Psoriasis is associated with fissured tongue but not geographic tongue: a prospective, cross‐sectional, case‐control study

Abstract

Summary 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.

Epidemiology of Psoriasis and Comorbid Diseases: A Narrative Review

“…The PASI score was statistically higher in patients affected by GT, and exhibited less improvement after treatment (204). However a prospective case-control study in an Austrian cohort found that psoriasis was associated with fissured tongue but not with GT (207), and the severity of the disease evaluated by the PASI scale did not influence mucosal involvement (208).…”

Aponeurosis linguae—Myocutaneous or myotendinous junctions of skeletal muscle fibres in the human tongue?

“…Different factors are associated with these two patterns (Dafar et al, 2016 ). The geographic tongue is characterized by the loss of filiform papillae and by habitual factors, for example chewing tobacco (Assimakopoulos et al, 2002 ; Dafar et al, 2016 ); the genesis of fissures is unknown, discussing genetic factors and systemic diseases (Dawson, 1974 ; Eidelman et al, 1976 ; Guggenheimer et al, 2000 ; Hamrah et al, 2021 ; Marcoval et al, 2012 ; Monshi et al, 2021 ). The papillae in fissured tongues are preserved and the tongue shows a higher accumulation of inflammatory cells (Kullaa‐Mikkonen & Sorvari, 1986 ).…”

Aktuelle Entwicklungen und Perspektiven bei Psoriasis

“…2 Seither erschienen in dieser Zeitschrift Publikationen zur Psoriasis in dreistelliger Zahl. In jüngster Zeit umspannen die Themen grundlegende pathophysiologische Aspekte, [3][4][5] therapeutische Ansätze, [6][7][8][9][10][11] epidemiologische Fragen, 12 diagnostische und klinische Entwicklungen, [13][14][15] psychosoziale Aspekte, [16][17][18] bis hin zu Versorgungsforschung und Registerstudien. [19][20][21][22] Empfehlungen zur praktischen Umsetzung neuer Erkenntnisse kulminieren schließlich in Leitlinien.…”