Study of the Correlation between the Extent and Clinical Severity, and the Histopathological Characteristics of Geographic Tongue.

Background: Geographic tongue is an oral lesion with an unknown etiology. Recently, the Geographic Tongue Area and Severity Index (GTASI) has been proposed to assess the area and severity of geographic tongue, aiming to measure the clinical severity of the condition. However, this index does not account for the histopathology, which vary based on the clinical stage of the lesion and the biopsy area. The present study aimed to evaluate the correlation between GTASI score and its histopathological features.

Materials and methods: This cross-sectional observational study included 40 participants diagnosed with GT confirmed both clinically and histopathologically.

Results: Considering GT severity, a vast majority 60% of cases were classified as mild, with females' predominance in both mild and severe categories. The average age of participants was 56 years for mild and severe cases and 47 years for moderate ones. The prevalent histopathological features of geographic tongue included parakeratosis, acanthosis, spongiosis, basal layer hyperplasia, mono- and polymorphonuclear exocytosis, suprapapillary hypotrophy, claviform epithelial ridges, fusion of epithelial ridges, conjunctival papillary edema, and chronic subepithelial infiltration, with no significant differences taking into consideration clinical severity level. Papillary vascular ectasia, Munro microabscesses, Kogoj pustules, and dense connective tissue were more prevalent in with more severe cases of GT. Mild inflammatory infiltrate intensity was predominant in persons with mild GT, while moderate infiltrate intensity was found predominantly in moderate cases of GT.

Conclusions: The clinical severity level of GT closely corresponds with its histopathological characteristics.