A patient with psoriasis may develop geographic or fissured tongue. Examination of the tongue and oral mucosa should be included in the evaluation of a patient with psoriasis.
Patient selection: psoriasis
The incidence of geographic tongue and fissured tongue is greater in a patient with psoriasis, especially if there is a family history of psoriasis.
(1) geographic tongue is more often in early-onset psoriasis (onset <= 30 years of age)
(2) fissured tongue tends to be seen more often in late-onset psoriasis (onset > 30 years of age)
Geographic tongue is associated with more severe psoriasis (classified as severe if PASI >= 13).
Other oral signs of psoriasis may include:
(1) white or grey mucosal plaques or annular lesions
(2) periodontitis
If systemic therapy improves skin lesions of psoriasis, then improvement would be expected in the oral lesions as well.
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