Geographic tongue (also known as ‘benign migratory glossitis’) is a benign condition of the tongue. It is characterised by irregular, red, smooth patches on the dorsum of the tongue with a surrounding white border. This is caused by a loss of epithelium, and can give the tongue the appearance of a map (hence ‘geographic’); the lesions can disappear then reappear in different patterns (hence ‘migratory’).
Geographic tongue is harmless, but its appearance may cause anxiety in those affected. It is less common in children than adults (known to affect 1-3 % adults worldwide) and women are twice as likely as men to be affected. Geographic tongue may be seen in multiple members of the same family, however its aetiology is not known. It is seen more commonly in people with atopic and autoimmune-related conditions, such as psoriasis, food allergies, asthma and type 1 diabetes mellitus.
Signs & symptoms
- Irregular, red, smooth patches on the dorsum of the tongue with a white border
- May be sudden in onset and persist for months.
- Often asymptomatic – some may experience irritation or a burning sensation when eating certain foods (spicy, acidic, hot, etc.)
There are no major complications secondary to geographic tongue.
- oral candidiasis
- oral lichen planus
- oral leucoplakia
Geographic tongue is diagnosed clinically, mainly through examination. Further investigations are not usually required.
Geographic tongue is not curable. It usually requires no treatment, although if patients are symptomatic with burning/irritation then the following can be tried:
- Antihistamine or anaesthetic mouthwashes
- Topical soluble corticosteroids (to use as mouth rinses)
- Avoid irritating food and drink (e.g. alcohol, hot foods, spicy foods, acidic foods)
Nandini D.B., et al. (2016) Paediatric geographic tongue: a case report, review and recent updates. J Clin Diagn Res, 10 (2), available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4800664/