The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients

Background. Tongue lesions are not uncommon in psoriasis, but their significance is not clear. Aims. To determine the prevalence of tongue lesions in patients with psoriasis and to detect possible associations. Methods. All consecutive patients with psoriasis seen in a dermatology clinic in northern Iran between January 2000 and January 2005 were enrolled in a prospective study. A questionnaire detailing the clinical and epidemiological features of the disease was completed for each patient, and all patients were examined for tongue lesions. Results. In total, 306 patients with psoriasis were enrolled in the study (170 women, 136 men; female : male ratio 1.25 : 1; mean age 29.7 years; mean age at onset of psoriasis 23.3 years). Overall, 47 patients (15.4%) had tongue lesions; 25 (8.2%) had fissured tongue, 17 (5.6%) had geographical tongue (benign migratory glossitis) and 5 (1.6%) patients had both fissured and geographical tongue. Geographical tongue was seen in 7.2% of patients with early onset psoriasis and only in 1.3% of patients with late-onset psoriasis. Overall, patients with tongue lesions were found to have more nail and genital involvement. Conclusion. It appears that geographical tongue, but not fissured tongue, is more common in early onset psoriasis and may be an indicator of disease severity.