Tomb R, Hajj H, Nehme E
Département de dermatologie, université Saint-Joseph, Beyrouth, Liban.
Ann Dermatol Venereol. 2010 Nov;137(11):695-702. doi: 10.1016/j.annder.2010.08.006. Epub 2010 Sep 24.
The literature contains little information about the incidence or prevalence of oral signs in psoriasis. The pustular forms are the most commonly incriminated, with geographic tongue being the most frequently cited oral sign. The aim of our study was to determine the various types of oral signs seen in a large population of psoriasis patients.
Four hundred psoriasis patients were recruited consecutively and a detailed oral examination performed by two clinicians. Similar examinations were performed over the same period in 1000 nonpsoriasis subjects comprising a control group in order to assess the incidence of the same oral signs in the general population.
Comparing the two groups, fissured tongue was seen in 33.2% of psoriasis patients versus 9.9% of control subjects (P<0.0001). There was thus a highly significant (P<0.0001) correlation between geographic tongue and psoriasis (7.7% of psoriasis patients versus 1% of controls). In addition, a strong correlation was seen between the presence of pustular psoriasis and fissured tongue (83.3% of patients with pustular psoriasis versus only 30% of patients with other forms of psoriasis).
Our study shows a strong correlation between psoriasis and fissured and geographic tongue, although these features are not pathognomonic for the disease. As regards geographic tongue, our results are consistent with the data in the literature. However, the prevalence of fissured tongue was considerably higher among our patients than in series published to date. These two types of sign involving the tongue, and which can occur in all forms of psoriasis, appear to be particularly strongly associated with pustular psoriasis. Patients are generally unaware of this sign and rarely complain of it.
关于银屑病口腔症状的发病率或患病率，文献中相关信息较少。脓疱型银屑病最常被认为与口腔症状有关，地图舌是最常被提及的口腔症状。我们研究的目的是确定大量银屑病患者中出现的各种口腔症状类型。
连续招募400例银屑病患者，由两名临床医生进行详细的口腔检查。同期对1000名非银屑病受试者组成的对照组进行类似检查，以评估一般人群中相同口腔症状的发生率。
两组比较，33.2%的银屑病患者出现裂纹舌，而对照组为9.9%（P<0.0001）。因此，地图舌与银屑病之间存在高度显著的相关性（P<0.0001）（7.7%的银屑病患者出现地图舌，而对照组为1%）。此外，脓疱型银屑病的存在与裂纹舌之间存在强相关性（83.3%的脓疱型银屑病患者出现裂纹舌，而其他类型银屑病患者仅为30%）。
我们的研究表明，银屑病与裂纹舌和地图舌之间存在强相关性，尽管这些特征并非该疾病的特异性表现。关于地图舌，我们的结果与文献数据一致。然而，我们患者中裂纹舌的患病率明显高于迄今发表的系列研究中的患病率。这两种涉及舌头的症状可出现在所有类型的银屑病中，似乎与脓疱型银屑病尤其密切相关。患者通常未意识到这一症状，很少对此进行抱怨。
