Geographic tongue

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Geographic tongue
Classification and external resources
Geographic Tongue
ICD-10 K14.1
ICD-9 529.1
OMIM 137400
DiseasesDB 29512
MedlinePlus 001049
eMedicine derm/664 
MeSH D005929

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Geographic tongue, also known as benign migratory glossitis, erythema migrans, or continental tongue, is a condition affecting the tongue. The colloquial names are due to the condition resembling a map.

Symptoms

The top side of the tongue is covered in small protrusions called papillae. In a tongue affected by geographic tongue, there are red patches on the surface of the tongue bordered by grayish white. The papillae are missing from the reddish areas and overcrowded in the grayish white borders. The small patches may disappear and reappear in a short period of time (hours or days), and change in shape or size. While it is not common for the condition to cause pain, it may cause a burning or stinging sensation, especially after contact with certain foods, such as spicy or citrus foods. Chemicals, such as mouth washes and teeth whiteners, can also aggravate the condition. Geographic tongue may also cause numbness. Co-existence of fissures of the tongue is often noticed.

Histopathology

Another example of geographic tongue, showing strong color contrast between the red/white areas.
Another example of geographic tongue, showing strong color contrast between the red/white areas.

Irregular areas of dekeratinized and desquamated filiform papillae (red in color) are surrounded by elevated whitish/yellow margins due to acantholysis and hyperkeratosis. Neutrophils migrate into the epithelial layer, creating what are termed Munro's Abscesses.

Cause

Its cause is uncertain, though tends to run in families and is associated with several different genes. Geographic tongue is more commonly found in people who are affected by environmental sensitivity, such as allergies, eczema, and asthma. Some think that it may be linked to stress or diets high in sugar or processed foods. Its prevalence also varies by ethnicity (0.6% of Americans, 4% of young Iraqis, 2% of young Finns) and gender (females affected 3 times more than males).

Treatment

While there is no known cure or commonly prescribed treatment for geographic tongue, there are several ways to suppress the condition, including avoiding foods which exacerbate the problem. Some people affected by geographic tongue also report that taking Vitamin B supplements causes the condition to go away temporarily. Burning may also be reduced by taking antihistamines. The condition is usually asymptomatic and significant, persisting pain is rare. Geographic tongue is not associated with any known systemic diseases.

It has recently been found that geographic tongue can respond to zinc enhancements, such as Solvazinc®[citation needed], taken orally. This opens up the question as to whether the condition is caused by an allergy or a deficiency.

References

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fi:Karttakieli ja:地図状舌

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

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