Background
Geographic tongue (benign migratory glossitis) is a benign condition that occurs in up to 3% of the general population. Most often, patients are asymptomatic; however, some patients report increased sensitivity to hot and spicy foods. The etiology and pathogenesis of geographic tongue are still poorly understood. Geographic tongue affects males and females and is noted to be more prominent in adults than in children.[1, 2]
The classic manifestation of geographic tongue is an area of erythema, with atrophy of the filiform papillae of the tongue, surrounded by a serpiginous, white, hyperkeratotic border. The patient often reports spontaneous resolution of the lesion in one area, with the return of normal tongue architecture, only to have another lesion appear in a different location of the tongue. Lesion activity in geographic tongue may wax and wane over time, and patients are occasionally free of lesions.
Pathophysiology
The most commonly affected site is the tongue; however, other oral mucosal soft tissue sites may be affected. Geographic tongue has been reported with increased frequency in patients with psoriasis[3, 4, 5, 6, 7] and in patients with fissured tongue.[8, 9] Geographic tongue and fissured tongue have been reported in association with chronic granulomatous disease.[10] Although geographic tongue is an inflammatory condition histologically, a polygenic mode of inheritance has been suggested because it is seen clustering in families. Associations with human leukocyte antigen (HLA)–DR5, HLA-DRW6, and HLA-Cw6 have also been reported.[11, 12]
Epidemiology
Frequency
United States
Geographic tongue has reportedly occurred in up to 3% of the general population in the United States.
International
International frequency rates for geographic tongue are similar to those reported in the United States.
Mortality/Morbidity
Geographic tongue is a benign condition.
Race
No racial or ethnic predilection is reported for geographic tongue.
Sex
Females have been reported to be affected twice as often as males.[13] Exacerbations have been suggested to be related to hormonal factors.
Age
Geographic tongue can affect all age groups; however, it is more predominant in adults than in children.
Kleinman DV, Swango PA, Pindborg JJ. Epidemiology of oral mucosal lesions in United States schoolchildren: 1986-87. Community Dent Oral Epidemiol. Aug 1994;22(4):243-53. [Medline].
Shulman JD. Prevalence of oral mucosal lesions in children and youths in the USA. Int J Paediatr Dent. Mar 2005;15(2):89-97. [Medline].
Cambiaghi S, Colonna C, Cavalli R. Geographic tongue in two children with nonpustular psoriasis. Pediatr Dermatol. Jan-Feb 2005;22(1):83-5. [Medline].
Zargari O. The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients. Clin Exp Dermatol. Mar 2006;31(2):192-5. [Medline].
Zhu JF, Kaminski MJ, Pulitzer DR, Hu J, Thomas HF. Psoriasis: pathophysiology and oral manifestations. Oral Dis. Jun 1996;2(2):135-44. [Medline].
Costa SC, Hirota SK, Takahashi MD, Andrade H Jr, Migliari DA. Oral lesions in 166 patients with cutaneous psoriasis: a controlled study. Med Oral Patol Oral Cir Bucal. Aug 1 2009;14(8):e371-5. [Medline].
Hernandez-Perez F, Jaimes-Aveldanez A, Urquizo-Ruvalcaba Mde L, et al. Prevalence of oral lesions in patients with psoriasis. Med Oral Patol Oral Cir Bucal. Nov 1 2008;13(11):E703-8. [Medline].
Shulman JD, Carpenter WM. Prevalence and risk factors associated with geographic tongue among US adults. Oral Dis. Jul 2006;12(4):381-6. [Medline].
Yarom N, Cantony U, Gorsky M. Prevalence of fissured tongue, geographic tongue and median rhomboid glossitis among Israeli adults of different ethnic origins. Dermatology. 2004;209(2):88-94. [Medline].
Dar-Odeh NS, Hayajneh WA, Abu-Hammad OA, et al. Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature. BMC Res Notes. Feb 17 2010;3(1):37. [Medline].
Gonzaga HF, Torres EA, Alchorne MM, Gerbase-Delima M. Both psoriasis and benign migratory glossitis are associated with HLA-Cw6. Br J Dermatol. Sep 1996;135(3):368-70. [Medline].
Fenerli A, Papanicolaou S, Papanicolaou M, Laskaris G. Histocompatibility antigens and geographic tongue. Oral Surg Oral Med Oral Pathol. Oct 1993;76(4):476-9. [Medline].
Jainkittivong A, Langlais RP. Geographic tongue: clinical characteristics of 188 cases. J Contemp Dent Pract. Feb 15 2005;6(1):123-35. [Medline].
Borrie F, Musthyala R, Macintyre D. Ectopic geographic tongue--a case report. Dent Update. Mar 2007;34(2):121-2. [Medline].
Morris LF, Phillips CM, Binnie WH, Sander HM, Silverman AK, Menter MA. Oral lesions in patients with psoriasis: a controlled study. Cutis. May 1992;49(5):339-44. [Medline].
Eidelman E, Chosack A, Cohen T. Scrotal tongue and geographic tongue: polygenic and associated traits. Oral Surg Oral Med Oral Pathol. Nov 1976;42(5):591-6. [Medline].
Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M. Benign migratory glossitis or geographic tongue: an enigmatic oral lesion. Am J Med. Dec 15 2002;113(9):751-5. [Medline].
Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. Am Fam Physician. Mar 1 2010;81(5):627-34. [Medline].
Abe M, Sogabe Y, Syuto T, Ishibuchi H, Yokoyama Y, Ishikawa O. Successful treatment with cyclosporin administration for persistent benign migratory glossitis. J Dermatol. May 2007;34(5):340-3. [Medline].
Sigal MJ, Mock D. Symptomatic benign migratory glossitis: report of two cases and literature review. Pediatr Dent. Nov-Dec 1992;14(6):392-6. [Medline].

