Geographic tongue
(benign migratory glossitis, erythema migrans)
DESCRIPTION: The lesions of this disease on the tongue are so characteristic that recognition should be instantaneous. The dorsal tongue displays map-like areas that are smooth and red with a whitish-yellow perimeter. The disease may involve any oral mucosal surface in which case the name erythema migrans is more appropriate. Atrophy of the filliform papillae is usually a finding on the dorsal tongue.
All ages are affected. We have seen it in a child six months old. The number of lesions varies from one to many. Old lesions heal and new ones form, waxing and waning in rhythm with most due to unknown forces. Some complain of a burning sensation.
ETIOLOGY: Unknown although a hypersensitivity reaction to unknown antigens has been suspected.
TREATMENT: None is usually required. In those with symptoms, topical steroid ointment or gel may be beneficial. Secondary fungal colonization should also be suspected in symptomatic lesions.
PROGNOSIS: This is a chronic disease lasting months to years with periods of remission and exacerbation.
DIFFERENTIAL DIAGNOSIS: Typical lesions are diagnostic. Variable clinical presentation may suggest lichen planus or candidiasis.
