Investigation of oral atopic diseases: Correlation between geographic tongue and fungiform papillary glossitis.

INTRODUCTION: The correlation between oral lesions and atopy is not new, but few studies have investigated the prevalence of mucosal changes in diseases within the atopic spectrum, leading to conflicting data. Some studies found a possible relationship between geographic tongue, transient lingual papillitis and atopic diseases. AIM: To investigate the frequency of geographic tongue and fungiform papillary glossitis in patients with atopic diseases, and its correlation with serum IgE levels and skin test results. MATERIAL AND METHODS: The sample was comprised of participants with atopic diseases paired with participants who received negative puncture skin tests. All were submitted to stomatological and medical evaluations, prick test and oral cytopathological. RESULTS: The female sex was more numerous in both groups. Mean age was 21 years. A total of 60 diagnoses of atopic diseases were obtained, with allergic rhinitis being the most prevalent. Fungiform papillary glossitis was the most frequent oral lesion in both groups, while geographic tongue was present in 2 cases (2%) in the test group and 2 (2%) in the control group. Atopic patients with fungiform papillary glossitis presented high serum IgE levels. In atopic patients with geographic tongue, the prick test positively identified extracts of Dermatophagoides pteronyssinus (100%) and Dermatophagoides farinae (100%). CONCLUSION: Due to the low frequency of geographic tongue lesions found in the study, it is no possible to conclude if that could be an oral manifestation of atopy. However fungiform papillary glossitis is a common alteration in atopic and non-atopic patients and has a relationship with high IgE serum levels. However, the consolidation of this result requires a larger sample size.

Geographic tongue and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review.

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 and psoriasis: clinical, histopathological, immunohistochemical and genetic correlation - a literature review

Abstract: 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.

Predisposition of allergy in patients with benign migratory glossitis.

OBJECTIVE: The purpose of this study was to investigate the presence of allergy in patients with benign migratory glossitis (BMG) using patch and prick tests. PATIENTS AND METHODS: Eighty patients (40 BMG and 40 healthy controls) received patch and prick tests. If at least one test result was positive, patients were considered to be allergic. RESULTS: The prick test was positive in 10 patients (25.0%) of the study group and in 4 patients (10.0%) of the control group. The patch test was positive in 12 patients (30.0%) of the study group and in 6 patients (15.0%) of the control group. When results of both tests were evaluated together, the study group showed a positive rate of 47.5% (n = 19), whereas the control group showed a positive rate of 22.5% (n = 9) (P = .02). CONCLUSION: Our results revealed that a combination of prick and patch tests can significantly enhance the diagnostic accuracy of predisposition of allergy in patients with BMG.

The prevalence and risk factors associated with benign migratory glossitis lesions in 7619 Turkish dental outpatients.

OBJECTIVE: The aim of this study was to investigate the frequency of benign migratory glossitis (BMG) in a Turkish population with respect to gender, age, smoking, atopic and allergic diseases, dermatological diseases (psoriasis and seborrheic dermatitis), systemic diseases, and fissured tongue (FT). PATIENTS AND METHODS: The study was conducted on 7619 patients (3819 female, 3800 male) with various dental complaints, ranging in age from 4 to 60 years, recruited from the Department of Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey. RESULTS: BMG was found in 1.5% (95% CI: 0.9-1.9) of all patients examined. Multivariate logistic regression indicated that age less than 30 (OR: 6.7 [95% CI: 2.9-15.5]), not smoking (6.3 [2.8-14.1]), and history of allergy or atopy (6.5 [3.3-12.5]) were significantly related to BMG. Of the patients with BMG, 34.5% (n = 40) had FT. No significant associations existed with gender, dermatological conditions (psoriasis and seborrheic dermatitis), or systemic diseases (diabetes mellitus, hematological disorders, cardiovascular disorders, hepatitis, gastrointestinal disorders, respiratory disorders, connective tissue disorders, and genitourinary disturbances). CONCLUSION: The present study demonstrated that BMG is more prevalent in young, nonsmokers, and atopic or allergic individuals.

Prevalence and risk factors associated with geographic tongue among US adults.

OBJECTIVE: To characterize the prevalence of geographic tongue (GT) among US adults. DESIGN: Population-based case-control study. MAIN OUTCOME MEASURES: The presence or absence of GT. SUBJECTS AND METHODS: Data from 16 833 adults examined during The Third National Health and Nutrition Examination Survey, 1988-1994 (NHANES III), a study based on multistage probability sampling were analyzed using SAS-callable SUDAAN 9.0.1. RESULTS: Geographic tongue point prevalence was 1.8% (95% CI: 1.4, 2.3). Multivariate logistic regression showed significant effects of race-ethnicity, with Whites (AOR = 1.8; 1.3, 2.5) and Blacks (AOR = 1.6; 1.2, 2.1) having greater odds of GT than Mexican-Americans; current corticosteroid therapy (AOR = 3.7; 1.54, 8.6). Cigarette smokers had lower GT prevalence (AOR = 0.4; 0.3, 0.6). Fissured tongue (FT) was strongly associated with GT among non-smokers: AOR = 17.5 (7.8, 39.5). We did not find significant associations with age, gender, oral contraceptive use, diabetes mellitus, allergy or atopy, psychological or dermatological conditions as previous research has suggested. CONCLUSIONS: Geographic tongue was more prevalent among Whites and Blacks compared with Mexican-Americans, positively associated with FT, and inversely associated with cigarette smoking.

Geographic tongue (migrant glossitis) and psoriasis.

BACKGROUND: The aim of this study was to examine the relationship of geographic tongue to psoriasis. METHODS: We report a comparative study on two groups of patients: the first (20 patients) with cutaneous psoriasis and lesions of the oral mucosa similar to geographic tongue; the second (20 patients), with benign migratory glossitis only. Biopsy samples of the lingual mucosa were taken from both groups. RESULTS: The histologic examination of oral biopsies from the first groups showed typical features of psoriasis. The second group showed the same features of psoriasis in 80% of patients. CONCLUSIONS: The clinical and histopathologic findings support the hypothesis that migrant glossitis can be considered an expression of oral psoriasis.

Oral manifestations in 45 HIV-positive children from Northern Thailand.

Forty-five Northern Thai children with HIV infection or AIDS were examined for oral manifestations. Of these children, 51.1% (n=23) were asymptomatic (category N), 48.9% were mildly, moderately or severely symptomatic (category A, B, C) and 48.9% (n=22) revealed oral lesions. Eleven patients (24.4%) showed one oral lesion, eight (17.8%) had two and three (6.6%) had three oral lesions. Erythematous candidiasis was the most common lesion (17.8%). Oral hairy leukoplakia was seen in 6.7% (n=3). Geographic tongue, not usually considered to be associated with HIV infection, was seen in 6.7% (n=3). Only 15 patients (33.3%) received antiretroviral therapy (ART). Comparison of patients with or without ART did not show differences in the prevalence of oral lesions. More studies in Thai HIV-infected children are needed to reveal the prevalence of oral manifestations, as well as for the predictive value of the most common or specific oral manifestations.

Atypical migratory stomatitis and Munchausen syndrome presenting as periorbital ecchymosis and mandibular subluxation.

Stomatitis areata migrans, unlike its analogue on the tongue, migratory glossitis, is not easily recognized and is so uncommon and varied in appearance that it may escape definitive diagnosis. It may be so puzzling to the clinician that the patient's credibility may be questioned. A detailed report of a case is presented in which an atypical migratory stomatitis went undiagnosed. Bizarre patient behavior followed in the form of self-inflicted injury (Munchausen syndrome) as the patient attempted to convince the care providers of the true existence of lesions in order to maintain their interest and to obtain relief from discomfort.

Oral lesions in patients with psoriasis: a controlled study.

Stomatitis areata migrans was found in 5.4 percent of patients with psoriasis compared to 1 percent of control patients, while benign migratory glossitis was identified in 10.3 percent of patients with psoriasis and 2.5 percent of control patients. The association of these disorders with psoriasis indicates that they may be manifestations of psoriasis of the oral mucosa.

Intraoral findings in patients with psoriasis with a special reference to ectopic geographic tongue (erythema circinata).

One hundred patients with a severe relapse of cutaneous psoriasis underwent a full intraoral examination. Nineteen patients had "ectopic geographic tongue" of the palate or buccal mucosa, and there appeared to be an increased incidence of periodontal disease. All other findings were within the normal range. HLA antigen studies of eight patients were carried out and showed an increased incidence of DR7.

Benign migratory glossitis in patients with juvenile diabetes.

The prevalence of tissue type HLA-B15 has been shown to be higher in atopic patients with benign migratory glossitis and in patients with insulin-dependent diabetes mellitus than it is in the general population. Despite this apparent link, the possible relationship between benign migratory glossitis and insulin-dependent diabetes mellitus does not appear to have been investigated previously. This study of 87 diabetic patients and 105 age- and sex-matched nondiabetic control subjects revealed a fourfold increase in the prevalence of benign migratory glossitis in the diabetic group. These results suggest that benign migratory glossitis may be linked to diabetes mellitus and that further investigation of this association is warranted.

Geographic tongue: sensitivity to the environment.

The prevalence of geographic tongue was assessed among 102 atopic patients with extrinsic asthma and/or rhinitis and was found to be significantly greater in these patients than in an asymptomatic, nonatopic control population. However, there was no difference between the prevalence of geographic tongue among atopic patients with extrinsic asthma and rhinitis as compared to a group of patients with asthma and rhinitis who were not atopic. These findings suggest that geographic tongue is a sign common to those patients who have a tendency to develop recurrent acute inflammatory disease on surfaces in contact with the external environment (for example, asthma or rhinitis), whether they are atopic or not.

Burning mouth: an analysis of 57 patients.

The burning mouth complaint of each of fifty-seven patients was thoroughly studied. Psychogenesis was found to be the most frequent cause, followed by geographic tongue and moniliasis. Multiple causative factors, such as psychogenesis and moniliasis and psychogenesis and geographic tongue, were found in some patients. The purely psychogenic group was composed mostly of postmenopausal women. The tongue and palate were the most frequently affected sites. There were some similarities among patients in the geographic tongue and psychogenesis groups. A diagnostic protocol for patients with burning mouth is described.