Psoriasis vulgaris atau psoriasis dengan lesi plak kronis merupakan presentasi klasik dan yang paling

sering dijumpai pada psoriasis. Lesi klasik psoriasis berupa plak eritema berbatas tegas dan ditutupi
skuama berwarna putih.

Geographic tonguemerupakan kondisi yang menunjuk pada beberapa istilah seperti exfoliation
areata linguae, glossitis exfoliativa marginata, lingua geographica, benign migratory glossitis,
erythema migrans, annulus migrans, wandering rash of the tongue, migratory glossitis.8 Lidah
dengan lesi Geographic tongue kurang disadari keberadaannya oleh penderita, kecuali lesi ini
menimbulkan rasa gatal atau terbakar pada daerah yang terlibat. Kondisi ini biasanya dimulai pada
masa kanak-kanak dan dapat bertahan selama hidup atau menghilang di usia pertengahan.

Lesi Geographic tongue digambarkan berhubungan dengan penyakit kulit tertentu seperti psoriasis
dan penyakit Reiter’s. dimana dinyatakan bahwa Geographic tongue merupakan salah satu
manifestasi di rongga mulut yang terjadi pada penderita dengan psoriasis kulit dan penyakit Reiter’s,
karena ditemukannya gambaran histopatologis yang sama. Beberapa penulis mengelompokkan
psoriasis, penyakit Reiter’s, Geographic tongue dan geographic stomatitis kedalam suatu kelompok
yang disebut lesi oral psoriasis.

Meskipun tidak bersifat spesifik pada penderita psoriasis dapat dijumpai lidah geografik yang juga
dikenal sebagai glositis migratori benigna atau glositis areata migrans. Kondisi ini terjadi akibat
hilangnya papila filiformis lokal pada lidah

An oral condition associated to PS is benign migratory glossitis (BMG).5-7 Also termed geographic
tongue, BMG is characterised by irregular areas of loss of filiform papillae, surrounded by white
margins with subtle elevation. As a characteristic, these areas vary widely in appearance, size,
number, location, due to the healing of one edge and proliferation of another; they frequently
disappear,recur and coalesce in variable proportions, so that the lesions appear to migrate.8,9 The
increased prevalence of BMG among psoriatic patients and similar microscopic characteristics,
support the idea that PS and BMG are associated conditions.10-12 This association was reinforced
by the determination of a genetic marker, the antigen HLA-Cw6, common for both PS and BMG,
suggesting that these conditions could share the same genetic basis.5 Nevertheless, clinical
expression led us to question the differences of biological and environmental factors. Regarding the
genetic determinants, the fact that HLACw6 is not the only factor, as both PS and BMG have been
classified as polygenic diseases, must be considered. In PS, the involvement of major loci in
chromosomes 6p, 17q, 4q, 2p, 8q e 20p was determined.13-15 In BMG, the investigation was
performed only in locus 6p.5 Accumulated evidence indicates that PS is a multifactorial disorder
caused by the concerted action of multiple disease genes in a single individual, triggered by
environmental factors. Some of these genes control the severity of multiple diseases by regulating
inflammatory processes and immunity (severity genes); whereas others are unique to PS. Various
combinations of these genes can occur even within a single family, being largely responsible for
many manifestations of PS. Many unaffected individuals carry one or more disease alleles, but lack
other genetic and/or environmental factors necessary to develop the disease
Studies show that geographic tongue is the oral manifestation more commonly associated with
psoriatic disease. These studies are based on observation of its fundamental lesions, on microscopic
similarity between the two conditions and on observation of the presence of a common genetic
marker, the human leukocyte antigen (HLA) HLA-Cw6.16-19 The difficulty in accepting the diagnosis
of geographic tongue as oral psoriasis resides in the fact that some nonpsoriatic patients present
geographic tongue.20 Some authors believe that the prevalence of oral lesions would be much
higher if the psoriatic patients underwent thorough oral examination.16 Also, there are few
controlled studies with histological and genetic tests on geographic tongue and its relation to
psoriasis