Information on the following diseases can be found in the Related Disorders section of this report:

• Anemia or Pellagra
• Median Rhomboid Glossitis
• Hairy Tongue
• Severe Acute Glossitis
• Burning Tongue (and/or Mouth) Syndrome
• Inflammation of the tongue (General)

The inflamed, denuded, smooth areas characteristic of Geographic Tongue usually occur on the margins and the tip of the tongue where they may appear as superficial bow-shaped lines. The lesions sometimes advance forward while healing occurs toward the back of the tongue. This change in location also causes a change in configuration. The lesions merge into figures that, to the imaginative, look like a map and gives this disorder its name.
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The exact cause of Geographic Tongue is unknown. Some clinicians believe that it may be caused by changes in the bacteria that are normally present in the mouth (oral flora) since it is often seen in association with psoriasis.

There are many other possible causes of Geographic Tongue.

The medical literature reports cases in association with a number of local stimuli, including:
1. Infectious bacteria and viruses 2. Lesions from mechanical injury such as jagged teeth, ill-fitting dentures, poor oral habits, or repeated biting of the tongue during convulsive seizures 3. Substances such as alcohol in excessive amounts, tobacco, and hot or spicy foods in excessive amounts 4. The tongue may become over-sensitized to toothpaste, mouthwashes, breath fresheners, candy dyes, and, rarely, plastic dentures or materials used in restoring teeth.

Systemic causes have been attributed to: 1. Lack of vitamins (avitaminosis) particularly of the Vitamin B group 2. Other illnesses or conditions such as pellagra, pernicious anemia, iron deficiency anemia, certain generalized skin diseases such as lichen planus, erythema multiforme, aphthous lesions, Behcet's syndrome, pemphigus vulgaris, or syphilis.

For more information on the above disorders, choose the following words as your search terms in the Rare Disease Database: anemia, skin, lichen planus, erythema multiform, lesions, Behcet, pemphigus, and syphilis.
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Geographic Tongue may affect as many as 3% of the general population. The disorder shows no partiality by race or ethnic group. It is more predominant among adults than children and may occur twice as frequently among females as males.
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Persons with Anemia or Pellagra may also have a tongue with denuded smooth areas. Lesions are moderately painful.

In Moeller's Glossitis, the tongue is slick, glossy, or glazed. The lesions are very distressing and persistent.

Median Rhomboid Glossitis is a developmental lesion of the tongue. This lesion consists of a smooth, reddish, nodular area on the back portion of the middle third of the tongue.

Hairy Tongue is characterized by yellowish, brownish, blackish or bluish discoloration of the tongue, usually caused by the absence of normal bacteria in the mouth. Excessive growth of the threadlike elevations (filiform papillae) in front of the taste buds also occurs.

Severe Acute Glossitis can occasionally be caused by local infection, burns, or injury to the tongue. This type of Glossitis may develop rapidly, producing marked tenderness or pain with swelling. The swelling may be sufficient to cause the tongue to block air passages in the most severe cases.

Burning Tongue (and/or Mouth) Syndrome causes patients to experience a burning sensation in the mouth and/or the tongue. There is no obvious clinical evidence of inflammation.

Inflammation of the tongue may also occur in association with Candidiasis (Thrush), anemias, Diabetes Mellitus, latent nutritional deficiencies, or malignancies.

For more information on the above disorders, choose the following words as your search terms in the Rare Disease Database: tongue, Hairy Tongue, Burning Mouth, Candidiasis, anemia, and Diabetes Mellitus.

There is no medical treatment for this benign disorder. Some physicians advise patients to avoid irritants and substances that may sensitize the tongue. A bland or liquid diet, preferably cooled, is perhaps better. Meticulous oral hygiene is important, but care should be taken to preserve proper bacterial balance within the mouth.
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JOURNAL ARTICLES
Adams SP. Dermacase. Geographic tongue. Can Fam Physician. 2002;48:697, 702.

Geist JR, Parise M. Oral pathology quiz #4. Ectopic geographic tongue. J Mich Dent Assoc. 2002;84:28-31.

Femiano F. Geographic tongue (migrant glossitis) and psoriasis. Minerva Stomatol. 2001;50:213-17.

Flaitz CM. Ectopic erythema migrans in an adolescent with a skin disorder. Pediatr Dent. 2000;22:63-64.

Gracious BL, Llana M, Barton DD. Lithium and geographic tongue. J Am Acad Child Adolesc Psychiatry. 1999;38:1069-70.

FROM THE INTERNET
Kacker A. MEDLINEplus Health Information. In: Medical Encyclopedia. Geographic tongue. 2001;2pp.
www.nlm.nih.gov/medlineplus/ency

Moses S. Family Practice Notebook. Geographic Tongue. 2002:1p.
www.fpnotebook.com/ENT165.htm

Kelsch R. Geographic Tongue. eMedicine Journal. Last Update; 2/27/2002:4pp.
www.emedicine.com/derm/topic664.htm

Cuttic N, Strycharski A. World Dentsitry. Geographic Tongue (Benign Migratory Glossitis). nd:2pp.
www.worlddent.com/2001/05/series