OD 26 - Developmental Mucosal Conditions

Question 1

What is hairy tongue?

Answer 1

Elongation of filiform papillae on the dorsum of the tongue

Question 2

What can cause hairy tongue?

Answer 2

Infection 
Fever
Xerostomia 
Antibiotics and tobacco
But can often have no etiological cause/factor

Question 3

What is the treatment of hairy tongue?

Answer 3

Find and eliminate cause
Reassure
Tongue brush/scrapers
Keratinolytic drugs –> podophyllin 25% in tinture of benzoin

Question 4

Who is most commonly affected by geographic tongue?

Answer 4

More common in children, but mostly diminishes with age

Question 5

What causes and is associated with geographic tongue?

Answer 5

CAUSE - obscure

ASSOCIATED WITH

• Pustular psoriasis (most common)
• Allergy
• Juvenile diabetes
• Reiter/Down syndrome
• etcccccc.

Question 6

What is the definition of geographic tongue?

Answer 6

Depapillation of filiform papillae on the dorsum of the tongue causing erythematous configurations that VARY, forming white margins

Question 7

What are the symptoms of geographic tongue?

Answer 7

Most asymptomatic

Some have pain/burning

Question 8

How is geographic tongue diagnosed?

Answer 8

Clinical appearance and history

Confusion/concern = biopsy

Question 9

What is the treatment of geographic tongue?

Answer 9

Asymptomatic patient = no tx
Symptoms treated with vitamins, mouth rinses, anti-anxiety meds, anti-inflammatory meds (incl. topical and systemic corticosteroids) and anti-fungals

Question 10

What is median rhomboid glossitits?

Answer 10

Congenital abnormality with red surface in the middle of the dorsum of the tongue

Question 11

How is median rhomboid glossitits diagnosed?

Answer 11

Clinical appearance and location

Rare for biopsy or candida smear

Question 12

Who is fissured tongue frequently seen in?

Answer 12

Down syndrome

Melkersson-Rosenthal Syndrome

Question 13

What are the 3 features seen in Melkersson-Rosenthal Syndrome?

Answer 13

Fissured tongue
Facial nerve paralysis
Chelitis granulomatosa

Question 14

What is the treatment for median rhomboid glossitits?

Answer 14

None

Short course anti-fungal - esp. if symptoms

Question 15

What is the diagnosis and treatment of fissured tongue?

Answer 15

Clinical obs and history 
No tx (reassure pt.)

Question 16

What is crenated tongue? and who does it present in?

Answer 16

Shallow impressions of the lateral margins of the tongue due to teeth - mucosa normal/red
Frequent in macroglossia, bruxism and chronic anxiety of pushing tongue forward

Question 17

What is the diagnosis and treatment of crenated tongue?

Answer 17

Clinical obs and history 
No tx (reassure pt.)

Question 18

What are fordcyes granules?

Answer 18

Raised yellow/orange spots, heteropic sebaceous glands

Question 19

Who is likely to have fordcyes granules?

Answer 19

Seen in around 80% of people

Developing in puberty due to sex hormones and becoming more prominent with ageing

Question 20

What is the diagnosis and treatment of fordcyes granules?

Answer 20

Clinical obs and history 
No tx (reassure pt.) or laser therapy for cosmetics

Question 21

What is the clinical presentation of white sponge naevus?

Answer 21

Presents at birth
Asymptomatic, diffuse, bilateral white lesions with shaggy/spongy/wrinkled surface
Usually involving buccal mucosa but sometimes tongue, FOM, pharynx, oesophagus, nose, genital, anus

Question 22

What are the genetics of white sponge naevus?

Answer 22

Inherited anomaly

Mutations of keratin 13 and 4 - hyperkeratosis

Question 23

What is the diagnosis and treatment of white sponge naevus?

Answer 23

Clinical and biopsy for conformation

No specific treatment as asymptomatic and behind, however topical tetracycline can be given for cosmetics

Question 24

What is leukoedema?

Answer 24

Bilateral grey-white diffuse filmy/milky surface with symmetric in distribution and occurring on buccal mucosa (tx=reassurance)