Geographic tongue is an inflammatory disorder of the tongue characterized by asymptomatic erythematous patches with serpiginous borders. Candidiasis of the tongue may be confused with geographic tongue. A 63-year-old male patient with painful white annular lesions localized to the left side of his tongue is presented. He applied topical corticosteroid and antiinflammatory agents, but his lesions did not respond to those therapies. Using direct mycologic examination and culture, the patient was diagnosed with candidiasis. After systemic and topical antifungal therapy, clinical improvement was observed. With this case, the clinical forms of oral candidiasis were discussed, and it was suggested that the clinical presentation of mucosal candidiasis may vary according to the stage of infection and individual immunity.
Anti-Inflammatory Agents ; Candidiasis ; Candidiasis, Oral ; Glossitis, Benign Migratory ; Humans ; Male ; Middle Aged ; Tongue

BACKGROUND: Geographic tongue (GT) is an inflammatory disorder of the oral mucosa. The clinical characteristics of GT have not been studied in Korea. OBJECTIVE: The purpose of this study was to investigate the clinical characteristics, associated factors, and treatment outcomes of GT. METHODS: We reviewed the medical records and clinical photographs of 55 cases who had been diagnosed with GT during the last 5 years. RESULTS: Of the 55 cases, 15 were male and 40 were female. The average age of onset was 29.3 years, and the highest incidence occurred in the 10~19 age group. The clinical type without circinate border was found in 67.3% of the cases and the clinical type with circinate border in 32.7% of the cases. Fissured tongue was found in 40% of the cases. Except for the 11 asymptomatic cases, the rest of the cases complained of various symptoms related to pain, irritation, and sensory changes. Hot, spicy or salty food acted as an aggravating factor in 74.5% of the cases and fatigue or stress in 61.8% of the cases. The majority of our cases (80.0%) were treated with topical steroid or steroid gargle or with a combination of both, and improvement was observed in 75.0% of this group. CONCLUSION: This is the first clinical study of GT in Korean literature. This study showed differences with previous studies in the proportion of cases with symptoms and aggravating factors. This study also suggested that topical steroid or steroid gargle could be the treatment of choice for GT.
Age of Onset ; Fatigue ; Female ; Glossitis, Benign Migratory ; Humans ; Incidence ; Male ; Medical Records ; Mouth Mucosa ; Tongue, Fissured

Generalized pustular psoriasis is a rare disease, even psoriasis involving oral mucosa is very rare. There are many reports of tongue lesions in patients with psoriasis that are clinically and histologically indistinguishable from geographic tongue, and there are many reports of fissured tongue in association with psoriasis. It has been debated whether oral psoriasis exists or not, or occurs as part of generalized pustular psoriasis. We experienced two cases of combined geographic tongue and fissured tongue in patient with generalized pustular psoriasis, and report these cases with review of the literature about the oral lesions in psoriasis, geographic tongue, and fissured tongue.
Glossitis, Benign Migratory* ; Humans ; Mouth Mucosa ; Psoriasis* ; Rare Diseases ; Tongue ; Tongue, Fissured*

Geographic tongue, also called benign migratory glossitis, is a common and superficial benign inflammatory disorder that affects the tongue epithelium. The majority of geographic tongue lesions typically manifest as irregular central erythematous patches. These lesions, which are caused by the loss of filiform papillae, are defined by an elevated whitish band-like border that can change location, size, and pattern over a period of time. Histological observations of the oral mucosa affected by geographic tongue revealed nonspecific inflammation. Some reports described cases of migratory stomatitis, wherein lesions simultaneously manifested on the extra lingual oral mucosa. This condition is also called ectopic geographic tongue, which is clinically and histologically similar to the type normally confined to the tongue. In most cases, patients are asymptomatic and do not require treatment. The condition may spontaneously exhibit periods of remission and exacerbation with good prognosis. The specific etiology of geographic tongue remains unknown. Geographic tongue is age-related and is prevalent among young individuals. Various etiological factors that have been suggested in literature include immunological factors, genetic factors, atopic or allergic tendency, emotional stress, tobacco consumption, hormonal disturbances, and zinc deficiency. Geographic tongue may coexist with other disorders, such as fissured tongue, psoriasis, diabetes mellitus, gastroin- testinal diseases, burning mouth syndrome, and Down syndrome. Experts currently disagree on whether geographic tongue is an oral manifestation of psoriasis. Moreover, some scholars suggest that geographic tongue is a prestage of fissured tongue. The objective of this review is to summarize current research on risk factors of geographic tongue.
Epithelium ; Female ; Glossitis, Benign Migratory ; Humans ; Mouth Mucosa ; Risk Factors ; Tongue ; Tongue, Fissured

BACKGROUND: Lyme disease, an infection caused by Borrelia(B.) burgdorferi, has been reported in many countries. But in Korea, only 5 cases of serologically diagnosed lyme disease have been reported. Because several strains of B. burgdorferi were isolated from Ixodes ticks which were captured in Kangwon and Chungbuk province, there might be more cases of serologically undiagnosed lyme diseases presenting with erythema migrans. OBJECTIVE: To understand the clinical patterns and laboratory findings of erythema migrans in Korea. METHODS: A clinical survey was retrospectively performed on 9 patients with erythema migrans which occurred after tick bites. RESULTS: Among 9 patients with erythema migrans, 3 patients were male and 6 patients were female. The onset age of erythema migrans ranged from 26 to 71 years old (mean, 51.3 years old). The mean duration of erythema migrans after tick bite was 26.4 days and the diameter of the lesion ranged from 6 to 34 cm (mean, 18.3 cm). All cases developed from May to September and systemic symptoms such as fatigue, fever and/or chills, myalgia, palpitation, headache, arthralgia and dyspnea were present at the time of hospital visits of 3 patients. Clinically, 3 patterns of erythema migrans were seen; typical target pattern, homogenous and erythematous plaque pattern, and linear solitary plaque pattern with central postinflammatory pigmentation. Only 2 of the 7 patients (28.6%) were seropositive for IgM and IgG antibody titers by enzyme-linked immunosorbent assay in consecutive serologic tests. PCR for Borrelia DNA in paraffin-embedded tissue showed full negativity in 6 patients with erythema migrans. CONCLUSION: Although lyme disease is not endemic in Korea, some patients with erythema migrans might be undiagnosed as lyme disease serologically with erythema migrans. To take into consideration false negative serelogic results in early erythema migrans, early oral tetracycline therapy should be included through clinical and historical diagnosis.
Age of Onset ; Arthralgia ; Bites and Stings ; Borrelia ; Chills ; DNA ; Dyspnea ; Enzyme-Linked Immunosorbent Assay ; Erythema ; Fatigue ; Female ; Fever ; Glossitis, Benign Migratory ; Headache ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Ixodes ; Korea ; Lyme Disease ; Male ; Pigmentation ; Polymerase Chain Reaction ; Retrospective Studies ; Serologic Tests ; Tetracycline ; Ticks