Stress associated to geographic tongue transformation from passive to active during the Covid-19 pandemic: case report

Abstract

Objective: Report a case of passive geographic tongue that became active due to the presence of severe stress associated to the coronavirus disease 2019 (COVID-19) pandemic. Case details: In January 2019, a 42-years-old Caucasian female was included in a survey on geographic tongue (GT). At that time, although she reported having the condition, on intraoral examination, no atrophic areas or whitish margins were observed on her tongue (classic clinical signs of GT). In November 2020, she was contacted again and reported changes in her GT. At this time, the lateral borders of her tongue presented erythematous areas surrounded by whitish margins. The research participant also reported that she was under severe stress due to the pandemic. Final considerations: This case reported has demonstrated consistency with literature data regarding the onset, worsening of symptoms and changes in clinical aspects of geographic tongue associated with emotional and psychological factors. To ensure that changes in clinical aspects of GT may be related to pandemic stress, further research of oral manifestations of COVID-19 is needed.

Stress as worsening of the signs and symptoms of the geographic tongue during the COVID-19 pandemic: a pilot study

“…Recent studies have demonstrated the association of GT to the presence of anxiety, stress, and depression [ 20 , 38 ], corroborating the results of this study, where stress was statistically related to the worsening of the symptoms of geographic tongue. Furthermore, it was observed that younger patients were more susceptible to stress and, consequently, developed exacerbation or worsening of their symptoms.…”

“…It continues to be doubtful whether or not signs and symptoms are manifestations of the disease or arise because of the lack of immune response [ 47 ]. The oral manifestations associated with COVID-19 are real, therefore the intraoral examination is important to be performed in all patients with COVID-19 [ 38 , 48 ].…”

“…Although its etiology remains unknown, studies show that genetic factors, allergies, vitamin deficiency, psoriasis, stress, and depression may be associated with GT [ 16 , 21 ]. Furthermore, some studies demonstrate oral lesions in patients during the COVID-19 pandemic [ 33 , 37 , 38 ]. Based on this, this study’s scientific question is: was there an exacerbation of GT signs and symptoms caused by the pandemic stress or by COVID-19?…”