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By Lawrence A. Schiffman, DO, and Stephen M. Schleicher, MD
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CASE:
A 14-year-old girl complains of a discolored
tongue. She denies sore throat, change in taste,
or difficulty swallowing. Her medical history is
unremarkable and she takes no oral medications.
Physical examination finds whitened, irregularly shaped patches on the dorsal surface
of her tongue. The papillae are not enlarged.
The remainder of the oral cavity, including the
upper and lower palate, exhibits no visible
abnormalities.
WHAT IS YOUR DIAGNOSIS?
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Geographic tongue, or migratory glossitis, is a benign
condition that presents with raised, white patches intermingled
with reddened, atrophic areas on the dorsal
surface of the tongue. The map-like appearance of
the tongue gives the condition its name. Women are
affected more than men and most patients are asymptomatic.
A concomitant systemic or cutaneous abnormality
is rarely detected, and there is no correlation
with cigarette smoking. In most cases, the only
treatment required is reassurance. |
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Dr. Schiffman is a dermatology resident at St. John’s Episcopal Hospital in Far Rockaway, New York. Dr. Schleicher is director of DermDx Centers and a
clinical instructor of dermatology at the Philadelphia College of Osteopathic Medicine, at Kings College in Wilkes-Barre, Pennsylvania, and at Arcadia
University in Glenside, Pennsylvania. He is also a member of the EMERGENCY MEDICINE editorial board.
Emerg Med 38(9):53-54, 2006
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