Geographic tongue is the name given to a condition called Benign migratory glossitis. Discoloration of the tongue is the main feature of this disease.
These discolorations of the tongue resemble the continental outlines on a globe, which is the reason for this disease being called the ‘geographic tongue’.
The discolorations of the tongue found in this disease are the serpiginous white lines surrounding areas of smooth, de-papillated mucosa and are constantly changing.
Because of the constantly changing appearance of these lesions on the tongue, this condition is also called as the ‘wandering rash of the tongue’ by some.
The exact reason for the geographic tongue is unknown. However, researchers have found a relationship between this condition and psychological stress.
Also, in people with the Psoriasis of the skin, there has been a noted increase in the incidence of this disease.
Clinical Features of Benign Migratory Glossitis
The tongue in some affected individuals may appear bald and reddish.
Burning sensation, pain and discomfort may be present in some individuals, especially on consuming food items that are spicy and acidic. However, in the majority of cases, geographic tongue is asymptomatic.
Histology of Geographic Tongue
When you observe a tissue of geographic tongue under the microscope, the following features may be seen.
All the microscopic features found in the case of Psoriasis are also seen in the case of the geographic tongue or benign migratory glossitis.
But this won’t be obvious unless a biopsy is done from a tissue that is specifically taken from the area which is medically called as the ‘prominent serpiginous line’ at the periphery of a de-papillated patch on the affected tongue.
Small microabscesses called ‘Monro’s abscesses’ can be seen microscopically in cases of benign migratory glossitis. These are produced by certain inflammatory cells in the tissue.
Rete ridges are the other unique feature of benign migratory glossitis.
Treatment for Geographic Tongue
In the majority of cases, no treatment is necessary. If the lesion is symptomatic topical prednisolone may be used.
If there is a chance of infection caused by secondary candidiasis a topical or systemic antifungal medication may be used.
In some rare cases of benign migratory glossitis, where the individual is suffering symptomatically, systemic administration of broad-spectrum antibiotics has been found useful. But this may not always be the case.