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Year : 2016  |  Volume : 17  |  Issue : 1  |  Page : 75-76

Painful geographical tongue in two siblings

Department of Dermatology, Venereology, and Leprology, Pt B D Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India

Date of Web Publication4-Jan-2016

Correspondence Address:
Priyadarshini Sahu
C/O., Rabi Narayan Sahu, 432, Sector IV, R.K. Puram, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2319-7250.173159

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How to cite this article:
Dayal S, Sahu P, Jain VK. Painful geographical tongue in two siblings. Indian J Paediatr Dermatol 2016;17:75-6

How to cite this URL:
Dayal S, Sahu P, Jain VK. Painful geographical tongue in two siblings. Indian J Paediatr Dermatol [serial online] 2016 [cited 2022 Jan 20];17:75-6. Available from: https://www.ijpd.in/text.asp?2016/17/1/75/173159


A 14-month-old boy was presented with a history of excessive crying and pain due to oral lesions while taking food since 1-week. History revealed that he had similar complaints in the past which wane off within 8–10 days and reappeared at a different site after a healthy period of 2 weeks. There was no history of atopy and specific oral habits (such as the use of nursing bottle, pacifier, or gnawing finger). On intraoral examination, the patient had two well-circumscribed, erythematous, depapillated areas bounded by whitish elevated borders on the dorsum of tongue [Figure 1]. There was no evidence of whitish exudate resembling cottage cheese appearance as seen in candidiasis. Other systemic and cutaneous examinations were within normal limits. Patient's 2-year-old elder brother also had a similar history of painful oral lesions. On examination of the sibling, there was a single central area of depapillation with multiple furrows and a whitish serpiginous border enclosing the lesion since 1-year [Figure 2]. Exfoliative cytology in both the siblings was negative for Candida. A very interesting fact was elicited from the mother's history that both children used to eat bathing soap, which might be the inflicting cause. The typical clinical appearance and history, including the migratory pattern, confirmed the diagnosis of geographic tongue (GT). Histological confirmation could not be done due to the parents' unwillingness for biopsy and easy clinical diagnosis. The parents were asked to strictly refrain the children from eating soap and were treated with oral antihistaminics and betamethasone mouth paint for 3 weeks, leading to complete resolution of symptoms. Now, after 6 months, the lesions were completely stopped to reappear after refraining the children from taking soap.
Figure 1: Well-demarcated erythematous patches surrounded by whitish elevated border on the dorsum of the tongue

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Figure 2: Central area of depapillation with multiple furrows surrounded by whitish serpiginous border

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GT is characterized by multifocal, irregular erythematous lesions due to the loss of filiform papillae, delineated by an elevated whitish border. It predominantly affects the dorsum and lateral aspect of the tongue.[1] Painful GT is a rare occurrence in children though asymptomatic, GT is comparatively common.[2] Asymptomatic cases usually resolve on their own, but symptomatic cases need treatment. Although the etiology is unknown, it is accepted that it may be associated in children with oral habits and other medical history (such as psoriasis or atopy).[3],[4] After a thorough search of literature, we found only about six cases of painful GT in children, but none had been reported due to soap.[2],[5],[6] The dramatic improvement after stopping the children from eating soap and absence of recurrence even after 6 months of follow-up, suggests soap as a possible cause, which is very peculiar and to the best of our knowledge, it has never been reported before.

Declaration of Patient Consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

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Conflicts of Interest

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  References Top

Assimakopoulos D, Patrikakos G, Fotika C, Elisaf M. Benign migratory glossitis or geographic tongue: An enigmatic oral lesion. Am J Med 2002;113:751-5.  Back to cited text no. 1
Menni S, Boccardi D, Crosti C. Painful geographic tongue (benign migratory glossitis) in a child. J Eur Acad Dermatol Venereol 2004;18:737-8.  Back to cited text no. 2
Bruce AJ, Rogers RS 3rd. Oral psoriasis. Dermatol Clin 2003;21:99-104.  Back to cited text no. 3
Menni S, Saleh F, Bigardi A. Geographic tongue. A possible manifestation of atopic dermatitis. Eur J Pediatr Dermatol 1994;4:149-52.  Back to cited text no. 4
Shekhar MG. Geographic tongue in monozygotic twins. J Clin Diagn Res 2014;8:ZD01-2.  Back to cited text no. 5
Goswami M, Verma A, Verma M. Benign migratory glossitis with fissured tongue. J Indian Soc Pedod Prev Dent 2012;30:173-5.  Back to cited text no. 6
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