Review Article| Volume 21, ISSUE 1, P123-134, January 2003

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Glossitis and other tongue disorders

      The tongue can often provide clinical clues to systemic conditions and demonstrate a number of conditions unrelated to other systemic disease. Because it is visible to patients easily, they may present for evaluation of a variety of incidentally noted disorders. Understanding normal anatomy and architecture and reassuring patients is often all that is necessary. When tongue abnormalities are present, however, recognizing them as benign or associated with other disease is a valuable clinical skill. Examination of the tongue and oral mucosa is an essential part of a physical examination. Clinicians need to recognize and know a spectrum of disorders affecting the tongue. This article reviews a number of tongue conditions encountered including furred tongue, black hairy tongue, smooth tongue, fissured tongue, median rhomboid glossitis, geographic tongue, sublingual varices, oral hairy leukoplakia (OHL), herpetic geometric glossitis, and macroglossia.
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        • Powell F.C.
        • Rogers III, R.S.
        A practical approach to oral lesions.
        Prim Care. 1983; 10: 495-511
        • Beaven D.W.
        • Brooks S.E.
        Coatings of the tongue.
        in: Beaven D.W. Brooks S.E. Color atlas of the tongue in clinical diagnosis. Year Book Medical Publishers, Chicago1988: 73-86
        • Darwazh A.M.
        • Pillai K.
        Prevalence of tongue lesions in 1013 Jordanian dental outpatients.
        Community Dent Oral Epidemiol. 1993; 21: 323-324
        • McNally M.A.
        • Langlais R.P.
        Conditions peculiar to the tongue.
        Dermatol Clin. 1996; 12: 257-272
        • Wolfson S.A.
        Black hairy tongue associated with penicillin treatment.
        JAMA. 1949; 140: 1206-1208
        • Brightman V.J.
        Diseases of the tongue.
        in: Lynch M.A. Brightman V.J. Greenberg M.S. Burket's oral medicine. 9th edition. JB Lippincott, Philadelphia1994: 257-273
        • Johnson R.H.
        • Spalding J.M.K.
        Arterial hypertension.
        in: Johnson R.H. Spaulding J.M.K. Disorders of the autonomic nervous system. FA Davis, Philadelphia1974: 103-104
        • Siddique N.
        • Sufit R.
        • Siddique T.
        Degenerative motor, sensory, and autonomic disorders.
        in: Goetz C.G. Pappert E.J. Goetz: textbook of clinical neurology. 1st edition. WB Saunders Company, St. Louis1999: 711-717
        • Powell F.C.
        Glossodynia and other disorders of the tongue.
        Dermatol Clin. 1987; 5: 687-693
        • Halperin V.
        • Kolas S.
        • Jefferis K.R.
        • et al.
        The occurrence of Fordyce spots, benign migratory glossitis, median rhomboid glossitis and fissured tongue in 2,478 dental patients.
        Oral Surg. 1953; 6: 1072-1077
        • Alexander R.W.
        • James R.B.
        Melkersson-Rosenthal syndrome: review of literature and report of a case.
        J Oral Surg. 1972; 30: 599-604
        • Greene R.M.
        • Rogers III, R.S.
        Melkersson-Rosenthal syndrome: a review of 36 patients.
        J Am Acad Dermatol. 1989; 21: 1262-1270
        • Luscher E.
        Syndrome von Meldersson-Rosenthal.
        Schweiz Med Wochenschr. 1949; 79: 1-3
        • Rogers III, R.S.
        Melkersson-Rosenthal syndrome and orofacial granulomatosis.
        Dermatol Clin. 1996; 14: 371-379
        • Zimmer W.M.
        • Rogers III, R.S.
        • Reeve C.M.
        • Sheridan P.J.
        Orofacial manifestations of Melkersson-Rosenthal syndrome: a study of 42 patients and review of 220 cases from the literature.
        Oral Surg Oral Med Oral Pathol. 1992; 74: 610-619
        • Redman R.S.
        Prevalence of geographic tongue, fissured tongue, median rhomboid glossitis, and hairy tongue among 3,611 Minnesota schoolchildren.
        Oral Surg Oral Med Oral Pathol. 1970; 30: 390-395
        • Cooke B.D.
        Median rhomboid glossitis: candidiasis and not a developmental anomaly.
        Br J Dermatol. 1975; 93: 399-405
        • Farman A.G.
        • Van Wyck C.W.
        • Staz H.
        • et al.
        Central papillary atrophy of the tongue.
        Oral Surg. 1977; 43: 48-58
      1. Gallagher G.T. Biology and pathology of the oral mucosa. In: Freedberg I.M., Eisen A.Z., Wolff K., et al, editors. Fitzpatrick's dermatology in general medicine, 5th edition. vol. 1. New York: McGraw-Hill; 1999. p. 1314–16.

        • Wright B.A.
        Median rhomboid glossitis: not a misnomer.
        Oral Surg. 1978; 46: 806-814
        • Wright B.A.
        • Fenwick F.
        Candidiasis and atrophic tongue lesions.
        Oral Surg. 1981; 51: 55-61
        • Rahamimoff P.
        • Muhsam H.V.
        Some observations in 1,246 cases of geographic tongue.
        Am J Dis Child. 1957; 93: 519-525
        • Sigal M.G.
        • Mock D.
        Symptomatic benign migratory glossitis: report of two cases and literature review.
        Pediatr Dent. 1992; 14: 392-396
        • Kirkman N.
        Tumors and cysts of the epidermis.
        in: Elder D. Elenitsas R. Jaworsky C. Lever's histopathology of the skin. 8th edition. Lippincott-Raven, Philadelphia1997: 685-738
        • Marks R.
        • Simons M.J.
        Geographic tongue: a manifestation of atopy.
        Br J Dermatol. 1979; 101: 159-162
        • Greenspan D.
        • Greenspan J.S.
        • Conant M.
        • et al.
        Oral “hairy” leukoplakia in male homosexuals: evidence of association with both papillomavirus and a herpes-group virus.
        Lancet. 1984; 2: 831-834
        • Lupton G.P.
        • Tame W.D.
        • Redfield R.R.
        Oral hairyleukoplakia. A distinctive maskes of human T-cell lymphotropic virus type III (HTLV-III) infection.
        Arch Dermatol. 1987; 123: 624-628
        • Fowler C.B.
        • Reed K.D.
        • Brannon R.B.
        Intranuclear inclusions correlate with the ultrastructural detection of herpes-type virions in oral hairy leukoplakia.
        Am J Surg Pathol. 1989; 13: 114-119
        • Greenspan D.
        • Greenspan J.S.
        • Lennetle E.T.
        • et al.
        Replication of Epstein-Barr virus within the epithelial cells of oral “hairy” leukoplakia, an AIDs associated lesion.
        N Engl J Med. 1985; 313: 1564-1571
        • Ferguson F.S.
        • Archard H.
        • Nuovo G.J.
        • et al.
        Hairy leukoplakia in a child with, a rare symptom AIDS. Case report.
        Pediatr Dent. 1993; 15: 280-281
        • Itin P.
        • Rufli T.
        • Rudlinger R.
        • et al.
        Oral hairy leukoplakia in an HIV-negative renal transplant patient: a marker for immunosuppression.
        Dermatologica. 1988; 177: 126-128
        • Lifson A.R.
        • Hilton J.F.
        • Westenhouse J.L.
        • et al.
        Time from HIV seroconversion to oral candidosis or hairy leukoplakia among homosexual men enrolled in three prospective cohorts.
        AIDS. 1994; 8: 73-79
        • Shiboski C.H.
        Epidemiology of HIV-related oral manifestations in women: a review.
        Oral Dis. 1997; 3: S18-S27
        • Samet J.H.
        • Muz P.
        • Cabral P.
        • Jhamb K.
        • Suwanchinda A.
        • Freedberg K.A.
        Dermatologic manifestations in HIV-infected patients: a primary care perspective.
        Mayo Clin Proc. 1999; 74: 658-660
        • Greenspan D.
        • Greenspan J.S.
        • DeSuwza Y.G.
        • et al.
        Oral hairy leukoplakia in an HIV-negative renal transplant recipient.
        J Oral Pathol Med. 1989; 18: 32-34
        • Syrjanen S.
        • Laine P.
        • Niemela M.
        • et al.
        Oral hairy leukoplakia is not a specific sign of HIV-infection but related to immunosuppression in general.
        J Oral Pathol Med. 1989; 18: 28-31
        • Capple I.L.
        • Hamburger J.
        The significance of oral health in HIV disease.
        Sex Transm Infect. 2000; 76: 236-243
        • Felix D.H.
        • Jalal H.
        • Cubie H.A.
        • et al.
        Detection of Epstein-Barr virus and human papillomavirus type 1b DNA in hairy leukoplakia by in-situ hybridization and the polymerase chain reaction.
        J Oral Pathol Med. 1993; 22: 277-281
        • Grossman M.E.
        • Stevens A.W.
        • Cohen P.R.
        Brief report: herpetic geometric glossitis.
        N Engl J Med. 1993; 329: 1859-1860