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October 1993

Fissured Tongue in Generalized Pustular Psoriasis

Author Affiliations

Medical College Trichur, Kerala, India 680 596

Arch Dermatol. 1993;129(10):1346. doi:10.1001/archderm.1993.01680310118028

Psoriasis is a common skin disorder, but mucosal lesions are rare.1 In pustular psoriasis, the tongue shows lesions that are clinically and histologically indistinguishable from geographic tongue.2 A recent study of mucous membrane in generalized pustular psoriasis has revealed a high incidence of fissured tongue.

Patients, Methods, and Observations.  All patients with generalized pustular psoriasis seen in the last 14 months were observed for mucosal changes. Five patients were seen, and all of them had psoriasis vulgaris at some stage of their illness. Four of five patients showed well-formed deep fissures that extended anteroposteriorly (Figure). Fissures extending laterally were also seen, but they were superficial and less conspicuous. In one patient, fissures were more superficial and less marked than in the other four patients.All five patients had multiple smooth red patches of geographic tongue.

Comment.  Diagnosis of generalized pustular psoriasis was certain, as all the patients in

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