Geographic Tongue

Geographic Tongue

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Geographic Tongue is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • BMG
  • benign migratory glossitis
  • erythema areata migrans
  • erythema migrans
  • geographic stomatitis
  • wandering rash of the tongue

Disorder Subdivisions

  • None

General Discussion

Geographic tongue is a benign condition characterized by inflammation of the tongue (glossitis) that appears in a map-like (geographic) pattern. The normal tongue is covered by a layer of small bumps known as papillae. In affected individuals, certain areas of the tongue are missing these bumps. These affected areas usually appear as smooth, red or pink colored, degenerated (atrophic) patches. Geographic tongue tends to come and go it usually heals without treatment, but will recur again usually affecting a different area of the tongue. Most cases are not associated with any symptoms (asymptomatic) and the condition usually goes away without treatment. Geographic tongue is not associated with any long-term health complications in healthy individuals. The exact cause of geographic tongue is unknown.

Symptoms

In many cases, geographic tongue does not cause symptoms (asymptomatic). Symptoms that have been reported in association with geographic tongue include general discomfort of the tongue or mouth and soreness or a burning sensation of the tongue, which is often worsened by spicy or acidic foods.



The characteristic lesion in geographic tongue is reddish (erythematous), degenerated (atrophic) patch or area on the tongue that is abnormally smooth because of the lack of the small bumps that normally cover the tongue. These patches may have a slightly elevated, yellowish or white border. These patches cover the tongue in an irregular pattern giving the tongue a characteristic map-like appearance. The patches may change in size, shape and location from day to day.



In some cases, pain may occur or the lymph nodes under the lower jaw (submandibular lymph nodes) may become enlarged. In rare cases, pain or discomfort may be persistent.



When these lesions affect areas in the mouth other than the tongue, the condition may be referred to with another name such as erythema migrans or geographic stomatitis. Such sites include the mucous membrane lining the inside of the cheek (buccal mucosa), the floor of the mouth, the roof of the mouth, and the gums (gingiva).

Causes

The exact cause of geographic tongue is unknown. The condition often runs in families suggesting that genetics may play a role in the development of the disorder. Geographic tongue is often associated with a fissured tongue, a condition with a strong genetic link further suggesting that heredity plays a significant role in the development of geographic tongue.



A fissured tongue a benign condition that characterized by numerous shallow or deep grooves or furrows (fissures) on the back (dorsal) surface of the tongue. The surface furrows may differ in size and depth, radiate outward, and cause the tongue to have a wrinkled appearance.



In addition to fissured tongue, geographic tongue has been associated with many other conditions especially psoriasis. Psoriasis a chronic, inflammatory skin disease characterized by dry, reddish (erythematous), thickened patches of skin that are covered with silvery-gray scales. These patches may be referred to as papules or plaques and most often affect the scalp, elbows, knees, hands, feet and/or lower back.



Additional conditions with that may occur in conjunction with geographic tongue include allergies, emotional stress, juvenile diabetes, Reiter's syndrome and hormonal disturbances. However, no definitive link has been established between geographic tongue and any of these conditions.

Affected Populations

Some reports in the medical literature suggest that geographic tongue affects females slightly more often than males. It appears to occur with greater frequency in young adults. The prevalence of geographic tongue is unknown, but it is estimated to occur in approximately 3 percent of the general population.

Standard Therapies

Diagnosis

A diagnosis of geographic tongue is made based upon a thorough clinical evaluation, a detailed patient history and the characteristic appearance of the tongue lesions associated with this disorder. In most cases, surgical removal and microscopic study (biopsy) of affected tissue is not necessary because of the distinct appearance of the tongue.



Treatment

Medical treatment is not required 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



If pain or discomfort is persistent, some physicians may recommend anti-inflammatory drugs or painkillers that are applied directly to the affected areas (topical analgesics).

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, in the main, contact:

www.centerwatch.com

References

JOURNAL ARTICLES

Abe M, Sogabe Y, Syuto T, et al. Successful treatment with cyclosporine administration for persistent benign migratory glossitis. J Dermatol. 2007;34:340-343.



Shulman JD, Carpenter WM. Prevalence and risk factors associated with geographic tongue among US adults. Oral Dis. 2006;12:381-386.



Jainkittivong A,Langlais RP. Geographic tongue: clinical characteristics of 188 cases. J Contemp Dent Pract. 2005;6:123-135.



Pass B, Brown RS, Childers EL. Geographic tongue: literature review and case reports. Dent Today. 2005;24:56-57.



Femiano F. Geographic tongue (migrant glossitis) and psoriasis. Minerva Stomatol. 2001;50:213-217.



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



FROM THE INTERNET

Kelsch R. Geographic Tongue. Emedicine Journal, May 4, 2010. Available at: http://www.emedicine.com/derm/topic664.htm Accessed on: January 13, 2012.



Mayo Clinic for Medical Education and Research. Geographic Tongue. October 23, 2010. Available at: http://www.mayoclinic.com/health/geographic-tongue/DS00819 Accessed On: January 13, 2012.

Resources

Smell and Taste Center

Smell and Taste Center

University of Pennsylvania

5 Ravdin Building

3400 Spruce Street

Philadelphia, PA 19104

Tel: (215)662-6580

Fax: (215)349-5266

Email: Geraldine.Fischer@uphs.upenn.edu

Internet: http://www.med.upenn.edu/stc/index.html



NIH/National Institute of Dental and Craniofacial Research

Building 31, Room 2C39

31 Center Drive, MSC 2290

Bethesda, MD 20892

USA

Tel: (301)496-4261

Fax: (301)480-4098

Tel: (866)232-4528

Email: nidcrinfo@mail.nih.gov

Internet: http://www.nidcr.nih.gov/



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



For a Complete Report

This is an abstract of a report from the National Organization for Rare Disorders, Inc.® (NORD). Cigna members can access the complete report by logging into myCigna.com. For non-Cigna members, a copy of the complete report can be obtained for a small fee by visiting the NORD website. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational treatments (if available), and references from medical literature. For a full-text version of this topic, see http://www.rarediseases.org/search/rdblist.html.

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