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Genetic and Rare Diseases Information Center (GARD)

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Psoriasis

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* Not a rare disease

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Your Question

I believe that I may have geographic tongue.  Is there treatment for the condition?  At what age do symptoms of the condition typically start?  I have a family history of psoriasis.  Is geographic tongue related to psoriasis?  Are the two conditions genetic?  Is genetic counseling appropriate for geographic tongue and psoriasis? 

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What is geographic tongue?

Geographic tongue is a condition that causes lesions on the tongue that resemble psoriasis of the skin. The lesions may also occasionally occur in the mucosa of the mouth and labia; this condition is called areata migrans. The lesions typically disappear from one area and move to another. [1][2][3]
Last updated: 7/9/2013

What symptoms are seen in geographic tongue?

The lesions seen in geographic tongue resemble those of psoriasis. Most patients do not experience symptoms. It has been estimated that about 5% of individuals who have geographic tongue complain of sensitivity to hot or spicy foods when the their lesions are active. [2]
Last updated: 7/9/2013

At what age do symptoms of geographic tongue typically occur?

Geographic tongue may occur in children and adults and occurs more commonly in females than males. [3]
Last updated: 7/9/2013

What treatment is available for geographic tongue?

Because geographic tongue is a benign (harmless) condition and does not typically cause symptoms, treatment is usually unnecessary. Even those patients who experience sensitivity to hot or spicy foods, generally do not require treatment. With severe symptoms, topical corticosteroids, zinc supplements, and topical anesthetic rinses seem to reduce the discomfort in some patients. [2] [3]
Last updated: 7/9/2013

What causes geographic tongue? Is it genetic?

The exact cause of geographic tongue has not been identified. However, because the condition may be present in several members of the same family, genetics may increase a person's chances of developing the condition. A study by Guimarães (2007) showed that a specific variant of a gene called IL-1B (interleukin-1 beta) is associated with an increased risk of developing geographic tongue and suggests a genetic basis for the development of the disease.[4][5] Further research may result in a better understanding of the genetic influences involved in the development of geographic tongue.
Last updated: 7/9/2013

Is geographic tongue associated with psoriasis?

Geographic tongue may be associated with psoriasis, but it has also been associated with other atopic conditions, diabetes mellitus, reactive bronchitis, anemia, stress, hormonal disturbances, Down syndrome and lithium therapy. Additionally, geographic tongue may occur without an association to another condition; this type is called idiopathic (unknown cause).[6] It is currently unknown why some people with geographic tongue also have psoriasis.[4] In a study (1996) by Gonzaga et al. it was found that a specific type of HLA (human leucocyte antigen) called HLA-Cw6 was present in over 50% of patients with psoriasis and in more than 43% of patients with geographic tongue.[7] Daneshpazhooh et al. (2004) conducted a study involving 200 patients with psoriasis in order to learn more about the relationship between oral conditions like geographic tongue and psoriasis. They found that geographic tongue was more frequent in patients with psoriasis than in patients without the skin condition.[6] Zargari (2006) stated that it appears that geographic tongue is more common in early-onset psoriasis and may be an indicator of disease severity.[8]
Last updated: 7/9/2013

Is psoriasis genetic?

Psoriasis is a skin disease that is caused by the interaction of genetic, immunologic, and environmental factors.[9] About one-third of people with psoriasis have at least one family member with the condition.[9][10] Studies have shown that psoriasis is associated with a group of genes on chromosome 6 that codes for the HLA (human leukocyte antigens). The group of genes for the HLA play a role in predisposition and resistance to disease. Specific HLA influence the development of many disorders such as psoriasis. A person who has the specific HLA type associated with the disease may be at an increased risk of developing the condition.[10] In the cases of psoriasis, there is a strong association between it and HLA B13, B17, and B27. Additionally, studies have also demonstrated an association between the skin condition and other HLA antigens such as B16, B37, B38, Cw6, DR4, and DR7. HLA-B7 and HLA-27 identify patients with psoriasis destined for the development of arthritis. HLA-DR7a has been found in a large number of patients with psoriasis and psoriatic arthritis. HLA-Cw6 is increased in both psoriasis and psoriatic arthritis and is also associated with an earlier age of onset of psoriasis.[11]

Specific types of interleukins have also been associated with the lesions seen in psoriasis. Interleukin 12 (IL-12) and interleukin 23 (IL-23) are proteins produced by the body to aid in the fighting off infections. Both IL-12 and IL-23 have been associated with the development of the lesions seen in psoriasis.[12]

It is believed that there are probably other genes that influence the development of psoriasis; therefore, further studies are needed to learn more about which other genes might play a role increasing one's chances of developing the condition.
Last updated: 7/9/2013

How can I find out whether recent articles on the association of geographic tongue and psoriasis have been published?

You can find relevant articles on geographic tongue and psoriasis through PubMed, a searchable database of biomedical journal articles. Although not all of the articles are available for free online, most articles listed in PubMed have a summary available. To obtain the full article, contact a medical/university library or your local library for interlibrary loan. You can also order articles online through the publisher’s Web site. Using "geographic tongue AND psoriasis" as your search term should help you locate articles. Use the advanced search feature to narrow your search results. Click here to view a search.

The National Library of Medicine (NLM) Web site has a page for locating libraries in your area that can provide direct access to these journals (print or online). The Web page also describes how you can get these articles through interlibrary loan and Loansome Doc (an NLM document-ordering service). You can access this page at the following link http://nnlm.gov/members/. You can also contact the NLM toll-free at 888-346-3656 to locate libraries in your area.
Last updated: 7/9/2013

Should I obtain genetic counseling for geographic tongue and psoriasis?

Although it is thought that genetic factors influence the development of geographic tongue and psoriasis, much is still unknown about the genetics of the condition. f you are interested in finding out what type of information egarding the genetics of geographic tongue and psoriasis might be overed during a genetics session, we recommend that you contact a genetics clinic near you. To find a genetics clinic near you, we recommend contacting your primary doctor for a referral.

The following online resources can also help you find a genetics professional in your community:

Last updated: 7/9/2013

References
  • Cummings: Otolaryngology: Head and Neck Surgery, 3rd ed. Mosby-Year Book, Inc; 1998;
  • Rakel: Conn's Current Therapy 2007, 59th ed.. Saunders; 2007;
  • Gonsalves WC, Chi AC, Neville BW. Common Oral Lesions: Part I. Superficial Mucosal Lesions. American Family Physician. February 2007;
  • Geographic Tongue. MayoClinic.com. October 20, 2006; http://www.mayoclinic.com/health/geographic-tongue/DS00819/DSECTION=3. Accessed 2/13/2008.
  • Guimarães AL, Correia-Silva Jde F, Diniz MG, Xavier GM, Horta MC, Gomez RS. Investigation of funcational gene polymorphisms: IL-1B, IL-6, and TNFA in benign migratory glossitis in Brazilian individuals. J Oral Pathol Med. 2007 Oct;
  • Daneshpazhooh M, Moslehi H, Akhyani M, Etesami M. Tongue lesions in psoriasis: a controlled study. BMC Dermatol. 2004 November 4; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538751/?tool=pubmed. Accessed 2/13/2008.
  • Gonzaga HF, Torres EA, Alchorne MM, Gerbase-Delima M. Both psoriasis and benign migratory glossitis are associated with HLA-Cw6. Br J Dermatol. 1996 Sept;
  • Zargari O. The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients. Clin Exp Dermatol. 2006 Mar;
  • Ferri FF. Ferri: Ferri's Clinical Advisor 2008. Mosby, An Imprint of Elsevier; 2008;
  • Emory University School of Medicine. Department of Human Genetics. Division of Medical Genetics. Autoimmune Disorders. 2004; http://www.genetics.emory.edu/pdf/Emory_Human_Genetics_Autoimmune_Disorders.pdf. Accessed 2/14/2008.
  • Harris: Kelley's Textbook of Rheumatology, 7th ed.. Saunders, An Imprint of Elsevier; 2005;
  • Torti DC, Feldman SR. Interleukin-12, interleukin-23, and psoriasis: Current prospects. J Am Acad Dermatol. December 2007;
  • Guilhou JJ, Moles JP. New hypotheses in the genetics of psoriasis and other 'complex' diseases. Dermatology. 2008; http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term=18216469%5Buid%5D. Accessed 2/13/2008.
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.