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PubMed1984

Tobacco smoking and denture wearing as local aetiological factors in median rhomboid glossitis.

The importance of tobacco smoking and denture wearing in the aetiology of median rhomboid glossitis (MRG) has been evaluated in 39 patients. Significantly more of the MRG patients (85%) smoked tobacco compared with the corresponding proportion (41%) of the 39 healthy age-and sex-matched control subjects. Their tobacco consumption was also heavier. A significantly greater proportion of the MRG patients wore their dentures continuously compared with the controls. The number of MRG patients who were both tobacco smokers and denture wearers was significantly increased above that of the control group, as was the number who both smoked and wore dentures continuously. Only 1 patient neither smoked nor wore dentures and she was taking an antidepressant (imipramine hydrochloride) with a reported association with oral candidosis. It is suggested that these local factors may play a part in the development of MRG by favouring the local proliferation of Candida albicans on the dorsum of the tongue. Although conservative or surgical treatment may provide relief, management should also include attention to possible predisposing local factors.

Adult↗
PubMed1993

Nutritional correlates of atrophic glossitis: possible role of vitamin E in papillary atrophy.

Atrophy of the filiform papillae of the tongue is a sign of malnutrition. However, papillary atrophy has not been correlated with laboratory indices of nutritional status. We studied photographs of tongues from 30 elderly subjects and determined the percentage of normal papillary development (%NPD) relative to a reference photograph. We also determined 16 nutritional blood levels and used stepwise multiple linear regression to examine their relationship to %NPD. We found that %NPD correlated significantly (p < 0.0031) with levels of vitamin E and prealbumin, but not with 14 other laboratory indices. Subjects with overt atrophic glossitis (%NPD < 50%) tended to have multiple nutritional deficiencies. The high correlation of plasma vitamin E levels with %NPD may be related to its role as an antioxidant and in the maintenance of cellular membrane integrity.

Aged↗
PubMed1992

Quantitative evaluation of Langerhans cells in median rhomboid glossitis.

Langerhans cells (LC) serve as antigen presenting cells and provide immune surveillance within epithelia. Since depression of LC number and/or function may allow tolerance to antigens, we evaluated LC in median rhomboid glossitis (MRG), a condition linked to persistent candidal infection of lingual mucosa. Material included a total of 36 cases of MRG (7 of which did not show PAS + fungi) and 6 controls. LC were identified by their expression of S-100 and HLA-DR antigens and quantified using image analysis. Equal numbers of LC were identified using S-100 + and HLA-DR + markers. The density of LC (cells/mm of basement membrane, mean +/- SD) in both PAS + MRG (2.6 +/- 1.3) and PAS-MRG (3.0 +/- 1.7) was markedly depressed compared with controls (17.2 +/- 6.4), (P less than 0.001). These findings indicate that the LC network is perturbed in MRG, and are consistent with the view that of localized defect in immune surveillance may contribute to persistent fungal infection of the oral mucosa.

Candidiasis, Oral↗
PubMed2004

Prevalence of fissured tongue, geographic tongue and median rhomboid glossitis among Israeli adults of different ethnic origins.

BACKGROUND: Fissured tongue (FT), geographic tongue (GT) and median rhomboid glossitis (MRG) are frequently misdiagnosed and overtreated. FT is a relatively common variant of the tongue that includes numerous grooves or fissures on the dorsum of the tongue, while GT usually appears as areas of atrophy and raised white borders. MRG is an erythematous patch of atrophic papillae located in the central area of the dorsum of the tongue. The prevalence of these lesions varies among different ethnic groups. However, their occurrence among the adult Israeli Jewish population of different ethnic origins is unknown. OBJECTIVE: To examine the prevalence of benign tongue lesions among adult Israeli Jewish urban, rural and industrial populations of different ethnic origins. METHODS: A total of 2,464 healthy Israeli adults were clinically examined and divided into three ethnic groups, Ashkenazi, Sephardic or Eastern, based on place of birth of both parents. The prevalences of FT, GT and MRG were evaluated. FT was subdivided according to four subtypes: mild, moderate, typical and central. RESULTS: The prevalence of FT was 30.5%. The most prevalent, typical FT, grooves over one third of the dorsal tongue, was noted in 11.5% of the study group. GT and MRG were found in 12.7 and 2.4% of the study population, respectively. A strong correlation was found between the occurrence of FT and GT, and a gradual increase in prevalence of FT and GT was noted with age. MRG decreased with age. CONCLUSIONS: Although no statistically significant differences were found in the prevalence of FT, GT and MRG among the different ethnic groups, ethnic background probably plays some role in its occurrence.

Adolescent↗
PubMed1988

Acute atrophic glossitis after open-heart surgery.

The problem of Candida infections has become important in connection with transplant surgery and immunosuppression. To clarify the source of the postoperative acute atrophic glossitis (AAG) commonly seen in our department of cardiac surgery, 33 patients admitted for coronary artery bypass or valve replacement underwent clinical and microbiologic investigation before and after operation. None showed signs of AAG preoperatively, but 12 had cultures positive for Candida albicans, and in all 12 AAG appeared postoperatively. Six of the 21 patients with preoperatively negative cultures likewise had postoperative AAG. All 18 affected patients responded well to local nystatin treatment. No patient had disseminated candidiasis.

Acute Disease↗
PubMedDate not supplied

Dermatitis, glossitis, stomatitis, cheilitis, anemia and weight loss: a classic presentation of pancreatic glucagonoma.

Glucagonomas are rare tumors. They are predominantly located in the body or tail of the pancreas and display a constellation of signs and symptoms referred to as glucagonoma syndrome. The term necrolytic migratory erythema is used to characterize the distinctive rash associated with this syndrome. This report describes a classic presentation consisting of dermatitis, glossitis, stomatitis, angular cheilitis, anemia, and weight loss that was associated with the finding of a pancreatic mass and a markedly elevated plasma glucagon level. After pancreatic resection, the patient had complete resolution of the rash and normalization of plasma glucagon.

Anemia↗
PubMed2001

Folate and vitamin B12 levels in patients with oral lichen planus, stomatitis or glossitis.

Forty-one patients with oral lesions and symptoms were enrolled in the study. Their ages ranged from 16 to 79 years with a mean age of 48.5 years. They were divided into two groups. Group I consisted of 25 patients with oral lichen planus and group II consisted of 16 patients with stomatitis or glossitis. Their complete blood counts, hemoglobin typing, serum and red cell folate, and serum vitamin B12 levels were studied. The results revealed low red cell folate levels in 11 out of 25 patients (44%) in group I and 9 out of 16 patients (56%) in group II. The serum vitamin B12 levels were within normal range in both groups. They were defined as having folate deficiency (n = 10), folate deficient erythropoiesis (n = 3) and folate depletion (n = 7). None of them had anemia nor macrocytes. Therefore, folate levels should be investigated in patients with oral lesions and symptoms especially those with risk factors of age, poor nutrition or systemic diseases. When suspected, daily folic acid supplements should be given.

Adolescent↗
PubMed1975

Ulcerative glossitis. A facet of feline panleukopenia.

The clinical findings and the macroscopic and microscopic lesions in a kitten which died during an outbreak of ulcerative glossitis in a cattery are described. A brief review of the literature is given to support the theory that the virus of feline panleukopenia may well be the aetiological agent in this outbreak.

Animals↗
PubMedDate not supplied

Symptomatic benign migratory glossitis: report of two cases and literature review.

Benign migratory glossitis (geographic tongue) is a common clinical finding in routine pediatric dentistry. The condition usually discovered on routine clinical examination, appearing as an asymptomatic, ulcer-like region on the dorsum of the tongue. The lesion may recur at different sites on the tongue, creating a migratory appearance, and in many cases, will resolve completely. The presentation of symptomatic geographic tongue in children is rare. This article presents two cases of symptomatic geographic tongue. Both children presented with a chief complaint of significant oral pain which was affecting daily activity, eating, and sleeping. Both patients presented with a classical clinical presentation of ulcer-like regions on the dorsum of the tongue in which the filiform papillae were denuded. Successful management was achieved with topical and systemic antihistamine. The clinician should be aware that this condition may be symptomatic in children.

Age Factors↗
PubMed1985

Radiographic contrast medium--induced glossitis.

A new complication of intravenous radiographic contrast medium administration is recognized: severe glossitis. The pathophysiology of adverse reactions to contrast media is briefly reviewed.

Diatrizoate↗
PubMed1979

[Median candidiasis of the tongue (glossitis mediana candidamycetica) (author's transl)].

The median rhomboid glossitis is generally considered as a developmental anomaly of the tongue. Recent clinical, biological and experimental studies provide support for a fongous etiology: this lesion of the midline of the tongue is a chronic hyperplastic oral candidiasis, occurring sometimes in association with candidal commissural leukoplakias and palatine kissing lesions. The yeasts--mainly Candida albicans-- invade the upper parakeratotic layers of the epithelium inducing a proliferating acanthosis of the deeper epithelial ridges; superficial micro-pustules closely related to the candidal hyphae were found in most cases. Antifungal specific therapy appear effective in early lesions; later the condition becomes permanent and, in a few cases, may go further to malignant change. Fourteen cases are presented in this paper: the clinical, histopathological and therapeutic features are obviously in accord with this fongous infectious etiology (already suggested and demonstrated in 1965 by French stomatologists) and with the more recent experimental data published by Cawson, Sohnel and Kirkpatrick, Jones and Russell.

Antifungal Agents↗
PubMedDate not supplied

Pasteurella multocida from canine and feline teeth, with a case report of glossitis calcinosa in a dog caused by P. multocida.

A case of glossitis calcinosa in a dog caused by Pasteurella multocida is reported. Swelling of the tongue and reduced appetite were the predominant clinical symptoms. Due to latent infections with P. multocida in many species there is a risk of bitewounds being infected with this microorganism. In order to find the carrier-rate of P. multocida samples in canines, teeth and gingiva of 121 dogs and 30 cats were examined bacteriologically, revealing a carrier rates of 55% and 80% respectively. The rate is significantly higher in dogs with poor oral hygiene (calcula), and there is a tendency towards small dogs being more at risk than large dogs and male cats more than females. The isolated strains of P. multocida were most sensitive to chloramphenicol and tetracycline whereas, many were resistent to penicillin and sulfa. The theory, that this pattern should be explained by the common use of the latter drugs in veterinary practice, is not valid under Danish conditions, where chloramphenicol and tetracycline are commonly used in the small animal clinic. Accordingly suspected P. multocida infections should be treated with chloramphenicol or tetracycline, until the result of a sensitivity test is available, and not with penicillin which today is the general routine.

Animals↗
PubMed1981

[Glossitis rhombica mediana. A study of 4422 dermatologic patients].

Though known for a long time and by no means rare, median rhomboid glossitis (MRG) still gives rise to questions concerning its dignity and etiology. MRG was found in 54 out of 4,422 stomatologically investigated dermatological patients. The patient's ages ranged from 10 to 69 years, the sex ratio was 3:1 male to female. Candida albicans was found in 18 out of 22 MRG lesions examined mycologically. These findings, the constant location and the stationary course were interpreted as a secondary Candida albicans colonization on a dysembryogenetically determined locus minoris resistentiae. Dysembryogenetic, anatomic and microbial factors contribute to the etiology and pathogenesis of MRG.

Adolescent↗
PubMed1980

Septicemia caused by Capnocytophaga in a granulocytopenic patient with glossitis.

A patient receiving immunosuppressive treatment for multiple myeloma became granulocytopenic, and acute glossitis developed. Blood cultures were positive for Capnocytophaga, a fastidious Gram-negative bacillus that is known to be part of the normal oral flora and a pathogen for periodontitis. The infection responded to treatment with antibiotics, including penicillin G, to which the organism was sensitive. This is one of the first reports of Capnocytophaga septicemia, and suggests that this organism may be an important pathogen in immunosuppressed patients with oral mucosal lesions.

Acute Disease↗
PubMed1995

[Benign migratory glossitis: an enigmatic lesion].

Although benign migratory glossitis, commonly called "geographic tongue," is frequently observed, we still have not been able to determine its etiology. While the condition is usually asymptomatic, the spectacular appearance of the lesion frequently causes the patient considerable worry. Based on a review of the literature, different theories on the lesion's etiology as well as therapeutic modalities will be discussed.

Glossitis, Benign Migratory↗