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Geographic Tongue

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Oral manifestations of migratory stomatitis, or geographic tongue, may be associated with inherited genetic factors, immunological abnormalities, trepidation, and several other disorders including (but not limited to) psoriasis and diabetes (Jainkittivong). Geographic tongue involves lesions located non-specifically on ‘the tip, lateral borders, and dorsum of the tongue’ (Jainkittivong). These lesions frequently appear as ‘multifocal, circinate, irregular erythematous patches bounded by a slightly elevated, white or cream colored keratotic band or line’ (Jainkittivong). Often, ‘the central erythematous patch represents atrophy of the filiform papillae’ (Jainkittivong) and ‘the white border is composed of regenerating filiform papillae and a …show more content…
Marks demonstrated a correlation between rhinitis/extrinsic asthma and geographic tongue. The studies “suggest that geographic tongue is a sign common to those patients who have a tendency to develop recurrent acute inflammatory disease on surfaces in contact with the external environment (for example, asthma or rhinitis), whether they are atopic or not” (Marks). As previously discussed, increased levels of HLA-DRW6 antigen found in those diagnosed with geographic tongue have also been linked to short-ragweed Ra6 allergy (Marsh) as well as pemphigus vulgaris, dermatitis, herpetiformis, and type I diabetes (“HLA DR Antigen”), which further demonstrates a possible predisposition and correlation between autoimmunity/genetics and migratory stomatitis. Marks also conducted a similar study comparing geographic tongue patients with a healthy control and found that “There was a significantly high frequency of personal and/or family history of asthma, eczema and hay fever amongst the patients when compared to a control population” and “A raised total serum of IgE (greater than or equal to 200u/ml) was significantly more frequent in patients compared to a control population” (Marks*). This study also showed “an increased incidence of tissue type HLA-B15 in atopic patients with geographic tongue” (Jainkittivong). The HLA-B15 antigen has been associated with erythema multiforme, “an acute, self-limited, and sometimes recurring skin condition that …show more content…
Interestingly, “It has been reported [that] lesions arise in connection with pronounced emotional stress. Redman et al. found a higher prevalence of geographic tongue in mentally ill patients than in university students. They also noted that when under emotional stress the student group with geographic tongue tended to have more severe lesions.” (Jainkittivong). This study appeared to successfully correlate an increase in frequency and intensity of geographic lesions with psychosomatic response to stress. A separate study, unrelated to geographic tongue, may unravel the mysteries of this finding. A cohort study conducted by Naumova et al. took a group of thirty-four males and split them into groups; one exposed to stress and one group unexposed to stress. The researchers took saliva samples of the exposed students before making a speech in an attempt to induce stress. The experimental group’s “salivary cortisol concentration significantly increased after 20 minutes [when] compared to the baseline. The salivary protein concentration and pH also increased” (Naumova). These notable stress-induced changes in salivary composition may foster the optimal environment for development of these recurring geographic tongue lesions; as well as dictate their intensity. The findings of these previous studies may be interrelated with diabetic patients. In type I and II diabetic patients, the

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