FEATURES OF HYGIENIC CARE FOR LINGUA PLICATA

Hygienic care of lingua plicata is of particular relevance, since the degree of microbial contamination of the tongue folds is a key factor in initiation and progression of non-specific glottitises. The aim of the work was to study the effectiveness of hygienic modes of tongue care using "Albadent" balm-rinse in patients having a fissured tongue. Three subgroups of patients were included in the study; patients of the 1st subgroup had their tongues treated with a toothbrush pad, patients of the 2nd subgroup rinsed it with Albadent balm twice, and patients of the 3rd subgroup treated their tongues twice with an irrigator with Albadent balm solution. A comparative assessment of care regimens showed that in patients of the 1st subgroup the hygienic condition of the tongue improved by 2.7 times, and the prevalence of Candida albicans decreased twice. The patients reported unpleasant «scratching» sensations in the tongue after its mechanical treatment. In patients of the 2nd subgroup, the depth of the folds decreased, and hyperemia in the bottom of the folds decreased in half of the observed patients. The hygienic condition of the tongue improved by 2.2 times, and the prevalence of Candida albicans decreased by 2.5 times. Patients reported a pleasant freshness sensation in the tongue after treatment, continuing after spitting for 60-90 minutes. In patients of the 3rd subgroup, the depth of the folds changed insignificantly in the direction of decrease, and hyperemia of the bottom was not detected. The hygienic condition of the tongue improved twice, and the prevalence of Candida albicans decreased by 2 times. Patients reported a pleasant freshness sensation in the tongue after rinsing, continuing after spitting for 40–60 minutes.

Melkersson-Rosenthal syndrome associated to Hashimoto’s thyroiditis

Melkersson-Rosenthal syndrome (MRS) is a rare neuromucocutaneous granulomatous disorder classically defined by the triad: fissured tongue (lingua plicata), recurrent orofacial edema, and relapsing facial paralysis. Association with other dysimmune disorders was reported suggesting an immunological origin to this syndrome. The association with autoimmune thyroiditis remains exceptional and unusual. We report the original case of an MRS associated with Hashimoto autoimmune thyroiditis in a 39-year-old Tunisian man with favorable outcome under thyroxine and systemic glucosteroids. A dosage of thyroid hormones and a screening for anti-thyroid antibodies would be useful in patients with an MRS.

Melkersson-Rosenthal syndrome with coeliac and allergic diseases

A 45-year-old man presented with a 10-year history of relapsing oedema of the lips. Moreover, he exhibited recurrent facial nerve palsy since the age of 10 years, coeliac disease since the age of 12 years, atopic eczema, allergic rhinitis and asthma. Physical examination revealed lip swelling and lingua plicata. Thus, he presented the classic triad of Melkersson-Rosenthal syndrome which includes recurrent orofacial oedema, facial nerve palsy and fissured tongue. A lip biopsy confirmed our clinical diagnosis.This case is particularly rare, as the classic triad is seen only in a minority of the cases. Moreover, allergic and coeliac diseases were observed concomitantly. This paper illustrates a potential pathophysiological interconnection between these pathologies in which interferon gamma could play a key role. To our knowledge, this is the first case report in which Melkersson-Rosenthal syndrome has been observed concurrently with coeliac disease.

Lingua plicata in pustular psoriasis: a rare case report

<p class="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.</p>