Lingua plicata in pustular psoriasis: a rare case report

Abstract

Lingua plicata also referred to as scrotal tongue, furrowed tongue, grooved tongue, and plicated tongue is a relatively uncommon condition. It is characterized by multiple asymptomatic fissures or grooves over the tongue, resembling the surface of the brain due to the appearance of sulci and gyri, hence, it has also been referred to as cerebriform tongue.Despite being an asymptomatic condition, lingua plicata is a cause for concern as it can progress to secondary complications due to trapping of food in the fissures. Lingua plicata has been reported in association with pemphigus vegetans of the neumann variety and very rarely with other dermatological conditions such as psoriasis.Pustular psoriasis is an uncommon form of Psoriasis that may be localized or generalized. Acute generalized pustular psoriasis also known as Von Zumbusch disease, is a condition in which the patient characteristically shows features of toxicity, high grade fever and acute generalized pustules over an erythematous base and may be associated with oral mucosal changes in the form of erythema or geographic tongue. This case report describes a 33 year old male presenting with generalized pustular psoriasis and lingua plicata. The patient was treated with intravenous steroids and oral acitretin following which the psoriatic lesions and lingua plicata remitted.