Geographic Tongue

Key Points
Also known as Benign Migratory Glossitis, the condition results in irregularly-shaped red, map-like smooth swollen patches on the tongue or other parts of the mouth, occasionally with a white border.
Condition exhibits no symptoms, but may cause burning or irritation with hot or spicy foods.
Condition comes and goes, usually in sync with menstrual cycle or pregnancy.
Exact cause is unknown, but has been linked to other diseases.

Geographic tongue, also referred to as Benign Migratory Glossitis, is a condition characterized by irregularly shaped, red, map-like smooth swollen patches on the tongue, sometimes surrounded by a white border. Although geographic tongue is harmless, it may persist for months or longer, and can be recurring. Geographic tongue occurs in any race, age or sex, but appears more frequently in females and in adults.

There are no symptoms, but burning or irritation is common, particularly with hot or spicy foods. Discomfort comes and goes, and may worsen at certain times during the menstrual cycle or pregnancy. The patches are usually confined to the tongue, but may arise elsewhere in the mouth or on the lips.

The exact cause of geographic tongue is unknown, but it has been associated with patients suffering from psoriasis (especially pustular psoriasis, diabetes, anemia, atopy (asthma and/or eczema), and stress. It has also been linked to particular foods, especially cheese, or hormonal factors — due to the variation with the menstrual cycle. There may also be genetic links, as it is linked to family history.

Differential Diagnosis (Other conditions with similar appearance)
Cancers of the oral mucosa
Candidiasis, Mucosal
Contact Stomatitis
Fissured tongue
Lichen Planus
Psoriasis

Diagnosis
Key Points
Diagnosis is primarily done through clinical investigation.
Testing may be done to exclude other diseases.

Geographic Tongue is diagnosed through clinical investigation. Since the condition is benign and self-resolving, testing is usually performed only to exclude other diseases.

Treatment
Key Points
Condition is benign and self-resolving, so treatment is often not required.
Treatment of associated conditions may improve the appearance of the tongue.
* Oral discomfort can be treated with various medications, such as antiseptic or anaesthetic mouth rinses and topical corticosteroids.

Geographic Tongue is a benign condition that usually resolves itself without causing any problems for the patient so most people do not require treatment. There is no known cure. If there are associated medical conditions, treatment of these may improve the appearance of the tongue. Discomfort may be treated with a mouth gargle or rinse containing antiseptic and anaesthetic agents. Topical corticosteroids may also be helpful for occasional use, such as triamcinolone in dental paste applied several times a day when required.