Geographic tongue is a benign inflammatory condition of the oral cavity characterized by epithelial loss, particularly of the filiform papillae on the dorsum of the tongue. Geographic tongue is also called benign migratory glossitis because the signs move.
Geographic tongue usually begins in childhood and has an overall global prevalence of approximately 1% to 2.5% of the population. The prevalence in the pediatric population ranges from 0.37% to 14.3%. The highest prevalence occurs in the 20-29 year age group at approximately 39.4%. Geographic tongue has a slightly greater predilection for females than males. It is also seen in patients with asthma, eczema, hay fever, allergic rhinitis, patients with higher levels of immunoglobulin E Psoriasis, especially pustular psoriasis.Geographic tongue is characterized by irregularly shaped, red, map-like, smooth, swollen patches surrounded by white lines. Geographic tongue can appear suddenly, last for months or longer, and often recurs.
Most often there are no symptoms, but burning or irritation of the tongue is common, especially when eating hot, spicy, and acidic food.
Geographic tongue is usually diagnosed by its characteristic history and clinical features. Confirmation by histology is rarely necessary, but may be required in atypical cases. Further evaluation may be necessary if any of the following associations with geographic tongue are suspected.
- Erythroplakia
- Lichen planus
- Candidiasis
- Contact stomatitis
- Leukoplakia
- Trauma
- Aphthous ulcer
- Squamous cell carcinoma
Geographic tongue usually does not require treatment if asymptomatic. Patients can be reassured of its benign, self-limiting nature. For symptomatic lesions, topical corticosteroids, antihistamines, cyclosporine, vitamin A, zinc, acetaminophen, topical tacrolimus have been shown to be effective. Avoidance of alcohol, hot, spicy and sour foods, acidic fruits and beverages, and good oral hygiene are recommended to prevent worsening of symptoms.