This is a multicentric, observational and controlled study designed to verify the existence of a significant association between plaque-type psoriasis and oral lesions, such as geographic tongue and/or fissured tongue.
during a period of 9 months all consecutive patients with plaque-type psoriasis were enrolled using simple nonrandom (sequential) sampling. The control group included healthy subjects presenting to the same Dermatology centers to monitor pigmented skin lesions; the patients were matched for age and sex. All patients were examined for oral lesions.
Out of a total of 535 psoriatic patients and 436 control group patients, oral mucosal lesions were detected in 188 (35.1%) and 86 (19.7%) cases, respectively, and the difference is statistically significant. Fissured tongue (FT) and geographic tongue (GT), which were most frequently detected, were seen more frequently in psoriatic patients (FT: 22.6%; GT: 9.1%) than the control group (FT: 10.3%; GT: 5.2%) (p<0.05).
On the basis of the similar studies reported in the literature and the large number of patients involved in our study, we can conclude that FT and GT can be clearly suggested as oral manifestations of plaque-type psoriasis, although the reason for this association is not clear.
"According to the results of our study on this group of Jordanian psoriatic patients, FT was the most common oral finding, and significantly more frequent in psoriatic patients than controls, which confirms the results of other studies in other populations (2,3,21,22). Our findings that 35% prevalence of FT in psoriatic patients falls within the range of 6% to 47.5% reported in different studies (2,3,6,9,22,23) and in accordance to Costa et al. (2) and Germi et al. (21) who reported FT in 34.3% and 35.1% of their psoriatic patients respectively. In addition, the prevalence of FT among our control subjects (13%) was very close to that previously reported among Jordanians (11.5%) (24), which gives validity to the results. "
[Show abstract][Hide abstract] ABSTRACT: This study aimed to investigate and compare the prevalence of oral mucosal lesions in a group of psoriatic patients and healthy subjects, and its correlation to multiple clinical parameters.
100 psoriatic patients and 100 closely matched controls underwent clinical oral examination. Oral lesions were diagnosed according to the criteria proposed by the World Health Organization (WHO). The patients filled the Hospital Anxiety and Depression (HAD) questionnaire and the Dermatology Life Quality Index (DLQI). The severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). Categorical variables were evaluated using Chi-square test or Fisher's exact test with overall significance set at p< 0.05.
Oral mucosal lesions were diagnosed in 43 (43%) psoriatic patients and 17 (17%) control subjects (p=0.000). Comparing psoriatic patients to control subjects the prevalence of fissured tongue (FT) was 35% vs. 13% (p=0.000); geographic tongue (GT) 17% vs. 9% (p=0.09); combination of FT and GT 5% vs. 5% (p=1.00); oral candidosis 3% vs. 0% (p=0.81); leukoedema 1% vs. 3% (p=0.62); physiologic melanin pigmentations 4% vs. 1% (p=0.37) respectively. The clinical type of psoriasis, duration of the disease, method of disease management (medicated vs. non-medicated for psoriasis), smoking habit, psychological status or the disease severity did not influence the prevalence of FT and GT. Psoriatic patients who experienced "very large" to "extremely large" adverse effect of psoriasis on their quality of life have significantly higher prevalence of GT (p=0.04).
FT is significantly more common in psoriatic patients compared to controls; hence studies investigating the nature of this relationship are warranted. Oral health care providers should be aware of the predisposition of psoriatic patients to oral candidosis. Key words:Oral lesions, fissured tongue, geographic tongue, leukoedema, oral Candida, candidosis, psoriasis.
Journal of Clinical and Experimental Dentistry 12/2012; 4(5):e286-91. DOI:10.4317/jced.50905
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