$Unique_ID{BRK04274} $Pretitle{} $Title{Tongue, Geographic} $Subject{Tongue Geographic BMG Benign Migratory Glossitis Glossitis Areata Migrans Wandering Rash Tongue } $Volume{} $Log{} Copyright (C) 1987, 1988, 1989 National Organization for Rare Disorders, Inc. 332: Tongue, Geographic ** IMPORTANT ** It is possible the main title of the article (Geographic Tongue) is not the name you expected. Please check the SYNONYMS listing to find the alternate names and disorder subdivisions covered by this article. Synonyms BMG Benign Migratory Glossitis Glossitis Areata Migrans Wandering Rash Tongue General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Geographic Tongue is an inflammation of the tongue (Glossitis) that may go into remission and recur again. This form of inflammation is characterized by irregular, migrating denuded smooth areas (excoriations) on the tongue which may feel slightly sore and sometimes itchy. Symptoms Geographic Tongue is an inflammation of the tongue characterized by irregularly shaped denuded smooth areas which are sometimes slightly sore and itchy. These areas usually occur on the margins and the tip of the tongue, and may appear in bow-shaped lines on the surface. The lesions sometimes advance forward while healing occurs toward the back of the tongue. This change in location also causes a change in configuration. The coalescence of the lesions into figures which look like a map has given this disorder the name of Geographic Tongue. Causes The exact cause of Geographic Tongue is unknown. Some scientists suspect that it may be caused by changes in the bacteria which are normally present in the mouth (oral flora). There are many other possible causes of Geographic Tongue. Local causes may include the following: 1. Infectious bacteria and viruses 2. Lesions from mechanical injury such as jagged teeth, ill-fitting dentures, poor oral habits, or repeated biting of the tongue during convulsive seizures 3. Substances such as alcohol in excessive amounts, tobacco, and hot or spicy foods in excessive amounts 4. The tongue may become oversensitized to toothpaste, mouthwashes, breath fresheners, candy dyes, and, rarely, plastic dentures or materials used in restoring teeth. Systemic causes may include: 1. Lack of vitamins (avitaminosis) particularly of the Vitamin B group 2. Other illnesses or conditions such as pellagra, pernicious anemia, iron deficiency anemia, certain generalized skin diseases such as lichen planus, erythema multiforme, aphthous lesions, Behcet's syndrome, pemphigus vulgaris, or syphilis may cause Geographic Tongue. For more information on the above disorders, choose the following words as your search terms in the Rare Disease Database: anemia, skin, lichen planus, erythema multiform, lesions, Behcet, pemphigus, and syphilis. Affected Population Onset of Geographic Tongue usually occurs in childhood. The disorder affects both males and females and may appear at any age. Related Disorders Persons with Anemia or Pellagra may also have a tongue with denuded smooth areas. Lesions are moderately painful. In Moeller's Glossitis, the tongue is slick, glossy, or glazed. The lesions are very distressing and persistent. Median Rhomboid Glossitis is a developmental lesion of the tongue. This lesion consists of a smooth, reddish, nodular area on the back portion of the middle third of the tongue. Hairy Tongue is characterized by yellowish, brownish, blackish or bluish discoloration of the tongue, usually caused by the absence of normal bacteria in the mouth. Excessive growth of the threadlike elevations (filiform papillae) in front of the taste buds also occurs. Severe Acute Glossitis can occasionally be caused by local infection, burns, or injury to the tongue. This type of Glossitis may develop rapidly, producing marked tenderness or pain with swelling. The swelling may be sufficient to cause the tongue to block air passages in the most severe cases. Burning Tongue (and/or Mouth) Syndrome causes patients to experience a burning sensation in the mouth and/or the tongue. There is no obvious clinical evidence of inflammation. Inflammation of the tongue may also occur in association with Candidiasis (Thrush), anemias, Diabetes Mellitus, latent nutritional deficiencies, or malignancies. For more information on the above disorders, choose the following words as your search terms in the Rare Disease Database: tongue, Hairy Tongue, Burning Mouth, Candidiasis, anemia, and Diabetes Mellitus. Therapies: Standard It is generally recommended that people with Geographic Tongue avoid irritants and substances which may sensitize the tongue. A bland or liquid diet, preferably cooled, is best. Meticulous oral hygiene is imperative, but care should be taken to preserve proper bacterial balance within the mouth. Local application of triamcinolone acetonide in emollient dental paste to specific lesions may relieve symptoms and promote healing. Therapies: Investigational This disease entry is based upon medical information available through March 1988. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Geographic Tongue, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 NIH/National Institute of Dental Research 9000 Rockville Pike Bethesda, MD 20892 (301)496-4261 Clinical Smell and Taste Research Center University of Pennsylvania Hospital 3400 Spruce Street, G1 Philadelphia, PA 19104 (215) 662-2653 Department of Oral Biology Connecticut Chemosensory Clinical Research Center Farmington, CT 06032 (203) 674-2459 References MERCK MANUAL OF DIAGNOSIS AND THERAPY: Robert Berkow, et al., eds; Merck, Sharp & Dohme Research Laboratories, 1982. P. 2094.