II. Epidemiology
- Prevalence: 1-3% in U.S. (common)
- More common in those with a Family History of Geographic Tongue
III. Pathophysiology
- Unclear etiology
- Benign, recurrent inflammatory condition
- Scattered patches of lost Filiform Papillae result in localized, round regions of Smooth Tongue
IV. Symptoms
- Asymptomatic in most cases
- Tongue Burning or food sensitivity may occur with spicy foods
V. Signs
- Scattered bright red areas (bare patches) on Tongue dorsum
- Denuded of papillae, Smooth Tongue patches (filiform atrophy)
- Random pattern of small. well-demarcated smooth patches on dorsal or lateral Tongue
- Patches are surrounded by light yellow or white elevated rings (serpiginous white borders, map-like)
- Pattern changes within days
- May also affect other regions of Oral Mucosa (e.g. Stomatitis)
VI. Associated Conditions
- Fissured Tongue
- Other associated conditions with very limited evidence
VII. Management: Symptomatic lesions
- No treatment is uniformly effective
- Treatments that have been tried
- Tongue sensitivity may respond to Topical Steroid gel or Antihistamine rinse
- Acetaminophen
- Topical Corticosteroids
- Zinc supplementation
- Topical Anesthetic mouth rinses
- Sucralfate
- Consider other common oral condition treatment
- See Xerostomia
- See Burning Mouth Syndrome
- Refractory symptoms
- Consider systemic medications (e.g. Corticosteroids, Calcineurin Inhibitors) in severe cases
VIII. Course
- Variable, but often resolves spontaneously, only to recurr later without obvious triggers