Geographic stomatitis: an oral manifestation of psoriasis?

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 stomatitis was 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. (J Dermatol Case Rep.

Oral Psoriasis: An Overlooked Enigma

“…Also, control of cutaneous disease often helps resolve symptomatic oral psoriasis, which may occur during a flare. Typical symptoms, when present, may include oral pain, burning or changes in taste perception [13,17,35]. Patients may also express concern about the malignant potential of lesions or the unaesthetic appearance of the affected visible mucosa [30,35].…”

“…A pertinent family history and positive HLA typing for either B13, B17, B37, Cw4, or Cw6 genes, often associated with psoriasis, are also considered strongly supportive of this diagnosis [3,8,11,12]. Isolated reports of oral lesions with characteristic histological changes, in the absence of skin psoriasis [3,9], may represent manifestations of psoriasis in patients in remission from prior cutaneous disease [4,9] or those with a positive family history [4,13,14]. In the absence of the aforementioned diagnostic criteria, suspect oral findings may be considered psoriasiform mucositis rather than oral psoriasis [12].…”

Relation Between Psoriasis and Geographic Tongue

“…Picciani B et al, [11] presented a case of geographic stomatitis in a 37-year-old female with a positive family history of psoriasis. The data indicate that geographic stomatitis may have been oral manifestation of psoriasis.…”

Orale Psoriasis: Ein unbeachtetes und rätselhaftes Phänomen

“…Zudem bewirkt die Beherrschung der kutanen Erkrankung häufig auch eine Besserung der Symptome der oralen Psoriasis, die im Rahmen eines Schubs auftreten kön-nen. Wenn Symptome vorhanden sind, sind es typischerweise Schmerzen und Brennen im Mund sowie ein verändertes Geschmacksempfinden [13,17,35]. Einige Patienten sind auch besorgt in Bezug auf das maligne Potenzial der Läsionen oder das unästhetische Erscheinungsbild der betroffenen sichtbaren Schleimhaut [30,35].…”