Tongue lesions in psoriasis: a controlled study

The oral mucosa was examined in 200 psoriatic patients presenting to Razi Hospital in Tehran, Iran, and 200 matched controls.Fissured tongue (FT) and benign migratory glossitis (BMG) were the two most frequent findings. FT was seen more frequently in psoriatic patients (n = 66, 33%) than the control group (n = 19, 9.5%) [odds ratio (OR): 4.69; 95% confidence interval (CI): 2.61–8.52] (p-value < 0.0001). BMG, too, was significantly more frequent in psoriatic patients (28 cases, 14%) than the control group (12 cases, 6%) (OR: 2.55; 95% CI: 1.20–5.50) (p-value < 0.012). In 11 patients (5.5%), FT and BMG coexisted.FT was more frequent in pustular psoriasis (7 cases, 53.8%) than erythemato-squamous types (56 cases, 30.4%). On the other hand, the frequency of BMG increased with the severity of psoriasis in plaque-type psoriasis assessed by psoriasis area and severity index (PASI) score.Nonspecific tongue lesions are frequently observed in psoriasis. Further studies are recommended to substantiate the clinical significance of these seemingly nonspecific findings in suspected psoriatic cases.The occurrence of psoriatic lesions on oral mucous membranes was a subject of controversy [1,2]. Some investigators stated that they do not occur [3]; others, have claimed that they are uncommon. Still others say that they occur only in generalized pustular psoriasis (GPP) [4,5]. Nowadays, there is sufficient evidence that a subset of patients have oral lesions in association with skin disease [2].Oppenheim, in 1903, was the first to substantiate oral psoriasis with biopsy [6]. Since then, various lesions have been described, including grey, yellowish, white or translucent plaques or annular forms, diffuse areas of erythema, geographic tongue and fissured tongue [7-16].In all the cases reported in the literature, a positive biopsy showing a psoriasiform pattern has been the crucial component of the diagnosis [5,17-20]. Thus hyperkeratosis, parakeratosis, and an inflammatory infiltrate c