Question
My child, who is 1.5 years old, has experienced the disappearance of tongue coating from an area when they were less than one year old, which has then progressed to the entire tongue coating disappearing, leaving the tongue red. After a period of time, the symptoms will naturally disappear, and the tongue coating returns to normal, only to reappear again from the tip and sides of the tongue. Is this phenomenon a disease, and what should be done for treatment? Thank you.
Answer
Considering geographic tongue, geographic tongue is a circular lesion on the tongue’s back that resembles a map in appearance. In essence, it is a type of superficial chronic desquamative glossitis of the tongue mucosa. Due to its migratory nature, it is also known as migratory glossitis. In the early stages, there may appear one or more grayish-white slightly raised spots of varying sizes on the tip, back, or edge of the tongue (occasionally seen on the lips, cheeks, or upper palate mucosa). Later, the grayish-white gradually fades away, leaving a central red thread-like papillary desquamation area. The surface is smooth and dry with a 2-3mm grayish-white or gray-yellow slightly raised tissue (thread-like papillary keratosis and thickening) at the edge. The lesions gradually expand outward in an irregular arc pattern, resembling boundary lines on a map. The location and shape can change continuously, often moving from one area to another within a day or night. During this migratory process, the original lesions gradually heal while new ones appear or recur on newly repaired mucosa. Each episode lasts for 3-4 days or longer, and some may last for several years. The disease has no obvious conscious symptoms; sometimes there may be itching or slight discomfort or pain when eating irritating food. Geographic tongue is more common in children, and the exact cause is not yet clear. Some believe it is caused by inflammation, while others think it may be due to an allergic reaction. There are no special symptoms in clinical practice; occasionally there may be a poor appetite, and eating irritating foods such as sour or spicy foods may cause tongue pain. This condition does not have any specific treatment.