The purpose of this study was to investigate the clinical characteristics and assess other factors associated with geographic tongue in Thailand. One hundred and eighty-eight Thais with geographic tongue and 188 controls were interviewed regarding their medical history, symptoms, and the nature and migratory pattern of their lesions. Variations in the clinical appearance, lesion location, and any associated tongue fissures were recorded. The age range for the 188 subjects was 9 to 79 years. The highest incidence (39.4%) occurred in the 20-29 age group. Women were affected more than men (1.5:1). The leading group of medical conditions consisted of allergy-related disorders; however, the incidence of these problems among both subjects and controls was not significantly different (55.2% vs. 44.8%). Our results demonstrated a significant co-existence of geographic tongue and fissured tongue. Most of the geographic tongue lesions manifested a typical appearance consisting of a central atrophic area bounded by a raised white circinate line (69.1%) with multiple tongue sites affected (62.8%). The most common locations were at the lateral margins and tip of the tongue. The majority of our subjects (75.5%) were asymptomatic. The results of this study correspond with the findings of previous geographic tongue studies in other populations.

Geographic tongue: clinical characteristics of 188 cases.

Summary

Six-hundred-and-three people aged 40 or more years, from Maryborough in central Victoria, were enrolled in a randomized longitudinal study, which required daily application of either a SPF 15+. broad-spectrum, water-resistant sunscreen cream or the cream base without the active ingredients. The study duration was 7 months, from September 1991 until April 1992.



One-hundred-and-fourteen (18.9%) of these subjects developed an adverse reaction to the cream they were applying. Patch testing, photopatch testing and scratch testing with the ingredients of the creams revealed that only a small proportion (<10%) of the intlammatory eruptions were allergic in nature. None of the people tested was allergic to the sunscreen active ingredients. History and examination findings, where available, suggested that the majority of adverse responses were consistent with an irritant reaction, both to the sunscreen preparation and the base cream control. A higher than expected proportion of the people who developed an adverse reaction had a personal history consistent with atopy. Other reactions included acneiform eruptions and contact urticaria. A frequency of reactions to sunscreen preparations of over 15% means that further work is necessary to improve both the formulation of such products, and the manner and conditions nnder which they are used, to ensure satisfactory compliance.

The frequency of reactions to sunscreens : results of a longitudinal population-based study on the regular use of sunscreens in Australia

Objective: To characterize the prevalence of geographic tongue (GT) among US adults.



Design:  Population-based case–control study



Main outcome measures:  The presence or absence of GT.



Subjects and methods:  Data from 16 833 adults examined during The Third National Health and Nutrition Examination Survey, 1988–1994 (NHANES III), a study based on multistage probability sampling were analyzed using SAS-callable SUDAAN 9.0.1.



Results:  Geographic tongue point prevalence was 1.8% (95% CI: 1.4, 2.3). Multivariate logistic regression showed significant effects of race-ethnicity, with Whites (AOR = 1.8; 1.3, 2.5) and Blacks (AOR = 1.6; 1.2, 2.1) having greater odds of GT than Mexican-Americans; current corticosteroid therapy (AOR = 3.7; 1.54, 8.6). Cigarette smokers had lower GT prevalence (AOR = 0.4; 0.3, 0.6). Fissured tongue (FT) was strongly associated with GT among non-smokers: AOR = 17.5 (7.8, 39.5). We did not find significant associations with age, gender, oral contraceptive use, diabetes mellitus, allergy or atopy, psychological or dermatological conditions as previous research has suggested.



Conclusions:  Geographic tongue was more prevalent among Whites and Blacks compared with Mexican-Americans, positively associated with FT, and inversely associated with cigarette smoking.

Prevalence and risk factors associated with geographic tongue among US adults.

Although easily examined, abnormalities of the tongue can present a diagnostic and therapeutic dilemma for physicians. Recognition and diagnosis require a thorough history, including onset and duration, antecedent symptoms, and tobacco and alcohol use. Examination of tongue morphology and a careful assessment for lymphadenopathy are also important. Geographic tongue, fissured tongue, and hairy tongue are the most common tongue problems and do not require treatment. Median rhomboid glossitis is usually associated with a candidal infection and responds to topical antifungals. Atrophic glossitis is often linked to an underlying nutritional deficiency of iron, folic acid, vitamin B12, riboflavin, or niacin and resolves with correction of the underlying condition. Oral hairy leukoplakia, which can be a marker for underlying immunodeficiency, is caused by the Epstein-Barr virus and is treated with oral antivirals. Tongue growths usually require biopsy to differentiate benign lesions (e.g., granular cell tumors, fibromas, lymphoepithelial cysts) from premalignant leukoplakia or squamous cell carcinoma. Burning mouth syndrome often involves the tongue and has responded to treatment with alpha-lipoic acid, clonazepam, and cognitive behavior therapy in controlled trials. Several trials have also confirmed the effectiveness of surgical division of tongue-tie (ankyloglossia), in the context of optimizing the success of breastfeeding compared with education alone. Tongue lesions of unclear etiology may require biopsy or referral to an oral and maxillofacial surgeon, head and neck surgeon, or a dentist experienced in oral pathology.

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Common tongue conditions in primary care.

Color atlas of oral diseases , Color atlas of oral diseases , کتابخانه دیجیتال جندی شاپور اهواز

Color atlas of oral diseases

One hundred patients with geographic tongue have been studied for evidence of an association with atopy. There was a significantly high frequency of personal and/or family history of asthma, eczema and hay fever amongst the patients when compared to a control population. A raised total serum IgE( greater than or equal to 200 u/ml) was significantly more frequent in patients compared to a control population. These findings confirm the impression that in some patients geographic tongue is a sign of atopy.

Malcolm J. Simons

Papers

Geographic tongue—a manifestation of atopy