Map on tongue: An enigmatic oral lesion - rare case report of 2 pediatric patients

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Authors: Swati Phore and Rahul Panchal
Date: April-June 2015
From: Journal of Dental Research and Review(Vol. 2, Issue 2)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Case study
Length: 1,877 words

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Byline: Swati. Phore, Rahul. Panchal

It is truly said that the tongue is a mirror of the body. Very often, the manifestations of diseases or systemic conditions of body are reflected on the tongue. There are a variety of different lesions present on the tongue out of which geographic tongue (GT) is the second most common, but its frequency of occurrence in the pediatric population is very rare. This condition is most commonly asymptomatic and is usually discovered on routine clinical examination. This case report describes symptomatic GT, an uncommon occurrence reported in the pediatric literature.


Benign migratory glossitis was first reported as a wandering rash of the tongue, in 1831, by Rayer. [sup][1] This constantly changing pattern of serpiginous white lines surrounding areas of depapillated mucosa resembles land masses and oceans on a map. A number of synonyms are used in literature may refer to this condition such as geographic tongue (GT), erythema migrans, annulus migrans, wandering rash. Sapiro and Shklar also called it as "stomatisis areta migrans." [sup][2] The term "migratory" is used to denote apparent migration due to simultaneous epithelial desquamation at one site and proliferation at another. [sup][3]

It is characterized by circinate, erythematous, ulcer-like lesion on the dorsum and lateral border of the tongue due to loss of filiform papillae of tongue epithelium. [sup][4] GT is not able to change the perception of taste for salty, sweet, sour, or bitter. [sup][5]

The exact prevalence is not known. However, the prevalence of GT with other tongue lesions is 18.5%. [sup][6] Percentage of reported cases among children in India is 0.89%, and overall prevalence is 1-2.5% in general population. [sup][7] Khozeimeh and Rasti reported its prevalence as 4.8%. [sup][8] Redman observed 1% prevalence in school children with equal distribution among males and females. [sup][9] Similar prevalence was reported in an investigation by Meskin et al . [sup][10] Very high prevalence rates were reported in Japanese children (8%) and Israel (14%) with a peak age of 2-3 years. [sup][11],[12]

Here, the author presents two rare cases of GT in pediatric patients.

Case Reports

Case 1

A 5-year-old [Figure 1] male patient presented to the dental outpatient department with the chief complaint of burning sensation on the tongue on eating citrus and spicy foods. Medical history was noncontributory, and general physical examination was normal. On clinical examination, there was an irregularly erythematous lesion present with loss of filiform papillae on the tip of the tongue [Figure 2]. According to patient's mother, it was present from last 1-month and his father also have similar kind of lesion on the tongue occasionally which resolves on its own and reappears again without a definitive cause in both. After obtaining informed consent from the patient's parent, routine blood investigations were advised. Hemoglobin was found to be 14.2 g%, and total RBC...

Source Citation

Source Citation
Phore, Swati, and Rahul Panchal. "Map on tongue: An enigmatic oral lesion - rare case report of 2 pediatric patients." Journal of Dental Research and Review, vol. 2, no. 2, 2015, p. 78. Accessed 17 May 2021.

Gale Document Number: GALE|A422875158