41: Erythema migrans

Erythema migrans

Erythema migrans is a common genetic condition, where the tongue dorsum has red patches (‘geographic’ tongue)

It may cause a sore tongue

There is no available reliable treatment

Fissured tongue often has related erythema migrans

INTRODUCTION

Erythema migrans (geographic tongue, benign migratory glossitis) is a common cause of a sore tongue, where the tongue has red patches that resemble a map (‘geographic’ tongue) (Fig. 41.1). It is totally unrelated to erythema migrans of the skin (Lyme disease).

Fig. 41.1 Erythema migrans (geographic tongue), showing typical red lesions with irregular creamy borders

INCIDENCE

It occurs in 1–2% of adults.

AGE

It may be seen at any age.

GENDER

It can occur in either gender.

GEOGRAPHIC

It has no known geographic incidence.

AETIOLOGY AND PATHOGENESIS

There is a genetic background; there is:

often a family history

sometimes an HLA association (an increased incidence of HLA-Cw6, DR5 and DRW6 antigens and a decrease in B51 antigen), and an increased incidence of HLA-B15 in atopic patients with erythema migrans

an association with IL-1B polymorphism +3954.

Patients with fissured tongue often have erythema migrans.

Patients with erythema migrans are typically non-smokers.

Some patients with erythema migrans have:

psoriasis, probably about 4% of cases. Some have a family history of psoriasis. Histologically there is epithelial thinning at the centre of the lesion with an inflammatory infiltrate mainly of polymorphonuclear leukocytes (PMNL), reminiscent of psoriasis – even in patients without psoriasis (Fig. 41.2)

Fig. 41.2 Erythema migrans (geographic tongue), showing typical histopathological features of intra-epithelial foci of leukocytes, resembling psoriasis

atopic allergies, such as hay fever, and a few relate the discomfort or oral lesions to various foods (e.g. cheese)

diabetes mellitus.

People with Down syndrome have a higher prevalence of erythema migrans.

CLINICAL FEATURES

Erythema migrans typically involves the dorsum of the tongue, sometimes the ventrum, and rarely other areas on the oral mucosa.

Only gold members can continue reading. Log In or Register to continue

Related

Stay updated, free dental videos. Join our Telegram channel

Tags: Oral and Maxillofacial Medicine The Basis of Diagnosis and Treatment 3e

Jan 9, 2015 | Posted by mrzezo in Oral and Maxillofacial Pathology | Comments Off

VIDEdental - Online dental courses

Get VIDEdental app for watching clinical videos

Get VIDEdental app for watching clinical videos