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com aspecto semelhante a um mapa&#46; As les&#245;es variam em padr&#227;o e localiza&#231;&#227;o&#44; s&#227;o conhecidas como &#8220;glossite migrat&#243;ria&#8221; e sua preval&#234;ncia &#233; de 0&#44;28&#37; a 14&#44;4&#37;&#46; &#201; mais comum em crian&#231;as e diminui com a idade&#59; as mulheres s&#227;o afetadas com maior frequ&#234;ncia que os homens&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a> Os fatores de risco para LG incluem fatores imunol&#243;gicos&#44; gen&#233;ticos&#44; al&#233;rgicos e psicol&#243;gicos&#46; Ela pode ser acompanhada por outras doen&#231;as&#44; como psor&#237;ase&#44; LF&#44; s&#237;ndrome de ard&#234;ncia bucal&#44; diabetes <span class="elsevierStyleItalic">mellitus</span> e s&#237;ndrome de Down&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a> A LG &#233; geralmente assintom&#225;tica&#44; mas os pacientes frequentemente desenvolvem ansiedade grave e medo de c&#226;ncer&#59; portanto&#44; &#233; necess&#225;ria explica&#231;&#227;o detalhada dessa doen&#231;a&#46; Alguns pacientes apresentam sensa&#231;&#245;es de ard&#234;ncia e desconforto&#46; O tratamento sintom&#225;tico pode ser eficaz&#44; com o emprego de anti&#8208;histam&#237;nicos&#44; ansiol&#237;ticos e esteroides&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A LF &#233; geralmente considerada anomalia cong&#234;nita&#44; caracterizada por fissuras nas faces dorsal e&#47;ou dorsolateral da l&#237;ngua em diferentes arranjos e profundidades&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> A incid&#234;ncia &#233; de 0&#44;6&#37; a 29&#44;2&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> e sua frequ&#234;ncia aumenta com a idade&#46; A etiologia da LF tamb&#233;m &#233; desconhecida&#59; fatores gen&#233;ticos podem ser importante fator de risco para essa condi&#231;&#227;o&#46; A LF frequentemente coexiste com a LG&#44; s&#237;ndrome de Down&#44; acromegalia&#44; s&#237;ndrome de Sj&#246;gren e s&#237;ndrome de Melkersson&#8208;Rosenthal&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">As preval&#234;ncias de psor&#237;ase&#44; LG e LF s&#227;o todas espec&#237;ficas regionalmente&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> A associa&#231;&#227;o de psor&#237;ase com LG&#47;LF em popula&#231;&#245;es do Leste Asi&#225;tico permanece desconhecida&#46; Portanto&#44; o presente estudo teve como objetivo determinar a associa&#231;&#227;o da psor&#237;ase com LG&#47;LF na popula&#231;&#227;o Han do sudoeste da China e caracterizar essas associa&#231;&#245;es em rela&#231;&#227;o ao estado geral dos pacientes&#44; condi&#231;&#227;o da psor&#237;ase e modalidade de tratamento&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">A presente investiga&#231;&#227;o &#233; um estudo transversal&#44; caso&#8208;controle&#44; planejado e conduzido de acordo com a Declara&#231;&#227;o de Helsinque da World Medical Association&#46; Este estudo foi aprovado pelo comit&#234; de &#233;tica local e todos os 460 indiv&#237;duos deram o consentimento informado&#46; Duzentos e trinta pacientes com psor&#237;ase tratados no Departamento de Dermatologia do West China Hospital&#44; Sichuan University&#44; de outubro de 2022 a fevereiro de 2023&#44; foram inclu&#237;dos no grupo de casos&#46; O presente estudo n&#227;o excluiu pacientes com psor&#237;ase em uso de qualquer tratamento&#44; incluindo produtos biol&#243;gicos&#46; Duzentos e trinta indiv&#237;duos saud&#225;veis acompanhantes de outros pacientes&#44; nunca diagnosticados com psor&#237;ase e pareados por idade e g&#234;nero ao grupo de casos&#44; foram inclu&#237;dos no grupo controle&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">O diagn&#243;stico de psor&#237;ase foi realizado por dermatologista e estabelecido com base em manifesta&#231;&#245;es cl&#237;nicas t&#237;picas&#58; placas eritematosas descamativas&#44; ou confirmada por exame histopatol&#243;gico se as les&#245;es fossem at&#237;picas&#46; Todos os indiv&#237;duos foram submetidos a exame bucal detalhado&#46; O exame bucal foi realizado por dentistas qualificados e com experi&#234;ncia no diagn&#243;stico e tratamento de doen&#231;as bucais utilizando estomatosc&#243;pios e <span class="elsevierStyleItalic">swabs</span> sob luz artificial&#46; A LG foi diagnosticada por sua apresenta&#231;&#227;o cl&#237;nica t&#237;pica&#58; atrofia das papilas filiformes como les&#227;o semelhante a placa vermelha com hiperplasia das papilas filiformes circundantes&#46; A LG &#233; doen&#231;a cr&#244;nica recidivante&#8208;remitente com per&#237;odos de exacerba&#231;&#227;o e remiss&#227;o&#44; ent&#227;o foram preparadas fotografias cl&#237;nicas t&#237;picas da LG para determinar se cada indiv&#237;duo havia apresentado les&#227;o semelhante anteriormente&#46; A LF tamb&#233;m &#233; diagnosticada por meio de suas manifesta&#231;&#245;es cl&#237;nicas t&#237;picas&#58; fissuras na face dorsal e&#47;ou dorsolateral da l&#237;ngua em diferentes arranjos e profundidades&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">As informa&#231;&#245;es gerais&#44; incluindo idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade no in&#237;cio da psor&#237;ase &#40;in&#237;cio precoce&#58; in&#237;cio at&#233; os 40 anos&#59; in&#237;cio tardio&#58; in&#237;cio ap&#243;s 40 anos&#41;&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; &#237;ndice PASI &#40;<span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span>&#41;&#44; &#225;rea de superf&#237;cie corporal &#40;ASC&#41;&#44; &#205;ndice de Qualidade de Vida em Dermatologia &#40;DLQI&#44; <span class="elsevierStyleItalic">Dermatology Life Quality Index</span>&#41; e tipo de tratamento recebido foram registrados&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Foi comparada a propor&#231;&#227;o de indiv&#237;duos com LG e LF nos grupos caso e controle e foram comparados os seguintes dados&#58; idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade no in&#237;cio da psor&#237;ase&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; PASI&#44; ASC&#44; DLQI e propor&#231;&#227;o de pacientes psori&#225;sicos&#44; com ou sem LG&#47;LF&#44; em uso de produtos biol&#243;gicos&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os dados foram analisados utilizando o <span class="elsevierStyleItalic">software</span> IBM SPSS Statistics vers&#227;o 26&#46; De acordo com os resultados do teste de Kolmogorov&#8208;Smirnov&#44; as vari&#225;veis cont&#237;nuas deste estudo foram apresentadas como mediana &#40;intervalo interquartil&#41; e comparadas pelo teste U de Mann&#8208;Whitney&#46; As vari&#225;veis categ&#243;ricas foram apresentadas como n&#250;mero &#40;porcentagem&#41; e comparadas pelo teste Qui&#8208;Quadrado de Pearson ou teste exato de Fisher&#46; Valor de p bilateral &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 foi considerado estatisticamente significante&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Um total de 460 indiv&#237;duos foi inclu&#237;do neste estudo&#58; 230 pacientes com psor&#237;ase e 230 controles saud&#225;veis&#46; O grupo caso consistiu em 136 homens e 94 mulheres&#44; com mediana de idade de 36 &#40;29&#8208;49&#41; anos&#46; O grupo controle consistiu em 123 homens e 107 mulheres&#44; com mediana de idade de 39 &#40;31&#8208;51&#41; anos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Os grupos caso e controle foram pareados por idade e g&#234;nero &#40;idade&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;130&#59; sexo&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;222&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Foi encontrada associa&#231;&#227;o n&#227;o significante entre psor&#237;ase e LG &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;760&#41; e forte associa&#231;&#227;o entre psor&#237;ase e LF &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">N&#227;o foram observadas diferen&#231;as entre pacientes com psor&#237;ase com LG e aqueles sem LG em rela&#231;&#227;o a idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade no in&#237;cio da psor&#237;ase&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; PASI&#44; ASC&#44; DLQI e propor&#231;&#227;o de indiv&#237;duos utilizando produtos biol&#243;gicos&#46; Em compara&#231;&#227;o com pacientes com psor&#237;ase sem LF&#44; observou&#8208;se que os pacientes com psor&#237;ase e LF eram mais velhos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#44; tinham frequ&#234;ncia aumentada de psor&#237;ase de in&#237;cio tardio &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41; e tamb&#233;m apresentavam psor&#237;ase mais grave &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41; e pior qualidade de vida &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46; N&#227;o foram observadas associa&#231;&#245;es de LF com outras caracter&#237;sticas&#44; incluindo g&#234;nero&#44; tabagismo&#44; etilismo&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; ASC ou propor&#231;&#227;o de uso de produtos biol&#243;gicos no grupo de casos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0065" class="elsevierStylePara elsevierViewall">A psor&#237;ase &#233; doen&#231;a comum&#44; cr&#244;nica e imunomediada&#59; n&#227;o &#233; doen&#231;a cut&#226;nea isolada e est&#225; associada a risco aumentado de comorbidades&#44; incluindo artrite psori&#225;sica&#44; doen&#231;a cardiovascular&#44; diabetes <span class="elsevierStyleItalic">mellitus</span> e dist&#250;rbios gastrintestinais&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a> Acredita&#8208;se tamb&#233;m que afete a mucosa oral&#44; conhecida como &#8220;psor&#237;ase oral&#8221;&#46; O primeiro caso de psor&#237;ase oral foi relatado em 1903&#59;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">10</span></a> posteriormente&#44; v&#225;rios casos foram relatados&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">11&#8211;13</span></a> Nesses artigos&#44; as manifesta&#231;&#245;es da psor&#237;ase oral podem ser divididas em dois grupos&#58; 1&#41; les&#245;es espec&#237;ficas da psor&#237;ase e 2&#41; les&#245;es n&#227;o espec&#237;ficas&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> As les&#245;es espec&#237;ficas da psor&#237;ase s&#227;o altamente heterog&#234;neas e podem se apresentar como eritema difuso do palato&#59; o exame histopatol&#243;gico mostra padr&#227;o psori&#225;sico &#40;hiperceratose&#44; acantose com alongamento dos cones epid&#233;rmicos&#44; infiltrado inflamat&#243;rio misto com neutr&#243;filos e linf&#243;citos&#44; vasos sangu&#237;neos congestos&#44; microabscessos de Munro&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a> Tamb&#233;m pode se manifestar como placas&#47;p&#225;pulas esbranqui&#231;adas e eritematosas na mucosa bucal&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">13</span></a> Quando ocorre no l&#225;bio&#44; pode aparecer como l&#225;bios secos com descama&#231;&#227;o&#44; semelhante &#224; queilite&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> A apresenta&#231;&#227;o na gengiva &#233; semelhante &#224; gengivite descamativa&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a> Les&#245;es orais n&#227;o espec&#237;ficas na psor&#237;ase incluem LG e LF&#44; que ocorrem n&#227;o apenas na psor&#237;ase&#44; mas tamb&#233;m em outras doen&#231;as&#46; Nos &#250;ltimos anos&#44; muitos estudos de caso&#8208;controle encontraram aumento na propor&#231;&#227;o de LG e LF em pacientes com psor&#237;ase&#44; mas ainda assim alguns estudos n&#227;o observaram diferen&#231;as estatisticamente significantes&#46; A associa&#231;&#227;o entre LG&#47;LF e psor&#237;ase permanece controversa&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Muitos relatos de estudos epidemiol&#243;gicos encontraram correla&#231;&#227;o entre psor&#237;ase e LG&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;22</span></a> A psor&#237;ase e a LG compartilham um marcador gen&#233;tico comum&#58; o ant&#237;geno leucocit&#225;rio humano &#40;HLA&#8208;Cw6&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> Al&#233;m disso&#44; a psor&#237;ase e a LG apresentam caracter&#237;sticas histopatol&#243;gicas semelhantes&#58; paraceratose&#44; acantose&#44; p&#250;stulas espongiformes de Kogoj&#44; microabscessos de Munro&#44; ectasia vascular e infiltra&#231;&#227;o de c&#233;lulas inflamat&#243;rias &#40;particularmente linf&#243;citos T e neutr&#243;filos&#41; na submucosa&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> Entretanto&#44; n&#227;o foi encontrada associa&#231;&#227;o estatisticamente significante entre LG e psor&#237;ase neste estudo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;760&#41;&#44; provavelmente em virtude da especificidade regional da preval&#234;ncia de LG&#44; que foi baixa tanto no grupo caso &#40;2&#44;2&#37;&#41; quanto no grupo controle &#40;2&#44;6&#37;&#41;&#44; abaixo dos n&#237;veis j&#225; relatados&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#44;16</span></a> A LG &#233; mais prevalente em mulheres e crian&#231;as&#46; No entanto&#44; em pacientes com psor&#237;ase&#44; alguns estudos descobriram que a LG ocorre com maior frequ&#234;ncia em homens<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a> e em indiv&#237;duos mais velhos&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a> o que n&#227;o foi encontrado neste estudo &#40;idade&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;444&#59; g&#234;nero&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;162&#41;&#46; Alguns estudos demonstraram maior frequ&#234;ncia de etilismo em pacientes com psor&#237;ase ou LG&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> e estudos tamb&#233;m demonstraram que fumantes apresentam menor frequ&#234;ncia de LG&#44; o que pode ser atribu&#237;do ao fato de a nicotina ativar os receptores nicot&#237;nicos de acetilcolina nos macr&#243;fagos&#44; levando &#224; redu&#231;&#227;o na s&#237;ntese de TNF&#8208;&#945;&#44; IL&#8208;1 e IL&#8208;6&#59;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> essas c&#233;lulas imunol&#243;gicas e citocinas tamb&#233;m s&#227;o importantes na psor&#237;ase&#46; Portanto&#44; fatores ambientais como tabagismo e etilismo podem estar envolvidos no desenvolvimento de LG na psor&#237;ase&#46; Curiosamente&#44; nenhum dos cinco pacientes com psor&#237;ase e LG neste estudo era tabagista ou etilista&#44; embora as diferen&#231;as tamb&#233;m n&#227;o tenham sido estatisticamente significantes &#40;tabagismo&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;326&#59; etilismo&#58; p &#62;<span class="elsevierStyleHsp" style=""></span>0&#44;990&#41;&#46; Picciani et al&#46; descobriram que a LG era mais frequente na psor&#237;ase de in&#237;cio precoce e estava associada &#224; gravidade da doen&#231;a&#46; A psor&#237;ase de in&#237;cio precoce &#233; geralmente mais grave que a psor&#237;ase de in&#237;cio tardio e est&#225; mais associada ao HLA&#8208;Cw6&#59;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a> portanto&#44; os autores sugerem que a LG pode ser indicador de gravidade da psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> Darwazeh et al&#46; descobriram que a propor&#231;&#227;o de LG &#233; maior em pacientes com psor&#237;ase cuja qualidade de vida esteja significantemente afetada&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a> Diferentemente do artigo de Darwazeh et al&#44; em nosso estudo a preval&#234;ncia de LG no grupo caso n&#227;o estava relacionada &#224;s caracter&#237;sticas da psor&#237;ase&#44; como idade de in&#237;cio da doen&#231;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;990&#41;&#44; dura&#231;&#227;o da psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;546&#41;&#44; envolvimento ungueal &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;219&#41; e articular &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;990&#41;&#44; &#237;ndice PASI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;774&#41;&#44; ASC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;920&#41; e DLQI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;705&#41;&#46; No presente estudo&#44; foi observada maior propor&#231;&#227;o de uso de produtos biol&#243;gicos em pacientes com psor&#237;ase e LG em compara&#231;&#227;o com pacientes com psor&#237;ase sem LG&#44; mas a diferen&#231;a n&#227;o foi estatisticamente significante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;653&#41;&#46; Um estudo encontrou remiss&#227;o da LG em pacientes com psor&#237;ase tratados com secuquinumabe&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> Em geral&#44; este estudo n&#227;o encontrou nenhuma associa&#231;&#227;o estatisticamente significante entre psor&#237;ase e LG&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Este estudo encontrou correla&#231;&#227;o significante entre LF e psor&#237;ase &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; consistente com v&#225;rios outros estudos&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;21&#44;29&#8211;31</span></a> A LF foi significantemente associada &#224; idade dos pacientes com psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41; e &#224; idade no in&#237;cio da doen&#231;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41;&#46; Em compara&#231;&#227;o com pacientes com psor&#237;ase sem LF&#44; descobriu&#8208;se que os pacientes com psor&#237;ase e LF eram mais velhos e tinham frequ&#234;ncia aumentada de psor&#237;ase de in&#237;cio tardio&#44; o que est&#225; de acordo com estudos publicados&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">16&#44;30</span></a> Isso pode ser explicado&#44; em parte&#44; pelo aumento na preval&#234;ncia de LF com a idade&#46; Gonzaga et al&#46; encontraram aus&#234;ncia de associa&#231;&#227;o entre LF e HLA&#8208;Cw6&#44; sugerindo n&#227;o haver base gen&#233;tica comum para LF e psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a> Assim&#44; a LF &#233; considerada uma continua&#231;&#227;o da LG por alguns autores&#44;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#44;14</span></a> o que pode explicar&#44; em parte&#44; a associa&#231;&#227;o entre psor&#237;ase e LF encontrada neste estudo&#46; Os autores encontraram associa&#231;&#227;o significante entre gravidade da psor&#237;ase e LF &#40;PASI&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41;&#44; o que est&#225; de acordo com Altemir et al&#46; e em oposi&#231;&#227;o a Picciani et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">30&#44;31</span></a> Esses autores tamb&#233;m relatam diferen&#231;as cl&#237;nicas na LF de pacientes com e sem psor&#237;ase&#44; e verificaram que o padr&#227;o ramificado e difuso da LF com escala moderada a grave foi mais frequente em pacientes com LF e psor&#237;ase&#46; Os autores do presente estudo observaram que pacientes com psor&#237;ase e LF apresentaram pior qualidade de vida &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#44; comparados aos pacientes com psor&#237;ase sem LF&#44; o que pode ser decorrente das manifesta&#231;&#245;es mais graves da psor&#237;ase&#44; bem como das manifesta&#231;&#245;es orais da LF&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">O presente estudo apresenta limita&#231;&#245;es&#46; A LG tem per&#237;odos de exacerba&#231;&#227;o e remiss&#227;o e&#44; embora fotografias cl&#237;nicas t&#237;picas da LG tenham sido preparadas para determinar se cada indiv&#237;duo havia tido les&#227;o semelhante anteriormente&#44; n&#227;o foi poss&#237;vel evitar um desvio da preval&#234;ncia de LG em rela&#231;&#227;o &#224; verdadeira taxa de preval&#234;ncia&#59; portanto&#44; estudos de coorte prospectivos com tamanhos de amostra maiores s&#227;o necess&#225;rios&#46; Al&#233;m disso&#44; descobriu&#8208;se que os produtos biol&#243;gicos levam &#224; remiss&#227;o de LG e LF&#44;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">28&#44;33</span></a> o que pode ter influenciado a rela&#231;&#227;o LG&#47;LF no grupo de casos do presente estudo&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de psor&#237;ase&#44; LG e LF s&#227;o espec&#237;ficas da regi&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> A maioria dos estudos de caso&#8208;controle sobre a associa&#231;&#227;o de psor&#237;ase com LG e LF foram realizados na Europa&#44; sudeste da &#193;sia&#44; oeste da &#193;sia&#44; sul da &#193;sia&#44; Am&#233;rica do Norte e Am&#233;rica do Sul &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#44; que t&#234;m composi&#231;&#227;o racial diferente em compara&#231;&#227;o com o Leste Asi&#225;tico&#46; N&#227;o h&#225; evid&#234;ncias relevantes da associa&#231;&#227;o de psor&#237;ase com LG e LF em popula&#231;&#245;es do Leste Asi&#225;tico&#59; portanto&#44; este &#233; o primeiro estudo de caso&#8208;controle sobre a correla&#231;&#227;o entre psor&#237;ase e LG&#47;LF na popula&#231;&#227;o Han no sudoeste da China&#46; Os achados do presente estudo s&#227;o semelhantes aos de Monshi et al&#46; e Altemir et al&#46;&#44;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">29&#44;31</span></a> pois os autores demostraram que a psor&#237;ase est&#225; significantemente correlacionada com a LF&#44; e a LF est&#225; associada &#224; idade dos pacientes com psor&#237;ase&#44; &#224; idade de in&#237;cio da doen&#231;a&#44; &#224; gravidade da psor&#237;ase e &#224; qualidade de vida dos pacientes no grupo de casos&#46; Nenhuma associa&#231;&#227;o estatisticamente significante foi encontrada entre psor&#237;ase e LG neste estudo&#46; Portanto&#44; aten&#231;&#227;o deve ser dada ao tratamento de pacientes com psor&#237;ase e LF concomitante&#44; bem como &#224; documenta&#231;&#227;o e seguimento de doen&#231;as cut&#226;neas em pacientes com LF&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Suporte financeiro</span><p id="par0090" class="elsevierStylePara elsevierViewall">Esse trabalho recebeu suporte financeiro do <span class="elsevierStyleItalic">Fund of Sichuan Provincial Department of Science and Technology</span> &#40;2022YFS0039&#41;&#44; do Programa de Pesquisa e Desenvolvimento&#44; <span class="elsevierStyleItalic">West China Hospital of Stomatology&#44; Sichuan University</span> &#40;LCYJ2023&#8208;DL&#8208;2&#41;&#44; por bolsas de pesquisa da <span class="elsevierStyleItalic">National Natural Science Foundation of China &#40;</span>81771086&#41;&#44; e <span class="elsevierStyleItalic">CAMS Innovation Fund for Medical Sciences</span> &#40;CIFMS&#44; 2019&#8208;I2M&#8208;5&#8208;004&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Contribui&#231;&#227;o dos autores</span><p id="par0095" class="elsevierStylePara elsevierViewall">Yuting Hu&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Ying Li&#58; Revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Wei Yan&#58; Concep&#231;&#227;o e planejamento do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Yu Zhou&#58; Concep&#231;&#227;o e planejamento do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflito de interesses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase &#233; doen&#231;a cut&#226;nea imunomediada comum que pode afetar outros &#243;rg&#227;os e tecidos&#44; incluindo a mucosa oral&#46; Alguns estudos encontraram propor&#231;&#227;o aumentada de l&#237;ngua geogr&#225;fica &#40;LG&#41; e l&#237;ngua fissurada &#40;LF&#41; em pacientes com psor&#237;ase&#44; o que parece ser espec&#237;fico da regi&#227;o&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A associa&#231;&#227;o da psor&#237;ase com LG&#47;LF em popula&#231;&#245;es do Leste Asi&#225;tico permanece desconhecida&#46; Assim&#44; objetivou&#8208;se investigar a associa&#231;&#227;o da psor&#237;ase com LG&#47;LF na popula&#231;&#227;o Han no sudoeste da China&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O presente estudo foi realizado em 230 casos de psor&#237;ase e 230 controles saud&#225;veis no West China Hospital&#46; Foi comparada a propor&#231;&#227;o de indiv&#237;duos com LG&#47;LF nos dois grupos e tamb&#233;m idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade de in&#237;cio da psor&#237;ase&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; &#237;ndice PASI&#44; &#225;rea de superf&#237;cie corporal&#44; &#237;ndice de qualidade de vida em dermatologia e propor&#231;&#227;o de uso de produtos biol&#243;gicos em pacientes com psor&#237;ase com ou sem LG&#47;LF&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Foi encontrada forte associa&#231;&#227;o entre psor&#237;ase e LF &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e associa&#231;&#227;o n&#227;o significante entre psor&#237;ase e LG &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;760&#41;&#46; Comparando pacientes com psor&#237;ase sem LF&#44; foi observado que os pacientes com psor&#237;ase e LF eram mais velhos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41; e tinham frequ&#234;ncia aumentada de psor&#237;ase de in&#237;cio tardio &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41;&#44; tamb&#233;m psor&#237;ase mais grave &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41; e pior qualidade de vida &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A LG tem per&#237;odos de exacerba&#231;&#227;o e remiss&#227;o&#59; portanto&#44; n&#227;o &#233; poss&#237;vel evitar o desvio da preval&#234;ncia de LG nesse estudo da verdadeira taxa de preval&#234;ncia&#46; Al&#233;m disso&#44; descobriu&#8208;se que os produtos biol&#243;gicos levam &#224; remiss&#227;o de LG e LF&#44; o que pode ter influenciado a rela&#231;&#227;o LG&#47;LF no grupo de casos desse estudo&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase foi associada &#224; LF na popula&#231;&#227;o Han do sudoeste da China&#59; &#233; necess&#225;rio prestar aten&#231;&#227;o ao tratamento de indiv&#237;duos com psor&#237;ase e LF e &#224; observa&#231;&#227;o de doen&#231;as cut&#226;neas em pacientes com LF&#46;</p></span>"
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">94 &#40;40&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">107 &#40;46&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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          "pt" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas gerais dos grupos caso e controle</p>"
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          "leyenda" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">LF&#44; l&#237;ngua fissurada&#59; LG&#44; l&#237;ngua geogr&#225;fica&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;2&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sim&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sem LG &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>225&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LF &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&nbsp;\t\t\t\t\t\t\n
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Artigo original
Associação de psoríase com língua geográfica e fissurada na população Han no sudoeste da China
Yuting Hua, Ying Lia, Wei Yanb,
Autor para correspondência
yanweihappyhappy@163.com

Autores para correspondência.
, Yu Zhoua,
Autor para correspondência
yuzhou1983@scu.edu.cn

Autores para correspondência.
a State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Research Unit of Oral Carcinogenesis and Management, Chinese Academy of Medical Sciences, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
b Departamento de Dermatologia, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introdu&#231;&#227;o</span><p id="par0005" class="elsevierStylePara elsevierViewall">Psor&#237;ase &#233; doen&#231;a inflamat&#243;ria cr&#244;nica da pele&#44; imunomediada&#44; comum&#44; na qual fatores gen&#233;ticos desempenham papel fundamental&#46; Entretanto&#44; a import&#226;ncia de fatores ambientais&#44; como o tabagismo e o etilismo&#44; est&#225; aumentando&#46;<a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">1&#44;2</span></a> Sua preval&#234;ncia &#233; de aproximadamente 2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">3</span></a> Placas eritematosas com descama&#231;&#227;o&#44; localizadas ou disseminadas&#44; s&#227;o sua manifesta&#231;&#227;o t&#237;pica&#44; podendo ser classificada como comum&#44; pustulosa&#44; eritrod&#233;rmica ou artr&#237;tica&#44; dependendo das les&#245;es cl&#237;nicas&#46; Al&#233;m da pele&#44; a doen&#231;a tamb&#233;m pode afetar as unhas das m&#227;os&#47;p&#233;s e articula&#231;&#245;es&#44; afetando gravemente a qualidade de vida dos pacientes&#46; A psor&#237;ase pode afetar a mucosa oral e &#233; conhecida como &#8220;psor&#237;ase oral&#8221;&#44; com muitos estudos nos &#250;ltimos anos concentrando&#8208;se em suas les&#245;es orais inespec&#237;ficas&#58; l&#237;ngua geogr&#225;fica &#40;LG&#41; e l&#237;ngua fissurada &#40;LF&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A LG &#233; doen&#231;a inflamat&#243;ria benigna&#44; cr&#244;nica e recorrente da l&#237;ngua&#44; caracterizada por les&#245;es eritematosas multifocais formadas por atrofia das papilas filiformes&#44; circundadas por borda branca ou amarela levemente elevada&#44; correspondendo a hiperplasia das papilas filiformes&#44; com aspecto semelhante a um mapa&#46; As les&#245;es variam em padr&#227;o e localiza&#231;&#227;o&#44; s&#227;o conhecidas como &#8220;glossite migrat&#243;ria&#8221; e sua preval&#234;ncia &#233; de 0&#44;28&#37; a 14&#44;4&#37;&#46; &#201; mais comum em crian&#231;as e diminui com a idade&#59; as mulheres s&#227;o afetadas com maior frequ&#234;ncia que os homens&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a> Os fatores de risco para LG incluem fatores imunol&#243;gicos&#44; gen&#233;ticos&#44; al&#233;rgicos e psicol&#243;gicos&#46; Ela pode ser acompanhada por outras doen&#231;as&#44; como psor&#237;ase&#44; LF&#44; s&#237;ndrome de ard&#234;ncia bucal&#44; diabetes <span class="elsevierStyleItalic">mellitus</span> e s&#237;ndrome de Down&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">6</span></a> A LG &#233; geralmente assintom&#225;tica&#44; mas os pacientes frequentemente desenvolvem ansiedade grave e medo de c&#226;ncer&#59; portanto&#44; &#233; necess&#225;ria explica&#231;&#227;o detalhada dessa doen&#231;a&#46; Alguns pacientes apresentam sensa&#231;&#245;es de ard&#234;ncia e desconforto&#46; O tratamento sintom&#225;tico pode ser eficaz&#44; com o emprego de anti&#8208;histam&#237;nicos&#44; ansiol&#237;ticos e esteroides&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A LF &#233; geralmente considerada anomalia cong&#234;nita&#44; caracterizada por fissuras nas faces dorsal e&#47;ou dorsolateral da l&#237;ngua em diferentes arranjos e profundidades&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a> A incid&#234;ncia &#233; de 0&#44;6&#37; a 29&#44;2&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> e sua frequ&#234;ncia aumenta com a idade&#46; A etiologia da LF tamb&#233;m &#233; desconhecida&#59; fatores gen&#233;ticos podem ser importante fator de risco para essa condi&#231;&#227;o&#46; A LF frequentemente coexiste com a LG&#44; s&#237;ndrome de Down&#44; acromegalia&#44; s&#237;ndrome de Sj&#246;gren e s&#237;ndrome de Melkersson&#8208;Rosenthal&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">As preval&#234;ncias de psor&#237;ase&#44; LG e LF s&#227;o todas espec&#237;ficas regionalmente&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> A associa&#231;&#227;o de psor&#237;ase com LG&#47;LF em popula&#231;&#245;es do Leste Asi&#225;tico permanece desconhecida&#46; Portanto&#44; o presente estudo teve como objetivo determinar a associa&#231;&#227;o da psor&#237;ase com LG&#47;LF na popula&#231;&#227;o Han do sudoeste da China e caracterizar essas associa&#231;&#245;es em rela&#231;&#227;o ao estado geral dos pacientes&#44; condi&#231;&#227;o da psor&#237;ase e modalidade de tratamento&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">M&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">A presente investiga&#231;&#227;o &#233; um estudo transversal&#44; caso&#8208;controle&#44; planejado e conduzido de acordo com a Declara&#231;&#227;o de Helsinque da World Medical Association&#46; Este estudo foi aprovado pelo comit&#234; de &#233;tica local e todos os 460 indiv&#237;duos deram o consentimento informado&#46; Duzentos e trinta pacientes com psor&#237;ase tratados no Departamento de Dermatologia do West China Hospital&#44; Sichuan University&#44; de outubro de 2022 a fevereiro de 2023&#44; foram inclu&#237;dos no grupo de casos&#46; O presente estudo n&#227;o excluiu pacientes com psor&#237;ase em uso de qualquer tratamento&#44; incluindo produtos biol&#243;gicos&#46; Duzentos e trinta indiv&#237;duos saud&#225;veis acompanhantes de outros pacientes&#44; nunca diagnosticados com psor&#237;ase e pareados por idade e g&#234;nero ao grupo de casos&#44; foram inclu&#237;dos no grupo controle&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">O diagn&#243;stico de psor&#237;ase foi realizado por dermatologista e estabelecido com base em manifesta&#231;&#245;es cl&#237;nicas t&#237;picas&#58; placas eritematosas descamativas&#44; ou confirmada por exame histopatol&#243;gico se as les&#245;es fossem at&#237;picas&#46; Todos os indiv&#237;duos foram submetidos a exame bucal detalhado&#46; O exame bucal foi realizado por dentistas qualificados e com experi&#234;ncia no diagn&#243;stico e tratamento de doen&#231;as bucais utilizando estomatosc&#243;pios e <span class="elsevierStyleItalic">swabs</span> sob luz artificial&#46; A LG foi diagnosticada por sua apresenta&#231;&#227;o cl&#237;nica t&#237;pica&#58; atrofia das papilas filiformes como les&#227;o semelhante a placa vermelha com hiperplasia das papilas filiformes circundantes&#46; A LG &#233; doen&#231;a cr&#244;nica recidivante&#8208;remitente com per&#237;odos de exacerba&#231;&#227;o e remiss&#227;o&#44; ent&#227;o foram preparadas fotografias cl&#237;nicas t&#237;picas da LG para determinar se cada indiv&#237;duo havia apresentado les&#227;o semelhante anteriormente&#46; A LF tamb&#233;m &#233; diagnosticada por meio de suas manifesta&#231;&#245;es cl&#237;nicas t&#237;picas&#58; fissuras na face dorsal e&#47;ou dorsolateral da l&#237;ngua em diferentes arranjos e profundidades&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">As informa&#231;&#245;es gerais&#44; incluindo idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade no in&#237;cio da psor&#237;ase &#40;in&#237;cio precoce&#58; in&#237;cio at&#233; os 40 anos&#59; in&#237;cio tardio&#58; in&#237;cio ap&#243;s 40 anos&#41;&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; &#237;ndice PASI &#40;<span class="elsevierStyleItalic">Psoriasis Area and Severity Index</span>&#41;&#44; &#225;rea de superf&#237;cie corporal &#40;ASC&#41;&#44; &#205;ndice de Qualidade de Vida em Dermatologia &#40;DLQI&#44; <span class="elsevierStyleItalic">Dermatology Life Quality Index</span>&#41; e tipo de tratamento recebido foram registrados&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Foi comparada a propor&#231;&#227;o de indiv&#237;duos com LG e LF nos grupos caso e controle e foram comparados os seguintes dados&#58; idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade no in&#237;cio da psor&#237;ase&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; PASI&#44; ASC&#44; DLQI e propor&#231;&#227;o de pacientes psori&#225;sicos&#44; com ou sem LG&#47;LF&#44; em uso de produtos biol&#243;gicos&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Os dados foram analisados utilizando o <span class="elsevierStyleItalic">software</span> IBM SPSS Statistics vers&#227;o 26&#46; De acordo com os resultados do teste de Kolmogorov&#8208;Smirnov&#44; as vari&#225;veis cont&#237;nuas deste estudo foram apresentadas como mediana &#40;intervalo interquartil&#41; e comparadas pelo teste U de Mann&#8208;Whitney&#46; As vari&#225;veis categ&#243;ricas foram apresentadas como n&#250;mero &#40;porcentagem&#41; e comparadas pelo teste Qui&#8208;Quadrado de Pearson ou teste exato de Fisher&#46; Valor de p bilateral &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05 foi considerado estatisticamente significante&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Um total de 460 indiv&#237;duos foi inclu&#237;do neste estudo&#58; 230 pacientes com psor&#237;ase e 230 controles saud&#225;veis&#46; O grupo caso consistiu em 136 homens e 94 mulheres&#44; com mediana de idade de 36 &#40;29&#8208;49&#41; anos&#46; O grupo controle consistiu em 123 homens e 107 mulheres&#44; com mediana de idade de 39 &#40;31&#8208;51&#41; anos &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#41;&#46; Os grupos caso e controle foram pareados por idade e g&#234;nero &#40;idade&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;130&#59; sexo&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;222&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Foi encontrada associa&#231;&#227;o n&#227;o significante entre psor&#237;ase e LG &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;760&#41; e forte associa&#231;&#227;o entre psor&#237;ase e LF &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">N&#227;o foram observadas diferen&#231;as entre pacientes com psor&#237;ase com LG e aqueles sem LG em rela&#231;&#227;o a idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade no in&#237;cio da psor&#237;ase&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; PASI&#44; ASC&#44; DLQI e propor&#231;&#227;o de indiv&#237;duos utilizando produtos biol&#243;gicos&#46; Em compara&#231;&#227;o com pacientes com psor&#237;ase sem LF&#44; observou&#8208;se que os pacientes com psor&#237;ase e LF eram mais velhos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41;&#44; tinham frequ&#234;ncia aumentada de psor&#237;ase de in&#237;cio tardio &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41; e tamb&#233;m apresentavam psor&#237;ase mais grave &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41; e pior qualidade de vida &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46; N&#227;o foram observadas associa&#231;&#245;es de LF com outras caracter&#237;sticas&#44; incluindo g&#234;nero&#44; tabagismo&#44; etilismo&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; ASC ou propor&#231;&#227;o de uso de produtos biol&#243;gicos no grupo de casos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Discuss&#227;o</span><p id="par0065" class="elsevierStylePara elsevierViewall">A psor&#237;ase &#233; doen&#231;a comum&#44; cr&#244;nica e imunomediada&#59; n&#227;o &#233; doen&#231;a cut&#226;nea isolada e est&#225; associada a risco aumentado de comorbidades&#44; incluindo artrite psori&#225;sica&#44; doen&#231;a cardiovascular&#44; diabetes <span class="elsevierStyleItalic">mellitus</span> e dist&#250;rbios gastrintestinais&#46;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">9</span></a> Acredita&#8208;se tamb&#233;m que afete a mucosa oral&#44; conhecida como &#8220;psor&#237;ase oral&#8221;&#46; O primeiro caso de psor&#237;ase oral foi relatado em 1903&#59;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">10</span></a> posteriormente&#44; v&#225;rios casos foram relatados&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">11&#8211;13</span></a> Nesses artigos&#44; as manifesta&#231;&#245;es da psor&#237;ase oral podem ser divididas em dois grupos&#58; 1&#41; les&#245;es espec&#237;ficas da psor&#237;ase e 2&#41; les&#245;es n&#227;o espec&#237;ficas&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> As les&#245;es espec&#237;ficas da psor&#237;ase s&#227;o altamente heterog&#234;neas e podem se apresentar como eritema difuso do palato&#59; o exame histopatol&#243;gico mostra padr&#227;o psori&#225;sico &#40;hiperceratose&#44; acantose com alongamento dos cones epid&#233;rmicos&#44; infiltrado inflamat&#243;rio misto com neutr&#243;filos e linf&#243;citos&#44; vasos sangu&#237;neos congestos&#44; microabscessos de Munro&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a> Tamb&#233;m pode se manifestar como placas&#47;p&#225;pulas esbranqui&#231;adas e eritematosas na mucosa bucal&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">13</span></a> Quando ocorre no l&#225;bio&#44; pode aparecer como l&#225;bios secos com descama&#231;&#227;o&#44; semelhante &#224; queilite&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">11</span></a> A apresenta&#231;&#227;o na gengiva &#233; semelhante &#224; gengivite descamativa&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">12</span></a> Les&#245;es orais n&#227;o espec&#237;ficas na psor&#237;ase incluem LG e LF&#44; que ocorrem n&#227;o apenas na psor&#237;ase&#44; mas tamb&#233;m em outras doen&#231;as&#46; Nos &#250;ltimos anos&#44; muitos estudos de caso&#8208;controle encontraram aumento na propor&#231;&#227;o de LG e LF em pacientes com psor&#237;ase&#44; mas ainda assim alguns estudos n&#227;o observaram diferen&#231;as estatisticamente significantes&#46; A associa&#231;&#227;o entre LG&#47;LF e psor&#237;ase permanece controversa&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Muitos relatos de estudos epidemiol&#243;gicos encontraram correla&#231;&#227;o entre psor&#237;ase e LG&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;22</span></a> A psor&#237;ase e a LG compartilham um marcador gen&#233;tico comum&#58; o ant&#237;geno leucocit&#225;rio humano &#40;HLA&#8208;Cw6&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">23</span></a> Al&#233;m disso&#44; a psor&#237;ase e a LG apresentam caracter&#237;sticas histopatol&#243;gicas semelhantes&#58; paraceratose&#44; acantose&#44; p&#250;stulas espongiformes de Kogoj&#44; microabscessos de Munro&#44; ectasia vascular e infiltra&#231;&#227;o de c&#233;lulas inflamat&#243;rias &#40;particularmente linf&#243;citos T e neutr&#243;filos&#41; na submucosa&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">24</span></a> Entretanto&#44; n&#227;o foi encontrada associa&#231;&#227;o estatisticamente significante entre LG e psor&#237;ase neste estudo &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;760&#41;&#44; provavelmente em virtude da especificidade regional da preval&#234;ncia de LG&#44; que foi baixa tanto no grupo caso &#40;2&#44;2&#37;&#41; quanto no grupo controle &#40;2&#44;6&#37;&#41;&#44; abaixo dos n&#237;veis j&#225; relatados&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#44;16</span></a> A LG &#233; mais prevalente em mulheres e crian&#231;as&#46; No entanto&#44; em pacientes com psor&#237;ase&#44; alguns estudos descobriram que a LG ocorre com maior frequ&#234;ncia em homens<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">15</span></a> e em indiv&#237;duos mais velhos&#44;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">18</span></a> o que n&#227;o foi encontrado neste estudo &#40;idade&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;444&#59; g&#234;nero&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;162&#41;&#46; Alguns estudos demonstraram maior frequ&#234;ncia de etilismo em pacientes com psor&#237;ase ou LG&#44;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">14</span></a> e estudos tamb&#233;m demonstraram que fumantes apresentam menor frequ&#234;ncia de LG&#44; o que pode ser atribu&#237;do ao fato de a nicotina ativar os receptores nicot&#237;nicos de acetilcolina nos macr&#243;fagos&#44; levando &#224; redu&#231;&#227;o na s&#237;ntese de TNF&#8208;&#945;&#44; IL&#8208;1 e IL&#8208;6&#59;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">25</span></a> essas c&#233;lulas imunol&#243;gicas e citocinas tamb&#233;m s&#227;o importantes na psor&#237;ase&#46; Portanto&#44; fatores ambientais como tabagismo e etilismo podem estar envolvidos no desenvolvimento de LG na psor&#237;ase&#46; Curiosamente&#44; nenhum dos cinco pacientes com psor&#237;ase e LG neste estudo era tabagista ou etilista&#44; embora as diferen&#231;as tamb&#233;m n&#227;o tenham sido estatisticamente significantes &#40;tabagismo&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;326&#59; etilismo&#58; p &#62;<span class="elsevierStyleHsp" style=""></span>0&#44;990&#41;&#46; Picciani et al&#46; descobriram que a LG era mais frequente na psor&#237;ase de in&#237;cio precoce e estava associada &#224; gravidade da doen&#231;a&#46; A psor&#237;ase de in&#237;cio precoce &#233; geralmente mais grave que a psor&#237;ase de in&#237;cio tardio e est&#225; mais associada ao HLA&#8208;Cw6&#59;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">26</span></a> portanto&#44; os autores sugerem que a LG pode ser indicador de gravidade da psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">21</span></a> Darwazeh et al&#46; descobriram que a propor&#231;&#227;o de LG &#233; maior em pacientes com psor&#237;ase cuja qualidade de vida esteja significantemente afetada&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">27</span></a> Diferentemente do artigo de Darwazeh et al&#44; em nosso estudo a preval&#234;ncia de LG no grupo caso n&#227;o estava relacionada &#224;s caracter&#237;sticas da psor&#237;ase&#44; como idade de in&#237;cio da doen&#231;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;990&#41;&#44; dura&#231;&#227;o da psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;546&#41;&#44; envolvimento ungueal &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;219&#41; e articular &#40;p<span class="elsevierStyleHsp" style=""></span>&#62; 0&#44;990&#41;&#44; &#237;ndice PASI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;774&#41;&#44; ASC &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;920&#41; e DLQI &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;705&#41;&#46; No presente estudo&#44; foi observada maior propor&#231;&#227;o de uso de produtos biol&#243;gicos em pacientes com psor&#237;ase e LG em compara&#231;&#227;o com pacientes com psor&#237;ase sem LG&#44; mas a diferen&#231;a n&#227;o foi estatisticamente significante &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;653&#41;&#46; Um estudo encontrou remiss&#227;o da LG em pacientes com psor&#237;ase tratados com secuquinumabe&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">28</span></a> Em geral&#44; este estudo n&#227;o encontrou nenhuma associa&#231;&#227;o estatisticamente significante entre psor&#237;ase e LG&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Este estudo encontrou correla&#231;&#227;o significante entre LF e psor&#237;ase &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; consistente com v&#225;rios outros estudos&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">15&#8211;21&#44;29&#8211;31</span></a> A LF foi significantemente associada &#224; idade dos pacientes com psor&#237;ase &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41; e &#224; idade no in&#237;cio da doen&#231;a &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41;&#46; Em compara&#231;&#227;o com pacientes com psor&#237;ase sem LF&#44; descobriu&#8208;se que os pacientes com psor&#237;ase e LF eram mais velhos e tinham frequ&#234;ncia aumentada de psor&#237;ase de in&#237;cio tardio&#44; o que est&#225; de acordo com estudos publicados&#46;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">16&#44;30</span></a> Isso pode ser explicado&#44; em parte&#44; pelo aumento na preval&#234;ncia de LF com a idade&#46; Gonzaga et al&#46; encontraram aus&#234;ncia de associa&#231;&#227;o entre LF e HLA&#8208;Cw6&#44; sugerindo n&#227;o haver base gen&#233;tica comum para LF e psor&#237;ase&#46;<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">32</span></a> Assim&#44; a LF &#233; considerada uma continua&#231;&#227;o da LG por alguns autores&#44;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">4&#44;14</span></a> o que pode explicar&#44; em parte&#44; a associa&#231;&#227;o entre psor&#237;ase e LF encontrada neste estudo&#46; Os autores encontraram associa&#231;&#227;o significante entre gravidade da psor&#237;ase e LF &#40;PASI&#58; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41;&#44; o que est&#225; de acordo com Altemir et al&#46; e em oposi&#231;&#227;o a Picciani et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">30&#44;31</span></a> Esses autores tamb&#233;m relatam diferen&#231;as cl&#237;nicas na LF de pacientes com e sem psor&#237;ase&#44; e verificaram que o padr&#227;o ramificado e difuso da LF com escala moderada a grave foi mais frequente em pacientes com LF e psor&#237;ase&#46; Os autores do presente estudo observaram que pacientes com psor&#237;ase e LF apresentaram pior qualidade de vida &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#44; comparados aos pacientes com psor&#237;ase sem LF&#44; o que pode ser decorrente das manifesta&#231;&#245;es mais graves da psor&#237;ase&#44; bem como das manifesta&#231;&#245;es orais da LF&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">O presente estudo apresenta limita&#231;&#245;es&#46; A LG tem per&#237;odos de exacerba&#231;&#227;o e remiss&#227;o e&#44; embora fotografias cl&#237;nicas t&#237;picas da LG tenham sido preparadas para determinar se cada indiv&#237;duo havia tido les&#227;o semelhante anteriormente&#44; n&#227;o foi poss&#237;vel evitar um desvio da preval&#234;ncia de LG em rela&#231;&#227;o &#224; verdadeira taxa de preval&#234;ncia&#59; portanto&#44; estudos de coorte prospectivos com tamanhos de amostra maiores s&#227;o necess&#225;rios&#46; Al&#233;m disso&#44; descobriu&#8208;se que os produtos biol&#243;gicos levam &#224; remiss&#227;o de LG e LF&#44;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">28&#44;33</span></a> o que pode ter influenciado a rela&#231;&#227;o LG&#47;LF no grupo de casos do presente estudo&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">A preval&#234;ncia de psor&#237;ase&#44; LG e LF s&#227;o espec&#237;ficas da regi&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">8</span></a> A maioria dos estudos de caso&#8208;controle sobre a associa&#231;&#227;o de psor&#237;ase com LG e LF foram realizados na Europa&#44; sudeste da &#193;sia&#44; oeste da &#193;sia&#44; sul da &#193;sia&#44; Am&#233;rica do Norte e Am&#233;rica do Sul &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabela 4</a>&#41;&#44; que t&#234;m composi&#231;&#227;o racial diferente em compara&#231;&#227;o com o Leste Asi&#225;tico&#46; N&#227;o h&#225; evid&#234;ncias relevantes da associa&#231;&#227;o de psor&#237;ase com LG e LF em popula&#231;&#245;es do Leste Asi&#225;tico&#59; portanto&#44; este &#233; o primeiro estudo de caso&#8208;controle sobre a correla&#231;&#227;o entre psor&#237;ase e LG&#47;LF na popula&#231;&#227;o Han no sudoeste da China&#46; Os achados do presente estudo s&#227;o semelhantes aos de Monshi et al&#46; e Altemir et al&#46;&#44;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">29&#44;31</span></a> pois os autores demostraram que a psor&#237;ase est&#225; significantemente correlacionada com a LF&#44; e a LF est&#225; associada &#224; idade dos pacientes com psor&#237;ase&#44; &#224; idade de in&#237;cio da doen&#231;a&#44; &#224; gravidade da psor&#237;ase e &#224; qualidade de vida dos pacientes no grupo de casos&#46; Nenhuma associa&#231;&#227;o estatisticamente significante foi encontrada entre psor&#237;ase e LG neste estudo&#46; Portanto&#44; aten&#231;&#227;o deve ser dada ao tratamento de pacientes com psor&#237;ase e LF concomitante&#44; bem como &#224; documenta&#231;&#227;o e seguimento de doen&#231;as cut&#226;neas em pacientes com LF&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Suporte financeiro</span><p id="par0090" class="elsevierStylePara elsevierViewall">Esse trabalho recebeu suporte financeiro do <span class="elsevierStyleItalic">Fund of Sichuan Provincial Department of Science and Technology</span> &#40;2022YFS0039&#41;&#44; do Programa de Pesquisa e Desenvolvimento&#44; <span class="elsevierStyleItalic">West China Hospital of Stomatology&#44; Sichuan University</span> &#40;LCYJ2023&#8208;DL&#8208;2&#41;&#44; por bolsas de pesquisa da <span class="elsevierStyleItalic">National Natural Science Foundation of China &#40;</span>81771086&#41;&#44; e <span class="elsevierStyleItalic">CAMS Innovation Fund for Medical Sciences</span> &#40;CIFMS&#44; 2019&#8208;I2M&#8208;5&#8208;004&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Contribui&#231;&#227;o dos autores</span><p id="par0095" class="elsevierStylePara elsevierViewall">Yuting Hu&#58; Obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Ying Li&#58; Revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Wei Yan&#58; Concep&#231;&#227;o e planejamento do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Yu Zhou&#58; Concep&#231;&#227;o e planejamento do estudo&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflito de interesses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Fundamentos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase &#233; doen&#231;a cut&#226;nea imunomediada comum que pode afetar outros &#243;rg&#227;os e tecidos&#44; incluindo a mucosa oral&#46; Alguns estudos encontraram propor&#231;&#227;o aumentada de l&#237;ngua geogr&#225;fica &#40;LG&#41; e l&#237;ngua fissurada &#40;LF&#41; em pacientes com psor&#237;ase&#44; o que parece ser espec&#237;fico da regi&#227;o&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A associa&#231;&#227;o da psor&#237;ase com LG&#47;LF em popula&#231;&#245;es do Leste Asi&#225;tico permanece desconhecida&#46; Assim&#44; objetivou&#8208;se investigar a associa&#231;&#227;o da psor&#237;ase com LG&#47;LF na popula&#231;&#227;o Han no sudoeste da China&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O presente estudo foi realizado em 230 casos de psor&#237;ase e 230 controles saud&#225;veis no West China Hospital&#46; Foi comparada a propor&#231;&#227;o de indiv&#237;duos com LG&#47;LF nos dois grupos e tamb&#233;m idade&#44; g&#234;nero&#44; tabagismo&#44; etilismo&#44; idade de in&#237;cio da psor&#237;ase&#44; dura&#231;&#227;o da psor&#237;ase&#44; envolvimento ungueal e articular&#44; &#237;ndice PASI&#44; &#225;rea de superf&#237;cie corporal&#44; &#237;ndice de qualidade de vida em dermatologia e propor&#231;&#227;o de uso de produtos biol&#243;gicos em pacientes com psor&#237;ase com ou sem LG&#47;LF&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Foi encontrada forte associa&#231;&#227;o entre psor&#237;ase e LF &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; e associa&#231;&#227;o n&#227;o significante entre psor&#237;ase e LG &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;760&#41;&#46; Comparando pacientes com psor&#237;ase sem LF&#44; foi observado que os pacientes com psor&#237;ase e LF eram mais velhos &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;021&#41; e tinham frequ&#234;ncia aumentada de psor&#237;ase de in&#237;cio tardio &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#41;&#44; tamb&#233;m psor&#237;ase mais grave &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;047&#41; e pior qualidade de vida &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;045&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Limita&#231;&#245;es do estudo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A LG tem per&#237;odos de exacerba&#231;&#227;o e remiss&#227;o&#59; portanto&#44; n&#227;o &#233; poss&#237;vel evitar o desvio da preval&#234;ncia de LG nesse estudo da verdadeira taxa de preval&#234;ncia&#46; Al&#233;m disso&#44; descobriu&#8208;se que os produtos biol&#243;gicos levam &#224; remiss&#227;o de LG e LF&#44; o que pode ter influenciado a rela&#231;&#227;o LG&#47;LF no grupo de casos desse estudo&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclus&#245;es</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A psor&#237;ase foi associada &#224; LF na popula&#231;&#227;o Han do sudoeste da China&#59; &#233; necess&#225;rio prestar aten&#231;&#227;o ao tratamento de indiv&#237;duos com psor&#237;ase e LF e &#224; observa&#231;&#227;o de doen&#231;as cut&#226;neas em pacientes com LF&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Como citar este artigo&#58; Hu Y&#44; Li Y&#44; Yan W&#44; Zhou Y&#46; Association of psoriasis with geographic and fissured tongue in the Han population in southwestern China&#46; An Bras Dermatol&#46; 2024&#59;99&#58;826&#8211;32&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>460&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#205;ndia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">272&#47;320 &#40;0&#44;0456&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Brasil&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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Informação do artigo
ISSN: 26662752
Idioma original: Português
Dados atualizados diariamente
Ano/Mês Html Pdf Total
2024 Novembro 19 8 27
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Idiomas
Anais Brasileiros de Dermatologia (Portuguese)
en pt
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