Geographic Tongue

Aka: Geographic Tongue, Migratory Glossitis, Benign Migratory Glossitis, Glossitis Areata Exfoliativa, Glossitis Areata Migrans, Erythema Migrans of the Dorsal Tongue

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II. Epidemiology

  1. Prevalence: 1-3% in U.S. (common)
  2. More common in those with a Family History of Geographic Tongue

III. Pathophysiology

  1. Benign condition
  2. No good evidence that is associated with other conditions (e.g. atopy, Diabetes Mellitus, Psoriasis)
  3. Unclear etiology

IV. Symptoms

  1. Asymptomatic in most cases
  2. Tongue Burning or food sensitivity may occur with spicy foods

V. Signs

  1. Scattered bright red areas (bare patches) on Tongue dorsum
    1. Denuded of papillae, smooth (filiform atrophy)
    2. Map-like pattern on dorsal or lateral Tongue
  2. Surrounded by light yellow or white elevated rings (serpiginous white borders)
  3. Pattern changes within days

VI. Associated Conditions

  1. Fissured Tongue

VII. Management: Symptomatic lesions

  1. No treatment is uniformly effective
  2. Treatments that have been tried
    1. Topical Corticosteroids
    2. Zinc supplementation
    3. Topical Anesthetics
    4. Sucralfate
  3. Tongue sensitivity may respond to Topical Steroid gel or Antihistamine rinse
  4. Consider systemic medications (Corticosteroids, Calcineurin Inhibitors) in severe cases

VIII. References

  1. Assimakopoulos (2002) Am J Med 113(9): 751-5 [PubMed]
  2. Randall (2022) Am Fam Physician 105(4): 369-76 [PubMed]

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