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benign migratory glossitis (geographic tongue)
Etiology:
- may be observed in patients with psoriasis or atopic dermatitis
- occurs in otherwise healthy persons
- not linked to tobacco use or HIV1 infection
Epidemiology:
- about 2% of the population
Pathology:
- asymptomatic inflammation of the tongue with rapid loss & regrowth of filaform papillae
Clinical manifestations:
- generally asymptomatic
- when symptomatic, causes pain while eating
- does not cause taste disturbance [2]
- appearance of denuded red patches migrating across the surface of the tongue
- map-like erythematous patches with white hyperkeratotic rims on dorsal surface of tongue [7]
- migratory: can change in appearance within minutes to hours
* images [5]
Special laboratory:
- biopsy not required
Differential diagnosis:
- oral leukoplakia
- patches or plaques of the oral mucosa, associated with tobacco or chronic trauma
- oral hairy leukoplakia
- adherent white plaques, associated with EBV, HIV1 infection
- lichen planus
- occurs in older persons, associated with chronic trauma or medications
- lesions variable: reticular white plaques of the oral mucosa
- erosions & ulcerations may be painful
- oral candidiasis:
- non-adherent white plaques or pseudomembranes [7]
Management:
- no therapy is required
General
glossitis
References
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 190
- Geriatric Review Syllabus, 7th edition
Parada JT et al (eds)
American Geriatrics Society, 2010
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015
- Kelsch RD, James WD
Medscape: Geographic Tongue
http://emedicine.medscape.com/article/1078465-overview
- DermNet NZ (images)
Geographic tongue (benign migratory glossitis)
http://www.dermnetnz.org/site-age-specific/geographic-tongue.html
- Shulman JD, Carpenter WM.
Prevalence and risk factors associated with geographic tongue
among US adults.
Oral Dis. 2006 Jul;12(4):381-6.
PMID: 16792723
- NEJM Knowledge+