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Other names people use for this condition
  • Benign migratory glossitis
  • Erythema migrans
  • Ectopic geographic tongue
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Geographic tongue
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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? 



  • What is geographic tongue? (Back to Top)

  • 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 Reviewed: 2/13/2008

  • What symptoms are seen in geographic tongue?   (Back to Top)

  • 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 Reviewed: 2/13/2008

  • At what age do symptoms of geographic tongue typically occur? (Back to Top)

  • Geographic tongue may occur in children and adults and occurs more commonly in females than males. [3]
  • Last Reviewed: 2/20/2008

  • What treatment is available for geographic tongue? (Back to Top)

  • 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 Reviewed: 2/14/2008

  • What causes geographic tongue?  Is it genetic? (Back to Top)

  • 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 Reviewed: 2/20/2008

  • Is geographic tongue associated with psoriasis? (Back to Top)

  • 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).  [8]  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. [8]  Zargari (2006) stated that it appears that geographic tongue is more common in early-onset psoriasis and may be an indicator of disease severity. [6] 
  • Last Reviewed: 2/20/2008

  • Is psoriasis genetic?  (Back to Top)

  • Psoriasis is a skin disease that is caused by the interaction of genetic, immunologic, and environmental factors. [10]  About one-third of people with psoriasis have at least one family member with the condition.  [10] [11]  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. [11]  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-Cw*0602 is increased in both psoriasis and psoriatic arthritis and is also associated with an earlier age of onset of psoriasis.  [12] 

    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. [13]

    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 Reviewed: 2/14/2008

  • How can I find out whether recent articles on the association of geographic tongue and psoriasis have been published? (Back to Top)

  • You can find relevant journal articles on geographic tongue and psoriasis through a service called PubMed, a searchable database of medical literature. Information on finding an article and its title, authors, and publishing details is listed here.  Some articles are available as a complete document, while information on other studies is available as a summary abstract.  To obtain the full article, contact a medical/university library (or your local library for interlibrary loan), or order it online using the following link. Using "geographic tongue AND psoriasis" as your search term should locate articles. To narrow your search, click on the “Limits” tab under the search box and specify your criteria for locating more relevant articles.  Click here to view a search.
  • Last Reviewed: 2/19/2008

  • Should I obtain genetic counseling for geographic tongue and psoriasis? (Back to Top)

  • 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. If you are interested in finding out what type of information regarding the genetics of geographic tongue and psoriasis might be covered 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:

    We recommend that you contact a genetics clinic to discuss this information with a genetics professional. 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:

      * GeneClinics - A searchable directory of US and international genetics and prenatal diagnosis clinics. To locate genetics clinics in the United States, go to the following link and click on "Clinic Directory" to find a genetic service close to you.  To locate genetics clinics outside of the United States, go the following link, click on "Clinic Directory", and click on "International Clinic Directory Search".
    http://www.geneclinics.org/

      * ResourceLink - A database of genetics counseling services, searchable by location, name, institution, type of practice, or specialty. Hosted by the National Society of Genetic Counselors.
    http://www.nsgc.org/resourcelink.cfm

      * Genetic Centers, Clinics, and Departments - A comprehensive resource list for genetic counseling, including links to genetic centers and clinics, associations, and university genetics departments. Hosted by the University of Kansas Medical Center.
    http://www.kumc.edu/gec/prof/genecntr.html

    The American Society of Human Genetics (ASHG) is a professional organization of research and clinical geneticists. The ASHG maintains a database of these geneticists, some of which live outside of the United States. If you are interested in obtaining a list of the geneticists, some of which may only be researchers and may not offer medical care, please visit the following hyperlink, enter the name of the country in which you live in the "Country" search box, and click on "Click to Begin Search".
    http://genetics.faseb.org/cgi-bin/ASHG-Search


  • Last Reviewed: 2/13/2008


References  (Back)
  1. . Cummings: Otolaryngology: Head and Neck Surgery, 3rd ed. : Mosby-Year Book, Inc; 1998.
  2. . Rakel: Conn's Current Therapy 2007, 59th ed.. : Saunders; 2007.
  3. Gonsalves WC, Chi AC, Neville BW. Common Oral Lesions: Part I. Superficial Mucosal Lesions. American Family Physician. February 2007.
  4. Geographic Tongue. MayoClinic.com. October 20, 2006 Available at: http://www.mayoclinic.com/health/geographic-tongue/DS00819/DSECTION=3. Accessed February 13, 2008.
  5. 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.
  6. Zargari O. The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients. Clin Exp Dermatol. 2006 Mar.
  7. 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.
  8. Daneshpazhooh M, Moslehi H, Akhyani M, Etesami M. . BMC Dermatol. 2004 November 4;:. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=15527508. February 13, 2008.
  9. Guilhou JJ, Moles JP. . Dermatology. 2008;:. Available at: http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=DetailsSearch&Term=18216469%5Buid%5D. February 13, 2008.
  10. Ferri FF. Ferri: Ferri's Clinical Advisor 2008. : Mosby, An Imprint of Elsevier; 2008.
  11. Emory University School of Medicine. Department of Human Genetics. Division of Medical Genetics. Autoimmune Disorders. . 2004 Available at: http://www.genetics.emory.edu/pdf/Emory_Human_Genetics_Autoimmune_Disorders.pdf. Accessed February 14, 2008.
  12. . Harris: Kelley's Textbook of Rheumatology, 7th ed.. : Saunders, An Imprint of Elsevier; 2005.
  13. Torti DC, Feldman SR. Interleukin-12, interleukin-23, and psoriasis: Current prospects. J Am Acad Dermatol. December 2007.

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