Geographic Tongue: A Tongue That Changes Appearance: International Journal of Case Reports and Images September 2022

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Geographic tongue: A tongue that changes appearance
Article in International Journal of Case Reports and Images · September 2022

DOI: 10.5348/101344Z01TO2022CI
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Int J Case Rep Images 2022;13(2):135–136. Onda et al. 135
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Geographic tongue: A tongue that changes appearance

Takeshi Onda, Kamichika Hayashi, Akira Katakura, Masayuki Takano
CASE REPORT
A 66-year-old female presented with a chief complaint
of glossal erythema with daily changes in position
and shape (Figure 1A and B). She was anxious about
the possibility of malignancy. Upon periodically self-
inspecting her tongue using a mirror for one year, the
patient noted gradually enlarging erythematous macules
that fused to form larger patches and that moved from Figure 1: Oral findings at the first visit. (A) Front view: An
one area of the tongue to another. There was no noted erythematous round-shaped lesion with a well-defined border
pain or dysgeusia, and the patient had an unremarkable is observed extending from the dorsal surface of the tongue
medical history. Based on its pathognomonic history to the lateral borders of the tongue bilaterally. (B) Side view:
and clinical features, the condition was diagnosed as The center of the lesion is smooth and erythematous, while
the white edges are raised like embankments, resulting in its
geographic tongue. The patient was reassured that the
characteristic map-like appearance.
lesion was benign. It improved after four weeks of proper
dental hygiene with a toothbrush and tongue scraper.
[1]. While the specific cause has not been determined,

DISCUSSION genetics, constitutional abnormalities, vitamin
deficiencies, and mental or endocrine disorders may play
Geographic tongue is also referred to as benign a role in its pathogenesis [3]. This disease has also been
migratory glossitis, erythema migrans, annulus migrans, reported in patients with psoriasis; some studies have
and wandering tongue rash [1]. Geographic tongue is even referred to geographic tongue as psoriasis of the oral
characterized by the loss of the filiform papillae, resulting cavity [4]. Since the signs and symptoms of geographic
in erythematous sections of the tongue [2]. Typically tongue are pathognomonic, a biopsy is not necessary [5].
located at the border between the dorsal and the lateral If asymptomatic, geographic tongue does not require
edges of the tongue, these erythematous patches are treatment. External corticosteroids, antihistamines,
surrounded by well-defined white borders and resemble cyclosporine, vitamin A, zinc, acetaminophen, and
a map. Geographic tongue is present in 1–2.5% of the external tacrolimus are reportedly effective treatment
general population and is slightly more common in females modalities for symptomatic lesions [1, 4].
Takeshi Onda1, DDS, PhD, Kamichika Hayashi1, DDS,

PhD, Akira Katakura2, DDS, PhD, Masayuki Takano1, CONCLUSION
DDS, PhD
Affiliations: 1Department of Oral and Maxillofacial Surgery, Typically, geographic tongue is asymptomatic and
Tokyo Dental College, Tokyo, Japan; 2Department of Oral does not require treatment. In addition, its characteristic
Pathological Science and Surgery, Tokyo Dental College, history is sufficient to establish a diagnosis; a biopsy is
Tokyo, Japan. not needed. It is important to reassure the patient that the
Corresponding Author: Dr. Takeshi Onda DDS, PhD, De- condition is benign. If pain or discomfort develops due to
partment of Oral and Maxillofacial Surgery, Tokyo Dental inflammation, palliative treatments can be considered.
College, 2-9-18, Kanda-Misakicho, Chiyoda-ku, Tokyo Avoiding irritants and maintaining good oral hygiene are
101-0061, Japan; Email: ondatake@tdc.ac.jp recommended to avoid the exacerbation of symptoms.
Received: 03 July 2022

Keywords: Erythema migrans, Geographic tongue,
Accepted: 22 August 2022 Migratory glossitis
Published: 26 September 2022
International Journal of Case Reports and Images, Volume 13, Issue 2, 2022; Pages 135–136. ISSN: 0976-3198
Int J Case Rep Images 2022;13(2):135–136. Onda et al. 136
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for important intellectual content, Final approval of the

How to cite this article
version to be published, Agree to be accountable for all
Onda T, Hayashi K, Katakura A, Takano M. Geographic aspects of the work in ensuring that questions related
tongue: A tongue that changes appearance. Int J Case to the accuracy or integrity of any part of the work are
Rep Images 2022;13(2):135–136. appropriately investigated and resolved
Akira Katakura – Analysis of data, Interpretation of
data, Drafting the work, Revising the work critically for
Article ID: 101344Z01TO2022 important intellectual content, Final approval of the
********* aspects of the work in ensuring that questions related
doi: 10.5348/101344Z01TO2022CI to the accuracy or integrity of any part of the work are
appropriately investigated and resolved
Masayuki Takano – Analysis of data, Interpretation of
data, Drafting the work, Revising the work critically for
REFERENCES important intellectual content, Final approval of the
1. Shareef S, Ettefagh L. Geographic Tongue. 2021 Aug
3. In: StatPearls. Treasure Island (FL): StatPearls
aspects of the work in ensuring that questions related
Publishing; 2022. to the accuracy or integrity of any part of the work are
2. Ogueta CI, Ramírez PM, Jiménez OC, Cifuentes appropriately investigated and resolved
MM. Geographic tongue: What a dermatologist
should know. Actas Dermosifiliogr (Engl Ed) Guarantor of Submission
2019;110(5):341–6. The corresponding author is the guarantor of submission.
3. Khayamzadeh M, Najafi S, Sadrolodabaei P, Vakili F,
Kharrazi Fard MJ. Determining salivary and serum Source of Support
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4. Jacob CN, John TM, Jayaprakash R. Geographic Consent Statement
tongue. Cleve Clin J Med 2016;83(8):565–6. Written informed consent was obtained from the patient
5. Bakshi SS, Bhattacharjee S. Geographic tongue. J for publication of this article.
Allergy Clin Immunol Pract 2017;5(1):176.
Conflict of Interest
********* Authors declare no conflict of interest.
Author Contributions Data Availability

Takeshi Onda – Conception of the work, Design of the All relevant data are within the paper and its Supporting
work, Acquisition of data, Analysis of data, Interpretation Information files.
of data, Drafting the work, Revising the work critically
for important intellectual content, Final approval of the Copyright
version to be published, Agree to be accountable for all © 2022 Takeshi Onda et al. This article is distributed
aspects of the work in ensuring that questions related under the terms of Creative Commons Attribution
to the accuracy or integrity of any part of the work are License which permits unrestricted use, distribution
appropriately investigated and resolved and reproduction in any medium provided the original
author(s) and original publisher are properly credited.
Kamichika Hayashi – Analysis of data, Interpretation Please see the copyright policy on the journal website for
of data, Drafting the work, Revising the work critically more information.
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International Journal of Case Reports and Images, Volume 13, Issue 2, 2022; Pages 135–136. ISSN: 0976-3198
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See discussions, stats, and author profiles for this publication at: https://www.researchgate.

Geographic tongue: A tongue that changes appearance

Article in International Journal of Case Reports and Images · September 2022

Takeshi Onda Akira Katakura

SEE PROFILE SEE PROFILE

The user has requested enhancement of the downloaded file.

CLINICAL IMAGE PEER REVIEWED | OPEN ACCESS

Geographic tongue: A tongue that changes appearance

[1]. While the specific cause has not been determined,

Takeshi Onda1, DDS, PhD, Kamichika Hayashi1, DDS,

Received: 03 July 2022

for important intellectual content, Final approval of the

Author Contributions Data Availability

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