History

Patients with geographic tongue may present with a burning sensation or an irritation of the tongue noted with hot or spicy foods. Patients may report that the discomfort waxes and wanes over time, and they routinely describe that the lesions affect different areas of the tongue at different times. Patients are occasionally concerned about the diagnosis of oral cancer, which prompts them to be evaluated, despite reporting that they have noted these lesions over many years.

Physical Examination

The tongue exhibits a well-demarcated area of erythema, primarily affecting the dorsum, and often extending to involve the lateral borders of the tongue. Within the area of erythema, the normal tongue architecture is effaced, with loss of the filiform papillae and atrophy of the overlying mucosa. Surrounding this area of erythema is a well-defined, hyperkeratotic, yellow-white border with an irregular serpiginous outline. Similar lesions may be present concurrently on other aspects of the tongue or other mucosal sites, including the floor of the mouth and cheek the mucosa.^[17]

Differential Diagnoses

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