A 32-year old female was seen at the clinic for aphthous ulcers (See The Case of Two Pathologies - Part 1). During the intra-oral exam, a strange pattern was noted on her tongue.
The tongue appeared to have red areas surrounded by a thin and delicate white margin. The patient had noticed this pattern on her tongue on occasion, but was not concerned. There were no symptoms associated with this process.
This condition is referred to as erythema migrans (geographic tongue). No management is needed in asymptomatic cases.
Erythema migrans (Geographic Tongue):
Erythema migrans is believed to be an autoimmune process. The exact etiology for this condition is unknown. It is characterized by appearance of well-demarcated red spot surrounded by a white outline. The lesions heal over a period of time and usually appear at a different location (they tend to migrate). The duration of the lesions is highly variable. For some people the healing and reappearing cycle may be within hours, while for others longer durations have been reported.
Erythema migrans is seen in patients of all ages. Tongue is not the only site of occurrence, rarely, other oral sites may exhibit involvement. Symptoms are infrequent with this process. Occasionally, a complaint of pain or sensitivity to food may be encountered.
Erythema migrans is seen in patients of all ages. Tongue is not the only site of occurrence, rarely, other oral sites may exhibit involvement. Symptoms are infrequent with this process. Occasionally, a complaint of pain or sensitivity to food may be encountered.
No treatment is required if the patient is symptomless. For patients experiencing an intense amount of pain, topical steroid application may be recommended. This seems to heal the lesions quickly and provide relief.
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