10/12/2025
❇️ Different Tongue Lesions:
▶️ Normal Tongue
* Pink, moist surface with uniform papillae
* No ulcers, plaques, fissures, or discoloration
* Indicates healthy oral mucosa
▶️ Median Rhomboid Glossitis
* Well-defined, erythematous depapillated area on midline of dorsal tongue
* Strongly associated with Chronic Candida infection
* Usually asymptomatic
* Common in smokers, diabetics, and immunocompromised patients
▶️ Leukoplakia
* White patch that cannot be scraped off
* Strongly linked to to***co, alcohol, and areca nut
* Potentially malignant disorder
* Requires biopsy for dysplasia or carcinoma
▶️ Atrophic Glossitis
Smooth, shiny, erythematous tongue due to loss of papillae
Associated with:
* Iron deficiency
* Vitamin B12 deficiency
* Folate deficiency
May present with burning sensation
▶️ Oral Candidiasis
White curd-like plaques that scrape off, leaving erythematous surface
Common in:
* Denture wearers
* Diabetics
* Immunosuppressed patients
Treated with Topical or systemic antifungals
▶️ Geographic Tongue (Benign Migratory Glossitis)
* Multiple erythematous patches with white borders
* Lesions change location over time
* Benign, idiopathic, often associated with stress or psoriasis
* No malignant potential
▶️ Fissured Tongue
Deep grooves or fissures on dorsal surface
Common in:
* Elderly
* Down syndrome
* Melkersson–Rosenthal syndrome
Food debris retention → secondary inflammation possible
▶️ Strawberry Tongue
Enlarged, hyperemic fungiform papillae on erythematous background
Seen in:
* Scarlet fever
* Kawasaki disease
* Toxic shock syndrome
▶️ Hairy Tongue (Black Hairy Tongue)
Elongation of filiform papillae
Brown to black discoloration
Causes:
* Poor oral hygiene
* Smoking
* Antibiotic use
Benign and reversible
▶️ Oral Lichen Planus
* Characteristic Wickham’s striae (lace-like white pattern)
* T-cell mediated autoimmune disorder
* Common sites: buccal mucosa, tongue
* Low malignant transformation risk
▶️ Hairy Leukoplakia
* White, vertical corrugated plaques on lateral border of tongue
* Strongly associated with Epstein–Barr virus (EBV)
* Seen in HIV patients
* Not considered premalignant
▶️ Pemphigus Vulgaris
* Autoimmune vesiculobullous disorder
* Intraepithelial blister formation due to anti-desmoglein 3 antibodies
* Positive Nikolsky sign
* Often presents first in the oral cavity
* Potentially life-threatening if untreated