The occurrence of Fordyce spots, benign migratory glossitis, median rhomboid glossitis, and fissured tongue in 2,478 dental patients.
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Glossitis↗
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Both psoriasis and benign migratory glossitis are associated with HLA-Cw6.
This study was undertaken to investigate human leucocyte antigen (HLA) associations with benign migratory glossitis and psoriasis in Brazilian patients and particularly to determine whether benign migratory glossitis is also associated with HLA-Cw6, the classical association observed in psoriasis. The results showed a highly significant association of Cw6 with both psoriasis and benign migratory glossitis, with this antigen being present in 59.1% of the patients with psoriasis, in 43.8% of the patients with benign migratory glossitis, and in only 12.6% of the controls. Other significant positive associations, although at a lower significance level, were with B13, both in psoriasis and in benign migratory glossitis, and with B17, only in psoriasis. To our knowledge, this is the first report on the association of Cw6 with benign migratory glossitis. We believe that this finding reinforces the concept of a pathogenetic relationship between benign migratory glossitis and psoriasis.
Female↗
The association between atrophic glossitis and protein-calorie malnutrition in old age.
AIM: To examine the relationship between atrophic glossitis (absence of papillae in more than 50% of the tongue) and nutritional status. DESIGN: A randomized population survey. SETTING: The medical department of Aker University Hospital, and people living at home. PARTICIPANTS: 310 old people recently admitted to hospital and 106 randomly selected elderly people at home. MEASURES: The presence of atrophic glossitis and nutritional indices. RESULTS: Atrophic glossitis occurred in 13.2% of men and 5.6% of women at home and in 26.6% of men and 37% of women in hospital. The atrophic glossitis was related to reduced weight, body mass index, triceps skinfold thickness, arm-muscle circumference, muscular strength, activities of daily living and serum concentrations of cholesterol, ascorbic acid, cholecalcidiol and B12, but not to levels of zinc or folate. In a multiple logistic regression model, atrophic glossitis was related only to cholesterol (P = 0.032), muscular strength (P = 0.018) and activities of daily living (P = 0.03). CONCLUSION: Atrophic glossitis is common in elderly people and is a marker for malnutrition and reduced muscle function.
Aged↗
Helicobacter pylori colonization of tongue mucosa--increased incidence in atrophic glossitis and burning mouth syndrome (BMS).
Nested polymerase chain reaction (PCR) was performed to detect the presence of Helicobacter pylori in tongue mucosa in 268 patients divided into four groups according to their diagnosis: 87 with atrophic glossitis, 37 with benign migratory glossitis and 144 with burning mouth syndrome (BMS). The latter group was subdivided according to anatomic site of burning sensation: subgroup A (54 patients) with complaints limited to tongue and subgroup B (90 patients) with burning sensations in other parts of oral mucosa. H. pylori was found in 43 samples (16%). Bacteria were significantly less present in tongue mucosa affected with benign migratory glossitis compared with atrophic glossitis and BMS (P=0.025). This difference was more obvious when compared with atrophic glossitis only (P=0.006). Mucosal changes in these conditions might make the oral environment more acceptable for H. pylori colonization compared with normal mucosa, and this mechanism may play a role in its oro-oral transmission.
Burning Mouth Syndrome↗
Herpetic geometric glossitis in a pediatric patient with acute myelogenous leukemia.
Herpetic geometric glossitis, a recently described form of lingual herpes simplex virus type 1 (HSV-1) infection, has been reported in 6 human immunodeficiency virus (HIV) patients and 1 cardiac transplant patient who was receiving immunosuppressant therapy. An HIV-seronegative immunocompromised pediatric patient with acute myelogenous leukemia who developed herpetic geometric glossitis is described. Herpetic geometric glossitis can present in both adult and pediatric immunocompromised patients. The symptoms, morphology, laboratory findings and treatment of this infection are summarized. The possible consequences of untreated herpetic glossitis include superinfection and undernourishment. Although previously described patients responded to 1000 mg per day (divided in 5 doses) or oral acyclovir, with complete resolution of fissures, this patient developed herpetic geometric glossitis while receiving acyclovir and required higher doses of oral antiviral therapy (acyclovir, 3000 mg/day divided in 5 doses) to treat his HSV-1 lingual infection. Empiric treatment of an immunocompromised patient who has newly acquired painful tongue fissures or furrows with systemic acyclovir should be considered.
Acyclovir↗
Doxepin-induced acute glossitis.
A case of doxepin-induced acute glossitis is reported. Painful, tender, papular lesions on the tongue were observed in a 48-year-old woman seven days after initiation of doxepin and ampicillin therapy. Doxepin daily dosage (administered in four divided doses) subsequently was reduced from 175 to 150 to 125 mg, then both drugs were discontinued. The glossitis, treated with viscous lidocaine, resolved over a three-week period. Four weeks after doxepin therapy was firt initiated, the drug was reinstituted; glossitis recurred eight days later. After discontinuation of doxepin, the glossitis slowly regressed. Drug-induced glossitis, its mechanism of action, and treatment are reviewed. When unexpected oral inflammation and pain occur, the potential for drug-induced oral lesions should be considered. Treatment is primarily empirical, with unresponsive cases being candidates for therapy of corticosteroids applied topically to the oral lesions.
Acute Disease↗
Benign migratory glossitis in patients with juvenile diabetes.
The prevalence of tissue type HLA-B15 has been shown to be higher in atopic patients with benign migratory glossitis and in patients with insulin-dependent diabetes mellitus than it is in the general population. Despite this apparent link, the possible relationship between benign migratory glossitis and insulin-dependent diabetes mellitus does not appear to have been investigated previously. This study of 87 diabetic patients and 105 age- and sex-matched nondiabetic control subjects revealed a fourfold increase in the prevalence of benign migratory glossitis in the diabetic group. These results suggest that benign migratory glossitis may be linked to diabetes mellitus and that further investigation of this association is warranted.
Adolescent↗
Median rhomboid glossitis. An oral manifestation in patients infected with HIV.
A follow-up study included the oral examination of 39 persons known to be infected with the human immunodeficiency virus. In addition to the other human immunodeficiency virus-associated oral lesions, lesions clinically similar to the smooth form of median rhomboid glossitis, which is now believed to be erythematous candidiasis located in the dorsum of the tongue, were found in seven patients (18%). Patients with median rhomboid glossitis were classified in different stages of the Centers for Disease Control 1986 classification system and showed an average of CD+4 cell counts 397.5/mm3. Also the presence or the absence of anti-p24 antibodies in the serum and stimulated whole saliva of the patients with median rhomboid glossitis did not correlate with the stage of the disease or with low levels of CD+4 cell counts as in other forms of oral candidiasis. Therefore our results suggest that median rhomboid glossitis should be included as a distinct form of oral candidiasis in the classification of the oral manifestations of infection with the human immunodeficiency virus.
AIDS-Related Opportunistic Infections↗
Herpetic geometric glossitis: a distinctive pattern of lingual herpes simplex virus infection.
Two immunocompromised patients with herpetic geometric glossitis, a clinically distinctive form of lingual herpes simplex virus (HSV) type 1 infection, are described. The significant features of herpetic geometric glossitis are summarized, the clinical differential diagnosis of this form of HSV infection is reviewed, and the possible pathogenesis of these lingual lesions is discussed. Both of our patients, as well as all previously described patients with this condition, had extremely painful cross-hatched, branched, and/or linear fissures on the dorsal aspect of the tongue. Symptoms promptly resolved within 1 to 2 days, and the fissures subsequently healed within 3 to 12 days after systemic acyclovir therapy was initiated. In contrast to tongue lesions of herpetic geometric glossitis, similar-appearing lingual lesions of other conditions are usually asymptomatic. The similar morphology of corneal dendrites in herpetic epithelial keratitis and linear fissures in herpetic geometric glossitis suggest the possibility that these HSV mucosal lesions may have a common pathogenesis.
Acyclovir↗
[Glossitis granulomatosa--an unusual subtype of Melkersson-Rosenthal syndrome].
So-called "glossitis granulomatosa", described in 1952 by H. Schuermann as a peculiar manifestation of Melkersson-Rosenthal syndrome (MRS), is little known in oral medicine due to the paucity of cases published so far. During the past 25 years the author has observed eight definite cases of glossitis granulomatosa and confirmed its close connections with MRS. The recurrent inflammation tends to change into persisting macroglossia with considerable functional and sensory oral disturbances. The clinical diagnosis, histologically supported by biopsy, can definitely be established, yet the outcome of the mostly chronic macroglossitis (with danger of later tongue carcinoma) may be very doubtful. Knowledge of Schuermann's glossitis, a member of the group of etiologically unclarified lingual inflammations, is important for physicians involved in oral medicine because of its therapeutic and prognostic implications.
Adult↗
Median rhomboid glossitis associated with amyloid deposition.
There are some controversies over the pathogenesis and clinical features of median rhomboid glossitis. A case of median rhomboid glossitis associated with amyloid deposition was presented. Clinically there was no organ involved in amyloid other than the tongue. It was suspected that median rhomboid glossitis occurred first and that amyloid was induced later.
Amyloid↗
Immunohistochemical and ultrastructural identification of Fusobacterium necrophorum subsp. necrophorum in bovine fatal necrotizing glossitis.
A 37-day-old male Japanese black calf showing marked salivation and leucocytosis died and was examined the tissues histologically. Histological lesions were characterized by severe focal necrotic glossitis on the ventral side of the root of the tongue. Immunohistochemically, Fusobacterium necrophorum subsp. necrophorum antigen was detected in the necrotic tissues and its distribution corresponded to that of the gram-negative, nonsporeforming, long filamentous organisms. Ultrastructural similarities between the organism and F. necrophorum subsp. necrophorum, but not subsp. funduliforme were observed. These findings clearly demonstrated that the fatal necrotic glossitis was caused by F. necrophorum subsp. necrophorum. This is the first report of bovine fatal necrotizing glossitis with leucocytosis caused by F. necrophorum subsp. necrophorum infection, and this organism may be an important fatal pathogen in calves with glossal lesions.
Animals↗
Median rhomboid glossitis: secondary to colonisation of the tongue by Actinomyces (a case report).
Median rhomboid glossitis is an inflammatory lesion of the tongue, now believed to be secondary to candidiasis. We document a case of median rhomboid glossitis with heavy colonisation by Actinomyces in a 60-year-old male. We propose that Actinomyces, like Candida, induces pseudoepitheliomatous hyperplasia of the mucosa of the tongue and florid inflammatory hyperplasia of the underlying connective tissue, resulting in the characteristic elevated lesion. Actinomyces has not earlier been implicated as a cause of median rhomboid glossitis.
Actinomyces↗
Laboratory measurements of nutritional status as correlates of atrophic glossitis.
OBJECTIVE: To perform a comprehensive laboratory assessment of nutritional status in two elderly patients selected for the presence of atrophic glossitis, a classic physical sign of malnutrition. DESIGN: Case report. SETTING: Inpatient internal medicine ward at the William S. Middleton Memorial Veterans Medical Center, Madison, Wisconsin. MEASUREMENTS AND MAIN RESULTS: Blood specimens were analyzed by the Nutrition Evaluation Laboratory at the USDA Human Nutrition Research Center on Aging at Tufts University. Both subjects had biochemical evidence of protein-calorie malnutrition and were deficient or marginally deficient in several vitamins and trace minerals. CONCLUSIONS: Much work needs to be done to determine the sensitivity and positive predictive value of the classic physical signs of malnutrition as predictors of low biochemical levels and adverse clinical outcomes. The presence of atrophic glossitis should prompt the clinician to consider a basic nutritional assessment.
Aged↗
Median rhomboid glossitis: not a misnomer. Review of the literature and histologic study of twenty-eight cases.
A series of twenty-eight cases of median rhomboid glossitis were studied histologically. Of these twenty-eight cases, 85 percent showed fungal hyphae in the parakeratin layer. The literature is reviewed, and additional evidence is presented to support the theory the median rhomboid glossitis is not a developmental condition but the clinical expression of a localized chronic fungal infection.
Adult↗
Median rhomboid glossitis caused by Candida?
The etiology and pathogenesis of median rhomboid glossitis have been subjects of controversial discussions for a long time. In recent years, the possible role of Candida albicans has been stressed. The findings in 18 patients with median rhomboid glossitis only support partly the hypothesis of Candida albicans being an important etiologic factor.
Adult↗
Candida albicans in median rhomboid glossitis. A postmortem study.
To investigate the possible rôle of Candida in median rhomboid glossitis, the presence of Candida was looked for both in the foramen cecum area and the lateral borders of 100 human cadaver tongues. Almost equal %s were found in both locations. Although extrapolation of findings from postmortem material to normal subjects is somewhat hazardous, the results seem to question the importance of Candida in the etiology of median rhomboid glossitis.
Adult↗
Chronic herpes simplex virus type I glossitis in an immunocompromised man.
Herpes simplex virus (HSV) type 1 (HSV-1) infection of the tongue commonly accompanies acute primary herpetic gingivostomatitis. However, recurrent infection of the tongue is exceptional and is restricted to immunocompromised individuals. A 57-year-old man with corticosteroid-dependent chronic obstructive pulmonary disease and sciatica presented with a chronic median glossitis due to HSV-1. The main clinical and histological feature was massive necrosis of the entire mucosa. Immunohistochemistry demonstrated a considerable amount of HSV gB, gC and gD envelope glycoproteins dispersed in the chorion. In contrast, HSV-1 DNA was detected only in a limited number of epithelial cells using in situ hybridization. The extent of necrosis and the pattern of viral DNA and envelope protein distribution represent unique features of median herpetic glossitis, which are not found in more common types of HSV infection.
Chronic Disease↗