Tongue

Geographic Tongue

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Geographic Tongue, Migratory Glossitis, Benign Migratory Glossitis, Glossitis Areata Exfoliativa, Glossitis Areata Migrans, Erythema Migrans of the Dorsal Tongue

  • See Also
  1. Tongue Disorder
  2. Tongue Mass
  • Epidemiology
  1. Prevalence: 1-3% in U.S. (common)
  2. More common in those with a Family History of Geographic Tongue
  • Pathophysiology
  1. Unclear etiology
  2. Benign, recurrent inflammatory condition
  3. Scattered patches of lost Filiform Papillae result in localized, round regions of Smooth Tongue
  • Symptoms
  1. Asymptomatic in most cases
  2. Tongue Burning or food sensitivity may occur with spicy foods
  • Signs
  1. Scattered bright red areas (bare patches) on Tongue dorsum
    1. Denuded of papillae, Smooth Tongue patches (filiform atrophy)
    2. Random pattern of small. well-demarcated smooth patches on dorsal or lateral Tongue
  2. Patches are surrounded by light yellow or white elevated rings (serpiginous white borders, map-like)
  3. Pattern changes within days
  4. May also affect other regions of Oral Mucosa (e.g. Stomatitis)
  • Associated Conditions
  1. Fissured Tongue
  2. Other associated conditions with very limited evidence
    1. Atopy
    2. Psoriasis
    3. Reactive Arthritis
  • Management
  • Symptomatic lesions
  1. No treatment is uniformly effective
  2. Treatments that have been tried
    1. Tongue sensitivity may respond to Topical Steroid gel or Antihistamine rinse
    2. Acetaminophen
    3. Topical Corticosteroids
    4. Zinc supplementation
    5. Topical Anesthetic mouth rinses
    6. Sucralfate
  3. Consider other common oral condition treatment
    1. See Xerostomia
    2. See Burning Mouth Syndrome
  4. Refractory symptoms
    1. Consider systemic medications (e.g. Corticosteroids, Calcineurin Inhibitors) in severe cases
  • Course
  1. Variable, but often resolves spontaneously, only to recurr later without obvious triggers
  • References
  1. Assimakopoulos (2002) Am J Med 113(9): 751-5 [PubMed]
  2. Randall (2022) Am Fam Physician 105(4): 369-76 [PubMed]
  3. Straub (2024) Am Fam Physician 110(5): 467-75 [PubMed]