Geographic tongue affects up to 14 % of the population and the etiology is unknown. It is a benign condition where the tongue appears to have bands of red and white areas. The red areas are caused by papillary atrophy and these areas move and change spontaneously. No treatment is necessary except when sensitive to trigger foods such as spices , then a topical oral steroid would be used.
Fissured tongue is deepening of the normal physiologic grooves of the tongue. It usually occurs with aging and requires no treatment. Fissured tongue has been associated with Down syndrome, acromegaly, psoriasis, Sjogren Syndrome, and Melkersson-Rosenthal syndrome (facial nerve palsy). Gentle tongue brushing can help prevent inflammation from debris getting trapped in the grooves.
This is a benign condition where keratin accumulates on the papilla forming projections that resemble hair. The color can vary from white, tan, to black. It is associated with tobacco use and poor oral hygiene. Treatment with a tongue scraper usually improves appearance and helps with halitosis.
MEDIAN RHOMBOID GLOSSITIS
This condition appears as a red shiny spot on the center of the tongue. Its border is well circumscribed and it may occasionally burn or itch. This is usually associated with candida infection and can be treated with antifungals. Underlying causes of immunosuppression should be considered.
Atrophic glossitis presents as a smooth glossy appearance. This is caused by atrophy of the filiform papillae which usually accompanies an underlying condition. Nutritional deficiencies in folic acid, vitamin B, and iron can be a common cause. Other conditions associated with atrophic glossitis include amyloidosis, celiac disease, chemical irritants, drug reactions, candidiasis, sarcoidosis, Sjogrens, and pemphigus.
Sources: medicalpicturesinfo.com, emedicalhub.com, kandyganesan.com, regionalderm.com, hxbenefit.com