Atrophic Glossitis

Aka: Atrophic Glossitis, Smooth Tongue

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II. Pathophysiology

  1. Filiform Papillae atrophy results in a Smooth Tongue surface

III. Symptoms

  1. Tongue dryness
  2. Intermittent Tongue Burning
  3. Paresthesias of taste
  4. Tongue Pain may be severe in advanced stages

IV. Signs

  1. Complete or patchy Tongue baldness
  2. Smooth, slick, sore Tongue with lost papillae
  3. Atrophied hyperemic papillae (small punctate red dots)

V. Causes

  1. See Glossitis
  2. Xerostomia (Dry Mouth)
    1. See Xerostomia
    2. See Medication Causes of Dry Mouth
    3. Diabetes Mellitus
    4. Sjogren Syndrome
  3. Anemia
    1. Folic Acid Deficiency Anemia
    2. Vitamin B12 Deficiency Anemia
    3. Iron Deficiency Anemia
  4. Other possible Vitamin Deficiencies
    1. Pyridoxine deficiency
    2. Riboflavin deficiency
    3. Niacin Deficiency
    4. Zinc Deficiency
  5. Infections
    1. Oral Candidiasis
    2. Syphilis
  6. Infiltrative Disorders
    1. Amyloidosis
    2. Sarcoidosis
  7. Miscellaneous Disorders
    1. Anti-cancer drugs
    2. Riley-Day Dysautonia Syndrome

VI. Differential Diagnosis

  1. See Tongue Disorder
  2. See Glossitis

VII. Management

  1. Soft, bland diet
    1. Avoid spicy or acidic food and liquids
  2. Treat underlying cause
    1. Xerostomia
    2. Nutritional deficiency
  3. Symptomatic relief
    1. See Burning Mouth Syndrome

VIII. References

  1. Straub (2024) Am Fam Physician 110(5): 467-75 [PubMed]

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