic tongue might be "oral psoriasis". However, reports are inconclusive, prevalence rates vary and data for Europe are sparse. In this prospective case-control study we investigated the point-prevalence of tongue conditions in an Austrian cohort. PATIENTS AND METHODS Psoriasis patients and healthy volunteers were assessed regarding tongue and skin lesions, age, sex, smoking habits, allergies, onset of psoriasis, PASI scores and anti-psoriatic treatment. RESULTS We included 173 psoriasis patients, 58 women, 115 men (median age: 50 [37-60] years), and 173 volunteers, 79 women, 94 men (median age: 54 [43-64] years). Overall, 95 subjects had allergies, 64 psoriasis patients and 50 volunteers were smokers. Median age at onset of psoriasis was 26 (12-40) years, the median PASI score was 2 (0-4.1), most patients received ustekinumab (n = 47). Fissured tongue was significantly associated with psoriasis (25 [14.4 %] psoriasis patients, 13 [7.5 %] volunteers; P = 0.04). Geographic tongue was present in four individuals of each group (2.3%) and associated with smoking (P = 0.01) but not with psoriasis. CONCLUSIONS Overall, we found a low point-prevalence of tongue lesions in this Austrian cohort. Psoriasis was associated with fissured tongue but not with geographic tongue. Thus, we cannot corroborate the hypothesis that geographic tongue is an oral manifestation of psoriasis.
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Affiliation(s)
- Babak Monshi
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria
| | - Sofia Grabovac
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria
| | - Lilli Gulz
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria
| | - Christina Ellersdorfer
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria
| | - Marin Vujic
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria
| | - Leo Richter
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria
| | - Danijel Kivaranovic
- Department of Statistics and Operations Research, University of Vienna, Vienna, Austria
| | - Klemens Rappersberger
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria.,Sigmund Freud University Vienna, School of Medicine, Vienna, Austria
| | - Igor Vujic
- Department of Dermatology, Venereology and Allergology, Teaching Hospital of the Medical University Vienna, Vienna, Austria.,Sigmund Freud University Vienna, School of Medicine, Vienna, Austria
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Rodriguez-Archilla A, El-Ouastani S. Possible association between benign migratory glossitis and fissured tongue with psoriasis: A meta-analysis. DENTISTRY AND MEDICAL RESEARCH 2021. [DOI: 10.4103/dmr.dmr_51_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Picciani BLS, Santos LR, Teixeira-Souza T, Dick TNA, Carneiro S, Pinto JMN, Avelleira JCR, Azulay DR, Luiz RR, de Sousa Gonzaga HF. Geographic tongue severity index: A new and clinical scoring system. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:330-338. [PMID: 31974034 DOI: 10.1016/j.oooo.2019.12.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 11/03/2019] [Accepted: 12/18/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study was designed to develop a severity index for geographic tongue (GT) based on the Psoriasis Area and Severity Index. STUDY DESIGN This cross-sectional observational study, with a retrospective sample of 100 participants, included 5 photographs of each case (dorsum, right border, left border, apex, and lingual belly), totaling 500 images of GT, which were evaluated by 3 experienced researchers in the area of GT and psoriasis. At the end of the analysis, GT was classified as mild, moderate, or severe. RESULTS Of the 100 patients, white women were most prevalent, accounting for 53% of cases. Of these participants, 34% had psoriasis and 24% reported a burning sensation. The values of the proposed new index obtained at time 1 (0.855) and time 2 (0.819) presented low variability, and intra- and interrater correlations produced satisfactory values ranging from 0.950 to 0.898 and 0.898 to 0.850, respectively. CONCLUSION The new index, Geographic Tongue Area and Severity Index, provides a better characterization of GT by assessing the severity of lesions in an easy and reliable manner, and it is indicated as a first step for interpreting the condition in clinical routines and clinical trials.
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Affiliation(s)
| | - Lílian Rocha Santos
- Graduate Program in Pathology, School of Medicine, Fluminense Federal University, Niterói, RJ, Brazil
| | - Thays Teixeira-Souza
- Graduate Program in Pathology, School of Medicine, Fluminense Federal University, Niterói, RJ, Brazil
| | - Thaylla Núñez Amin Dick
- Graduate Program in Pathology, School of Medicine, Fluminense Federal University, Niterói, RJ, Brazil
| | - Sueli Carneiro
- Sector of Dermatology, Medical Clinic Department, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
| | | | | | - David Rubem Azulay
- Institute of Dermatology, Santa Casa da Misericórdia, Rio de Janeiro, RJ, Brazil
| | - Ronir Raggio Luiz
- Institute of Public Health Studies, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
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8
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Ogueta I, Ramírez M, Jiménez C, Cifuentes M. Geographic Tongue: What a Dermatologist Should Know. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2019.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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9
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Ogueta C I, Ramírez P M, Jiménez O C, Cifuentes M M. Geographic Tongue: What a Dermatologist Should Know. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:341-346. [PMID: 31005233 DOI: 10.1016/j.ad.2018.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/19/2018] [Accepted: 10/28/2018] [Indexed: 11/19/2022] Open
Abstract
Geographic tongue, also known as benign migratory glossitis, is a benign chronic inflammatory condition of the tongue. It is characterized by erythematous lesions with filiform papillae atrophy, surrounded by white limited areas in the dorsal and lateral aspects of the tongue, producing a map-like aspect. This lesions change in size and shape with time, and are characterized by periods of exacerbation and remission without scaring. The cause is unknown, but multiple associations have been described, which will be discussed below.
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Affiliation(s)
- I Ogueta C
- Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
| | - M Ramírez P
- Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - C Jiménez O
- Escuela de Medicina, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - M Cifuentes M
- Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
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Jorge MA, Gonzaga HFDS, Tomimori J, Picciani BLS, Barbosa CA. Prevalence and heritability of psoriasis and benign migratory glossitis in one Brazilian population. An Bras Dermatol 2018; 92:816-819. [PMID: 29364438 PMCID: PMC5786396 DOI: 10.1590/abd1806-4841.20176389] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 03/25/2017] [Indexed: 01/21/2023] Open
Abstract
Background An oral condition associated to psoriasis is benign migratory glossitis. The
review of the literature does not show any publication about heritability in
both soriasis and benign migratory glossitis and prevalence of psoriasis in
the Brazilian population. Objective This research was carried out in order to determine the prevalence of
psoriasis and benign migratory glossitis in the Brazilian population from a
Brazilian sample, as well as the heritability in these conditions. Methods Six thousand patients were studied from the records of the outpatient
dermatology department. The sample had 129 patients with cutaneous
psoriasis, 399 with benign migratory glossitis without psoriasis and a
control group with 5,472 patients. After data collection, the statistical
analysis was made using Woolf, Chi-square and Falconer tests. Results The prevalence of psoriasis was 2.15% and the benign migratory glossitis was
7.0%. The prevalence of benign migratory glossitis in the psoriasis group
was high (16.3%), and that was statistically significant. Family history in
the psoriasis group was 38% for the condition itself and 2,75% for benign
migratory glossitis and in the benign migratory glossitis group was 17.54%
for the condition itself and 1.5% for psoriasis. The study of heritability
was 38.8% for psoriasis and 36.6% for benign migratory glossitis, both with
medium heritability. Study limitations This study was only in the state of São Paulo. Conclusion This is the first publication that quantifies how much of these conditions
have a genetic background and how important the environmental factors are in
triggering them.
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Affiliation(s)
- Maria Augusta Jorge
- Research Center, Centro de Ensino Superior de Dracena (CESD) - Dracena, SP, Brazil
| | | | - Jane Tomimori
- Department of Dermatology, Universidade Federal de São Paulo (Unifesp) - São Paulo (SP), Brazil
| | | | - Calógeras Antônio Barbosa
- Department of Genetics and Evolution, Faculty of Health Sciences, Universidade Federal de São Carlos (UFSCar) - São Carlos (SP), Brazil
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Picciani BLS, Teixeira-Souza T, Pessôa TM, Izahias LMS, Pinto JMN, Azulay DR, Avelleira JCR, Carneiro S, Dias EP. Fissured tongue in patients with psoriasis. J Am Acad Dermatol 2018; 78:413-414. [PMID: 29332713 DOI: 10.1016/j.jaad.2017.08.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 07/30/2017] [Accepted: 08/08/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | - Thays Teixeira-Souza
- Postgraduate Program in Pathology, School of Medicine, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Thiago Moreira Pessôa
- Postgraduate Program in Pathology, School of Medicine, Fluminense Federal University, Rio de Janeiro, Brazil
| | - Lívia Maria Santos Izahias
- Postgraduate Program in Pathology, School of Medicine, Fluminense Federal University, Rio de Janeiro, Brazil
| | | | - David Rubem Azulay
- Institute of Dermatology Rubem David Azulay, Santa Casa da Misericórdia, Rio de Janeiro, Brazil
| | | | - Sueli Carneiro
- Sector of Dermatology, Medical Clinic Department, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | - Eliane Pedra Dias
- Postgraduate Program in Pathology, School of Medicine, Fluminense Federal University, Rio de Janeiro, Brazil
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Digestive system in psoriasis: an update. Arch Dermatol Res 2017; 309:679-693. [PMID: 28905102 PMCID: PMC5648743 DOI: 10.1007/s00403-017-1775-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 08/21/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023]
Abstract
Psoriasis is a chronic inflammatory immune-mediated disorder associated and often coexisting with many other immune-related clinical conditions including those affecting the gastrointestinal tract. Data obtained from the reviewed literature suggest an association between psoriasis and pathologies of the oral cavity, both psoriasis-specific lesions, as well as non-specific, such as geographic tongue or fissured tongue. These findings show the importance of thorough examination of oral mucosa in psoriatic patients. Inflammatory bowel diseases (IBD) are also linked with psoriasis. Crohn’s disease and ulcerative colitis share a common genetic background, inflammatory pathways and have an evident iatrogenic anti-TNF treatment link, necessitating dermatological or gastroenterological care in patients with IBD or psoriasis, respectively, as well as treatment adjusted to manifestations. The presence of celiac disease-specific antibodies in psoriatic patients and their correlation with the severity of the disease show the association between these disorders. The linking pathogenesis comprises vitamin D deficiency, immune pathway, genetic background and increase in the intestinal permeability, which suggests a potential benefit from gluten-free diet among psoriatic patients. The link between psoriasis and non-alcoholic fatty liver disease implies screening patients for components of metabolic syndrome and lifestyle changes necessity. Some studies indicate increased prevalence of cancer in patients with psoriasis, probably due to negative influence of skin lesion impact on lifestyle rather than the role of psoriasis in carcinogenesis. However, there are no sufficient data to exclude such an oncogenic hit, which is yet to be confirmed. Therefore, all psoriasis-associated comorbidities establish the importance of a multidisciplinary approach in the treatment of these patients.
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Picciani BLS, Domingos TA, Teixeira-Souza T, Santos VDCBD, Gonzaga HFDS, Cardoso-Oliveira J, Gripp AC, Dias EP, Carneiro S. Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review. An Bras Dermatol 2017; 91:410-21. [PMID: 27579734 PMCID: PMC4999097 DOI: 10.1590/abd1806-4841.20164288] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 05/26/2015] [Indexed: 02/08/2023] Open
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.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sueli Carneiro
- Universidade do Estado do Rio de Janeiro (UERJ) - Rio de Janeiro (RJ), Brazil
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Picciani B, Santos VDC, Teixeira-Souza T, Izahias LM, Curty Á, Avelleira JC, Azulay D, Pinto J, Carneiro S, Dias E. Investigation of the clinical features of geographic tongue: unveiling its relationship with oral psoriasis. Int J Dermatol 2017; 56:421-427. [DOI: 10.1111/ijd.13460] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 07/21/2016] [Accepted: 08/22/2016] [Indexed: 12/21/2022]
Affiliation(s)
- Bruna Picciani
- Postgraduate Program in Pathology; School of Medicine; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - Vanessa de Carla Santos
- Postgraduate Program in Pathology; School of Medicine; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - Thays Teixeira-Souza
- Postgraduate Program in Pathology; School of Medicine; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - Lívia Maria Izahias
- Postgraduate Program in Pathology; School of Medicine; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - Áquila Curty
- Postgraduate Program in Pathology; School of Medicine; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - João Carlos Avelleira
- Institute of Dermatology Rubem David Azulay; Santa Casa da Misericórdia; Niterói Rio de Janeiro Brazil
| | - David Azulay
- Institute of Dermatology Rubem David Azulay; Santa Casa da Misericórdia; Niterói Rio de Janeiro Brazil
| | - Jane Pinto
- Department of Dermatology; Fluminense Federal University; Niterói Rio de Janeiro Brazil
| | - Sueli Carneiro
- Sector of Dermatology; Medical Clinic Department; Rio de Janeiro Federal University; Rio de Janeiro Rio de Janeiro Brazil
| | - Eliane Dias
- Postgraduate Program in Pathology; School of Medicine; Fluminense Federal University; Niterói Rio de Janeiro Brazil
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15
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Picciani BLS, Teixeira-Souza T, Curty &AA, Izahias LMS, Pessoa TM, Carneiro S, Gonzaga HFS, Dias EP. Unraveling oral psoriasis and its relationship with geographic tongue: A literature review. World J Dermatol 2016; 5:84-92. [DOI: 10.5314/wjd.v5.i2.84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 12/23/2015] [Accepted: 02/16/2016] [Indexed: 02/06/2023] Open
Abstract
Differentiating between oral psoriasis and geographic tongue is difficult and controversial because some patients with geographic tongue do not necessarily have psoriasis. Furthermore, the number of clinical studies, reporting histopathological and genetic evidence for the definitive diagnosis of oral psoriasis, is limited. The aim of this literature review was to obtain data for supporting the diagnosis of oral psoriasis with particular emphasis on the relationship between psoriasis and geographic tongue. Based on the current data, it can be concluded that geographic tongue is the most common oral lesion in psoriasis, and histopathological, immunohistochemical, and genetic similarities have been observed between the two diseases. This review also emphasizes the importance of conducting oral examinations in patients with psoriasis and skin examinations in patients with geographic tongue.
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16
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Mattsson U, Warfvinge G, Jontell M. Oral psoriasis-a diagnostic dilemma: a report of two cases and a review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:e183-9. [PMID: 25944682 DOI: 10.1016/j.oooo.2015.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 03/08/2015] [Accepted: 03/12/2015] [Indexed: 12/29/2022]
Abstract
Whether psoriasis can manifest itself in the oral mucosa has been a matter of debate for many years. If an oral version of psoriasis exists, most researchers regard this manifestation as rare. The present report describes two patients who presented with lesions possibly related to cutaneous psoriasis. One patient had patchy erythematous lesions on the gingiva, and one had serpiginous lesions in the hard palate. We discuss these cases in relation to the existing literature, with special emphasis on the clinical and histopathologic criteria for the diagnosis of oral psoriasis.
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Affiliation(s)
- U Mattsson
- Associate Professor, Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - G Warfvinge
- Professor, Department of Oral Pathology, Faculty of Odontology, Malmö University, Sweden
| | - M Jontell
- Professor, Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Sweden
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17
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Cunha KS, Rozza-de-Menezes RE, Luna EB, Almeida LMDS, Pontes RRLDA, Almeida PN, de Aguiar LV, Dias EP. High prevalence of hyposalivation in individuals with neurofibromatosis 1: a case-control study. Orphanet J Rare Dis 2015; 10:24. [PMID: 25759173 PMCID: PMC4351927 DOI: 10.1186/s13023-015-0239-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 02/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neurofibromatosis type 1 (NF1) is one of the most common genetic diseases in humans and has widely variable expressivity. Oral manifestations are common, but there are no studies that investigated functional alterations in salivary glands in NF1. Our aim was to evaluate the salivary flow rate in NF1 individuals, comparing to a control group, and to investigate the possible causes and some consequences of salivary gland alteration. METHODS This is a case-control study that evaluated the salivary flow rate of NF1 individuals (n = 49) and compared to an age and sex-matched control group. We have also investigated the possible causes and consequences of hyposalivation in NF1 individuals through anamnesis, a specific questionnaire, physical examination, tongue coating evaluation and cytopathological exam to assess the prevalence of oral candidiasis. RESULTS Hyposalivation at rest was present in 59% (29/49) of NF1 individuals in contrast to 22% (11/49) in the control group, being statistically significant (P <0.0001; Wilcoxon rank-sum test). The analysis of the adjusted residual showed that the prevalence of hyposalivation in NF1 individuals (46.9%) was 4-fold higher than in controls (10.2%). None of the possible causes of hyposalivation (medications, low liquid intake, caffeinated or stimulant drink use, mouth breathers, alcohol, smoke and plexiform neurofibroma close to or involving major salivary glands areas) had important impact on the salivary flow rate in NF1 individuals. CONCLUSIONS Hyposalivation may be a consequence of NF1, as occurs in other genetic diseases. More studies are necessary to understand if there is and what is the relationship between NF1 and hyposalivation.
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Affiliation(s)
- Karin Soares Cunha
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | - Rafaela Elvira Rozza-de-Menezes
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | - Eloá Borges Luna
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | - Lilian Machado de Sousa Almeida
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | | | - Paula Nascimento Almeida
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
- />Neurofibromatosis National Center (Centro Nacional de Neurofibromatose), Rio de Janeiro, RJ Brazil
| | | | - Eliane Pedra Dias
- />Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
- />Department of Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, RJ Brazil
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Geographic tongue and fissured tongue in 348 patients with psoriasis: correlation with disease severity. ScientificWorldJournal 2015; 2015:564326. [PMID: 25685842 PMCID: PMC4320844 DOI: 10.1155/2015/564326] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 12/23/2014] [Accepted: 12/27/2014] [Indexed: 02/08/2023] Open
Abstract
Geographic tongue (GT) and fissured tongue (FT) are the more frequent oral lesions in patients with psoriasis. The aims of this study were to compare the prevalence of GT/FT between psoriasis group (PG) and healthy controls (HC) and investigate the correlation between GT/FT and psoriasis severity using the PASI and age of psoriasis onset. Three hundred and forty-eight PG and 348 HC were selected. According to the age of psoriasis onset, the individuals were classified as having early psoriasis and late psoriasis. The severity of vulgaris psoriasis was determined according to PASI. A follow-up was conducted in patients with psoriasis vulgaris (PV) with GT to evaluate the progression of oral and cutaneous lesions. The FT and GT were more frequent in PG than in HC. The incidence of GT was higher in patients with early psoriasis and that of FT in late-psoriasis. There is association between psoriasis intensity and GT; and a higher monthly decrease of PASI score in patients without GT. The presence of GT and FT is higher in PG than in the HC. GT is associated with disease severity and may be a marker of the psoriasis severity.
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Picciani BLS, Carneiro S, Sampaio ALB, Santos BM, Santos VCB, Gonzaga HFS, Oliveira JC, Porto LC, Dias EP. A possible relationship of human leucocyte antigens with psoriasis vulgaris and geographic tongue. J Eur Acad Dermatol Venereol 2014; 29:865-74. [PMID: 25176018 DOI: 10.1111/jdv.12691] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 07/27/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Geographic tongue (GT) is the most frequent oral lesion in psoriatic patients (PP), and genetic involvement in these conditions has been described. The association of psoriasis with GT is still not clear, and the study of human leucocyte antigen (HLA) may help clarify this relation. OBJECTIVE The aim of this study was to investigate the association of HLA alleles with psoriasis vulgaris and GT. METHODS Fifty-eight Brazilian PP, 29 GT patients and 125 healthy controls individuals were selected. Information on demographic and clinical characteristics was collected. All patients underwent an oral examination and blood collection for HLA typing. RESULTS HLA-A did not show significant differences in frequencies among the groups. HLA-B*57 allele was more frequently found in PP and was not found in GT. HLA-B*58 allele was more frequently found in GT. HLA-C*06 and -C*18 alleles were associated with psoriasis. No significant differences in HLA-DRB1 and HLA-DQB1 were observed. CONCLUSION HLA-B*58 was associated with GT and HLA-B*57 was possibly associated with psoriasis. This suggested that some GT cases may represent true oral psoriasis and some may represent only GT. Therefore, it is necessary to make this distinction and increase our sample size to improve the correct diagnosis and treatment of these conditions.
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Affiliation(s)
- B L S Picciani
- Department of Pathology, Universidade Federal Fluminense, Rio de Janeiro, Brazil
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Gonzaga HFS, Chaves MD, Gonzaga LHS, Picciani BLS, Jorge MA, Dias EP, Tomimori J. Environmental factors in benign migratory glossitis and psoriasis: retrospective study of the association of emotional stress and alcohol and tobacco consumption with benign migratory glossitis and cutaneous psoriasis. J Eur Acad Dermatol Venereol 2014; 29:533-6. [PMID: 25073550 DOI: 10.1111/jdv.12616] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 05/26/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND The association between benign migratory glossitis (BMG) and psoriasis (PS) has been reported in the literature. OBJECTIVE This study aimed to determinate the environmental factors related to BMG and PS and to investigate their interactions. METHODS The study population included 129 patients with PS, 399 patients with BMG and a control group (CG) of 5472 individuals with neither PS nor BMG. The environmental factors evaluated in this study included alcohol and tobacco consumption and emotional stress. The Pearson's chi-squared test was used for analysing the association of the environmental factors with PS and BMG. RESULTS The prevalence of alcohol consumption in the PS group was significantly higher than that in the CG. Tobacco consumption had a weak negative association with the BMG group. With respect to the PS group, no statistically significant association was observed. Emotional stress was the most important factor in the two study groups. Emotional stress and alcohol use together presented a higher incidence in the study groups than in the CG. Emotional stress and tobacco consumption together had a three times higher incidence in the PS group than in the BMG group. The association of emotional stress, alcohol and tobacco consumption in the PS group was four times higher than that in the CG. LIMITATIONS This study was limited by the lack of the information about frequency, type and length time of use of tobacco and alcohol, and by difficult to measure stress thought self-report questionnaire. CONCLUSION The interactions between PS and environmental factors differ from those between BMG and environmental factors. These differences among interactions may be responsible for different forms of manifestations of these diseases, considering being both the same disease.
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Affiliation(s)
- H F S Gonzaga
- Discipline of Dermatology, Medical School, University of Marília (UNIMAR), Marília, SP, Brazil; Beneficent Association of the University Hospital of Unimar (ABHU), Marília, São Paulo, Brazil
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D'Erme AM, Agnoletti AF, Prignano F. Fissured tongue responding to biologics during the treatment of psoriasis: the importance of detecting oral involvement of psoriasis. Dermatol Ther 2013; 26:364-6. [DOI: 10.1111/dth.12000] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Angelo Massimiliano D'Erme
- Division of Dermatology, Department of Surgery and Translational Medicine; University of Florence; Florence; Italy
| | | | - Francesca Prignano
- Division of Dermatology, Department of Surgery and Translational Medicine; University of Florence; Florence; Italy
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Picciani B, Silva-Junior G, Carneiro S, Sampaio AL, Goldemberg DC, Oliveira J, Porto LC, Dias EP. Geographic stomatitis: an oral manifestation of psoriasis? J Dermatol Case Rep 2013; 6:113-6. [PMID: 23329990 DOI: 10.3315/jdcr.2012.1118] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 10/21/2012] [Indexed: 01/02/2023]
Abstract
BACKGROUND Geographic stomatitis is an uncommon oral lesion that presents similar clinical, histopathological and genetic features as those of psoriasis. These findings suggest that this lesion may actually represent an oral manifestation of psoriasis. We report one case of geographic stomatitis and discuss a possible connection between this condition and psoriasis. MAIN OBSERVATIONS A 37-year-old woman presented with red patches, surrounded by a white border on the labial mucosa and a positive family history of psoriasis. Histopathological examination, immunohistochemical analysis with antibodies against CD4, CD8, CD20, CD68, CD31, and Ki-67 and HLA-A*, -B*, -C*, -DRB1*, -DQA1* and -DQB1* genotyping were performed. Histopathological examination revealed parakeratosis, marked elongation of rete ridges with acanthosis and clubbing, exocytosis, Munro microabscesses, pustule of Kogoj, dilated tortuous vessels at the tip of dermal papillae, and predominant superficial and perivascular lymphocytic chronic inflammatory cell infiltrate. Immunohistochemistry analysis revealed a predominant T-cell subepithelial infiltrate. Based on the referred clinicopathological findings and in the absence of cutaneous lesions, the diagnosis of geographic stomatitiswas confirmed. CONCLUSIONS This case and theoretical data indicate that geographic stomatitis may be an oral manifestation of psoriasis. Moreover, to improve our understanding, psoriatic patients should routinely undergo a detailed oral examination and patients with geographic stomatitis should routinely be submitted to a cutaneous routine examination.
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Affiliation(s)
- Bruna Picciani
- Department of Pathology, Fluminense Federal University, Rio de Janeiro, Brazil
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Gupta SR, Batra V, Chaudhry Z, Sethi R. An unusual vesiculopustular and vegetative lesion on the lips. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 116:666-72. [PMID: 22901647 DOI: 10.1016/j.oooo.2012.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 04/02/2012] [Accepted: 04/17/2012] [Indexed: 12/01/2022]
Affiliation(s)
- Shalini R Gupta
- Oral Medicine and Radiology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
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