- Author: Robert D Kelsch, DMD; Chief Editor: William D James, MD more...
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.
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. 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]
Geographic tongue has reportedly occurred in up to 3% of the general population in the United States. International frequency rates for geographic tongue are similar to those reported in the United States.
No racial or ethnic predilection is reported for geographic tongue.
Females have been reported to be affected twice as often as males. Exacerbations have been suggested to be related to hormonal factors.
Geographic tongue can affect all age groups; however, it is more predominant in adults than in children.
Geographic tongue is a benign condition.
Defining geographic tongue, describing its clinical appearance, and reinforcing its benign nature is usually all that is needed to educate patients and allay any concerns they may have about geographic tongue.
Kleinman DV, Swango PA, Pindborg JJ. Epidemiology of oral mucosal lesions in United States schoolchildren: 1986-87. Community Dent Oral Epidemiol. 1994 Aug. 22(4):243-53. [Medline].
Shulman JD. Prevalence of oral mucosal lesions in children and youths in the USA. Int J Paediatr Dent. 2005 Mar. 15(2):89-97. [Medline].
Cambiaghi S, Colonna C, Cavalli R. Geographic tongue in two children with nonpustular psoriasis. Pediatr Dermatol. 2005 Jan-Feb. 22(1):83-5. [Medline].
Zargari O. The prevalence and significance of fissured tongue and geographical tongue in psoriatic patients. Clin Exp Dermatol. 2006 Mar. 31(2):192-5. [Medline].
Zhu JF, Kaminski MJ, Pulitzer DR, Hu J, Thomas HF. Psoriasis: pathophysiology and oral manifestations. Oral Dis. 1996 Jun. 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. 2009 Aug 1. 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. 2008 Nov 1. 13(11):E703-8. [Medline].
Shulman JD, Carpenter WM. Prevalence and risk factors associated with geographic tongue among US adults. Oral Dis. 2006 Jul. 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. 2010 Feb 17. 3(1):37. [Medline]. [Full Text].
Gonzaga HF, Torres EA, Alchorne MM, Gerbase-Delima M. Both psoriasis and benign migratory glossitis are associated with HLA-Cw6. Br J Dermatol. 1996 Sep. 135(3):368-70. [Medline].
Fenerli A, Papanicolaou S, Papanicolaou M, Laskaris G. Histocompatibility antigens and geographic tongue. Oral Surg Oral Med Oral Pathol. 1993 Oct. 76(4):476-9. [Medline].
Jainkittivong A, Langlais RP. Geographic tongue: clinical characteristics of 188 cases. J Contemp Dent Pract. 2005 Feb 15. 6(1):123-35. [Medline].
Borrie F, Musthyala R, Macintyre D. Ectopic geographic tongue--a case report. Dent Update. 2007 Mar. 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. 1992 May. 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. 1976 Nov. 42(5):591-6. [Medline].
Alikhani M, Khalighinejad N, Ghalaiani P, Khaleghi MA, Askari E, Gorsky M. Immunologic and psychologic parameters associated with geographic tongue. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Jul. 118 (1):68-71. [Medline].
Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M. Benign migratory glossitis or geographic tongue: an enigmatic oral lesion. Am J Med. 2002 Dec 15. 113(9):751-5. [Medline].
Reamy BV, Derby R, Bunt CW. Common tongue conditions in primary care. Am Fam Physician. 2010 Mar 1. 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. 2007 May. 34(5):340-3. [Medline].
Sigal MJ, Mock D. Symptomatic benign migratory glossitis: report of two cases and literature review. Pediatr Dent. 1992 Nov-Dec. 14(6):392-6. [Medline].