The condition often starts in childhood, sometimes at an early age, but others report that the highest incidence occurs in the over 40 age group. Females are sometimes reported to be more commonly affected than males, in a 2:1 ratio, although others report that the gender distribution is equal. Clinical Implications
Psoriasis
A recent study has proven the link between geographic tongue (GT) and psoriasis - the presence of geographic tongue can be a predictor of psoriasis. Clinical manifestation of GT and psoriasis can be histologically similar, however a genetic link between the two has been pathogenically identified. Patients with generalised pustular psoriasis and GT both exhibit the c.115 +6T >C mutation in the IL36RN gene. Patients who have GT have been shown to experience a greater severity of psoriasis and have a less positive response to treatment. Oral Manifestations in Patients with COVID-19
Many articles including case reports, case-series and cross-sectional studies have been done since the recent outbreak of COVID-19, causing a global pandemic. These studies have shown that approximately 20% of patients with COVID-19 can present with mucosal manifestations in their oral cavities, including geographic tongue. Geographic tongue is also thought to appear alongside the onset of the regular symptoms of COVID-19. Interleukin-6 (IL-6) is known to be an important biomarker in patients with COVID-19 in relation to a cytokine storm where too many inflammatory cells which have a detrimental effect on organ systems throughout the body. Geographic tongue is associated with elevated levels of IL-6, which possibly helps explain its presentation on confirmed COVID-19 patients.
A tuberculoma is a clinical manifestation of tuberculosis which conglomerates tubercles into a firm lump, and so can mimic cancer tumors of many types in medical imaging studies. Since these are evolutions of primary complex, the tuberculomas may contain within caseum or calcifications. With the passage of time Mycobacterium tuberculosis can transform into crystals of calcium. These can affect any organ such as the brain, intestine, ovaries, breast, lungs, esophagus, liver, pancreas, bones, and many others. As the histologic and clinical indications, as well as tumor markers such as the CA-125, are similar, it is often difficult to differentiate tuberculoma from cancer. For these reasons, tuberculosis should always be considered in the differential diagnosis of cancer.Tuberculoma is commonly treated through the HRZE drug combination (Isoniazid, Rifampin, Pyrazinamide, Ethambutol) followed by maintenance therapy. == References ==