Geographical tongue or benign migratory glossitis is an alteration of the language easily recognizable to the naked eye. There are spots and plaques on the tongue that can change places, remembering a map. It is not a serious pathology although it can cause discomfort to those who suffer it.
Anatomy of the tongue
The language is formed by three parts:
- Root, is the back that forms the floor of the mouth.
- Body, is what we know colloquially as a language.
- Apex or tip of the tongue, most anterior part.
The anterior part of the tongue is what is called the back of the tongue , in communication with the oral cavity and the pharynx. It has a V-shaped groove with the backward tip called terminal groove, which divides the anterior (oral) and the posterior (pharyngeal).
At the microscopic level, the back of the tongue is formed by different types of papillae:
- Circumvated papillae, the largest, located in front of the terminal groove.
- Foliate papillae, on the sides of the tongue.
- Filiform papilla, very numerous and responsible for tactile sensitivity.
- Fungiform papillae, more abundant at the edges and at the lingual apex.
Causes of the geographical language
It is not known what causes the geographical language, although it is associated with some systemic diseases:
- Atopic dermatitis, psoriasis and other skin pathologies
- Stress or anxiety
- Nutritional deficiencies, especially vitamin B deficiency
Clinic and pathogenesis of the geographical language
Although as we have said, the cause is not known, what happens in this pathology is a lingual inflammation that presents with alterations in the surface of the tongue. This inflammation causes the papillae to flatten and change the normal structure of the lingual dorsum.
Desquamated zones of variable form appear , with the erythematous center (reddened) and the whitish edges.
These lesions are superficial and as the lingual mucosa regenerates rapidly, its morphology and location change . That is why it is called migratory glossitis.
It does not usually entail an alteration of the sense of taste since the papillae are renewed normally and the lesions are usually localized. Nor are they usually painful, although they can increase sensitivity to some flavors, such as acidic foods or salt.
These flaking may appear from childhood (from 6 months of age) or in adulthood. Injuries can last between months and years, and new episodes may remit or appear over time.
Pathological anatomy of the lesions
At the microscopic level, a thickening of the superficial layer can be observed in the lesions , with abundant edema and inflammatory cells such as neutrophils and eosinophils.
Diagnosis of the geographical language
The diagnosis of this entity is usually based on lingual exploration. As we have said, the surface of the tongue has an appearance reminiscent of a map. The flaked and reddened areas are observed in the absence of other symptoms.
In addition, the patient usually reports that the lesions change location and shape over the days.
It is a benign pathology that does not require treatment. The objective of the diagnosis is to rule out other associated pathologies, since sometimes the subjects are alarmed by the appearance of the lesions.
After the inspection, you can investigate the patient’s eating habits in search of possible . In these cases, a vitamin complex can be taken to counteract the deficit.
Even so, in most cases it has no repercussions of any kind on the patient’s life. In addition, the lesions disappear on their own after a while and, although they reappear, it does not indicate the evolution to any type of more serious pathology.