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

OBJECTIVETo examine the flora samples from the tongue dorsum of the atrophic glossitis group and to discuss the relationship so as to provide a thinking pattern for therapy and a clue for deeper research.

METHODSTo collect personal information on 60 cases of atrophic glossitis and 40 cases of volunteers as control. The main items include general status, oral examination, salivary flow rate, pH value and bacteria test. All data were analyzed statistically.

RESULTS1) Among the 60 cases, 75.00% were female patients. Glosso-pain, dry mouth and taste loss were the most common symptoms. 2) In regard to the pathogenic factors, the systematic diseases were often visible, i.e. gastritis, coronary disease and anemia. 3) Oral hygiene of the patients was worse than that of the control group, the saliva flow rate and pH value were lower than that of the control. 4)The statistic analysis showed that the quantity of some bacteria of tongue dorsum and their detectable rate were different between the glossitis group and the control one, between the patients with atrophic glossitis who also suffered from different systematic diseases and the control group, and between the complete type and the partial type. These bacteria included Streptococcus sanguis, Stomatococcus, Staphylococcus aureus, Saccharomyces, etc.

CONCLUSIONAtrophic glossitis is the consequence co-affected by host, circumstances of oral cavity and bacteria. The tangible relationship between atrophic glossitis and micro-ecological changes on glossal dorsum has not been confirmed yet, however, flora change on dorsum may have relations with occurrence, and development of the disease.

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

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

Necrolytic migratory erythema (NME) is a typical cutaneous manifestation of glucagonoma syndrome. The entire syndrome consists of NME, glucose intolerance, weight loss, anemia, glossitis, diarrhea, and increased glucagon levels. We herein report a patient with glucagonoma syndrome who was diagnosed as having NME. A 48-year-old male presented with a 2-month history of painful erythematous, desquamative, erosive papules and plaques on both lower extremities. Histological examination revealed an intraepidermal cleft, the presence of vacuolated, pale epidermal cells, and necrosis in the upper epidermis. His glucagon level was 2650 pg/ml, with the upper limit of a normal range being 250 pg/ml. The patient was treated with octreotide, and showed an improvement of the skin eruption with normalization of the glucagon level within 4 weeks.
Anemia ; Diarrhea ; Epidermis ; Glossitis ; Glucagon ; Glucagonoma* ; Glucose Intolerance ; Humans ; Lower Extremity ; Male ; Middle Aged ; Necrolytic Migratory Erythema* ; Necrosis ; Octreotide ; Reference Values ; Skin ; Weight Loss

BACKGROUND: The traditional treatment of cobalamin deficiency anemia is performed by intramuscular injections. However, it has been suggested that oral replacement of cobalamin is also effective as an intramuscular injection. We studied the effectiveness of oral mecobalamin treatment in patients with cobalamin deficiency. METHODS: Patients with newly diagnosed cobalamin deficiency (<200 pg/mL) or who were previously maintained on intramuscular injection were given 2,000 microgram of oral mecobalamin daily. RESULTS: Sixteen patients were enrolled. The common causes of cobalamin deficiency were total gastrectomy (75%) and pernicious anemia (12.5%). Twelve patients received oral mecobalamin, except for four patients who were lost from follow-up after initial diagnosis. The mean pretreatment values of serum cobalamin and hemoglobin level were 58.3+/-21.9pg/mL and 8.1+/-1.9g/dL, respectively. After one, two, and six months of oral therapy, the respective mean values were 1,691.8+/-260.4pg/mL, 1,085.8+/-1,110.3pg/mL and 990.2+/-249.8pg/mL of serum cobalamin, and 10.4+/-1.3g/dL, 11.3+/-2.2g/dL and 12.1+/-2.3g/dL of hemoglobin. Initially elevated serum homocysteine were normalized after one month of oral therapy. Symptoms such as glossitis were relieved rapidly by oral treatment. CONCLUSION: High-dose oral mecobalamin supplement was a simple and effective treatment in patients with cobalamin deficiency, especially in total gastrectomized patients.
Anemia ; Anemia, Pernicious ; Diagnosis ; Follow-Up Studies ; Gastrectomy ; Glossitis ; Homocysteine ; Humans ; Injections, Intramuscular ; Vitamin B 12 Deficiency ; Vitamin B 12*

Adult ; Aged ; Capsules ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Glossitis ; drug therapy ; Humans ; Male ; Middle Aged ; Phytotherapy ; Tablets

Pernicious anemia is caused by the absence of intrinsic factor from autoimmune destruction of parietal cells. Patients with pernicious anemia are predisposed to the development of gastric cancer. We report here a case of pernicious anemia with early gastric cancer. A 65 year old woman was presented with severe anemia and glossitis. Her serum cobalamin level was low, and serologic test to anti-intrinsic factor antibody and anti-parietal cell antibody were positive. Gastroscopic examination revealed an early gastric cancer and type A atrophic gastritis. This patient underwent radical subtotal gastrectomy and received daily oral vitamin B12 replacement.
Aged ; Anemia ; Anemia, Pernicious* ; Female ; Gastrectomy ; Gastritis, Atrophic ; Glossitis ; Humans ; Intrinsic Factor ; Rabeprazole ; Serologic Tests ; Stomach Neoplasms* ; Vitamin B 12

Glucagoma is rare disease and has been reported only 100 cases so far worldwidely. The experience of this disease in our country is also lacking. The associated symptoms and signs can be characterized by necrolytic migratory erythematous lesion of the skin, hypoaminoacidemia, diabetes, weight loss, anemia, diarrhea, thrombocytopenia, glossitis. Among these, necrolytic migratory erythematous lesion of the skin is particulary considered as specific in this disease entity. In some cases, glucagonoma is diagnosed after metastasis to liver or bone marrow. Our patient initially diagnosed as having multiple metastatic adenocarcinoma of the liver. But subsequent development of the dermatologic manifestation enabled us to consider this rare disease. The constitutional symptoms and skin lesion abates rapidly at receiving Octreotide, somatostatin analogue, whereas no remarkable change observed after administration of the Zinc and aminoacid.
Adenocarcinoma ; Anemia ; Bone Marrow ; Diarrhea ; Erythema* ; Glossitis ; Glucagonoma* ; Humans ; Liver ; Neoplasm Metastasis* ; Octreotide ; Rare Diseases ; Skin ; Somatostatin ; Thrombocytopenia ; Weight Loss ; Zinc