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.
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.
The term neurofibromatosis (NF) is used for a group of genetic disorders that primarily affect the cell growth of neural tissues. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen´s disease, is the most common type of NF and accounts for about 90% of all cases. It is one of the most frequent human genetic diseases, with a prevalence of one case in 3,000 births. The expressivity of NF1 is extremely variable, with manifestations ranging from mild lesions to several complications and functional impairment. Oral manifestations can be found in almost 72% of NF1 patients. A case of a NF1 patient with a gingival neurofibroma in the attached gingiva of the lingual aspect of the lower central incisors is presented. The lesion was nodular, with sessile base, non-ulcerated, non-painful, with normal colour and measured 1 cm in diameter. An excisional biopsy of the oral lesion was performed. Histopathological and immunohistochemical analysis confirmed the clinical hypothesis of neurofibroma. Because NF1 is one of the most common genetic diseases and oral manifestations are very common, dentists should be aware of the characteristics of this disease.
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