Developmental mucosal conditions

Developmental mucosal conditions

1. Hairy tongue

   • What is it?
     • Elongation of the filiform papillae on the dorsum of the tongue
       • Can become black
   • Cause
     • Drugs
       • Abx
     • Xerestomia
     • Infections
     • Fever
     • Idiopathic
   • Treatment
     • Remove cause

2. Geographic tongue

   • What is it?
     • Depapillation of the filiform papillae on the dorsum of the tongue
     • Areas may/may not be bordered by a slight increase in the surrounding filiform papillae forming a white-appearing margins
   • Cause
     • Unknown
   • Symptoms
     • Range from mild to intense
     • Some complain of burning
     • Most asymptomatic
   • Histology
     • Very similar to pustular psoriasis
   • Prevelance
     • Appears more commonly in children and its frequency decrease with age
   • Treatment
     • None if asymptomatic
     • Antifungals, anti-inflammatory drugs (topical or systemic corticosteroids), vitamins, mouth rinses and antianxiety medication

3. Median rhomboid glossitis

   • What is it?
     • Occurs in the middle of the tongue
     • Rare sight for cancer
     • Red, smooth, rhomboidal
   • Cause = local candida infection
   • Treatment
     • None
     • Antifungals

4. Fissured tongue

   • Features
     • No breakdown of tissue
       • Bacteria & Fungi can build up in folds
   • Cause
     • Down's syndrome
     • Melkerson's Rosenthal syndrome
       • Fissured tongue
       • Facial nerve paralysis
       • Cheilitis granulomatosa
     • Congenital
   • Treatment
     • None
     • Reassure

5. Hypertrophy of the foliate papillae

   • Cause
     • Folate Papillae contain lymphatic tissue
       • So may become inflamed and enlarged in response to local chronic irritation or infection
   • Where is it?
     • Posterior lateral aspect of tongue
   • Treatment
     • None

6. White sponge Naevus

   • Aetiology
     • Genetic
       • Autosomal Dominant
       • Mutations K13 & 4
   • Clinical features
     • Presents at birth/ childhood
     • Bilateral white lesions with shaggy or spongy, wrinkled surface
     • Affects
       • Usually buccal mucosa
       • Tongue
       • FOM
   • Diagnosis
     • Biopsy
   • Treatment
     • None
     • Topical tetracycline

7. Leukodema

   • Cause
     • Racial pigmentation
       • Increased thickness of the epithelium and intracellular oedema of the malpighian laye
     • More common in black individuals
   • Presentation
     • Bilateral
   • Diagnosis
     • Stretching the tissue will make it disappear
   • Treatment
     • Reassure
     • Nothing