Glossitis

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Glossitis can mean tongue pain, or more often inflammation with depapillation of the dorsal surface of the tongue (loss of lingual papillae), leaving a smooth and erythematous (red) surface, (sometimes specifically termed glossitis atrophy ). In a broader sense, glossitis can mean inflammation of the tongue in general. Glossitis is often caused by a lack of nutrients and may not cause pain or cause discomfort. Glossitis usually responds well to treatment if the cause is identified and corrected. Tongue pain caused by glossitis is distinguished from burning mouth syndrome, where no change can be identified in the appearance of the tongue, and no identifiable cause.

Video Glossitis

Symptoms

Depending on what the true meaning of the word glossitis is implied, signs and symptoms may include:

• Appearance is smooth and shiny on the tongue, caused by loss of lingual papillae.
• Changes in the color of the tongue, usually to a darker red than the normal white-pink color of a healthy tongue.
• Tongue swelling.
• Difficulty with chewing, swallowing, or talking (either because tongue is swollen).
• Burning sensation. Some use the term secondary burning mouth syndrome in cases where detectable causes, such as glossitis, for burning sensation of the mouth.

Depending on the underlying cause, there may be additional signs and symptoms such as pallor, mouth ulceration, and angular cheilitis.

Maps Glossitis

Cause

Anemias

Iron deficiency anemia is primarily caused by blood loss, as can occur during menstruation or gastrointestinal bleeding. This often results in a shedding of glossitis atrophy, giving the appearance of a bald and shiny tongue, along with pale (pallor) of the lips and other mucous membranes tendency to recurrent oral ulceration, and cheilosis (swelling of the lips). The appearance of the tongue in iron deficiency anemia has been described as diffuse or patchy atrophy with tenderness or burning. One of the causes of iron deficiency anemia is sideropenic dysphagia (Plummer-Vinson or Paterson-Brown-Kelly syndrome) which is also characterized by woven and oesophageal dysphagia.

Pernicious anemia is usually caused by autoimmune destruction of gastric parietal cells. Parietal cells secrete the intrinsic factor necessary for vitamin B12 absorption. Vitamin B12 deficiency causes megaloblastic anemia and may appear as a glossis. The appearance of the tongue in vitamin B12 deficiency is described as "fat" or "burning red and sore". There may be linear or patchy red lesions.

Vitamin B deficiency

Vitamin B1 deficiency (thiamin deficiency) can cause glossitis. Vitamin B2 deficiency (ariboflavinosis) can cause glossitis, along with angular cheilitis, cheilosis, peripheral neuropathy and other signs and symptoms. Glossitis in vitamin B2 deficiency is described as magenta. Vitamin B3 deficiency (pellagra) can cause glossitis. Vitamin B6 deficiency (pyridoxine deficiency) can cause glossitis, along with angular cheilitis, cheilosis, peripheral neuropathy and seborrheic dermatitis. Folate deficiency (vitamin B9 deficiency) can cause glossitis, along with macrocytic anemia, thrombocytopenia, leukopenia, diarrhea, fatigue and possibly neurological signs. In addition to the pernicious anemia discussed above, other causes of vitamin B12 deficiency can cause glossitis, which tends to be painful, smooth and shiny.

Infection

Bacterial, viral or fungal infections can cause glossitis. Candida species are involved in the median rhomboid glucoid. Candida species may also be involved in creating more common glossitis with erythema, burning, and atrophy,

for example. Erythematous candidiasis (eg possibly in HIV/AIDS) may involve the tongue that provides glossitis with depapillation.

Syphilis is now relatively rare, but the tertiary stage can cause diffuse glossitis and lingual papilla atrophy, called "glossitis syphilis", "luetic glossitis" or "tertiary syphilis atrophy glossitis". The disease is caused by Treponema pallidum and is a sexually transmitted infection.

Other causes

Many conditions can cause glossitis via malnutrition or malabsorption, which creates the nutritional deficiencies described above, although other mechanisms may be involved in some of the conditions listed.

• Alcoholism
• Canker sores (celiac disease, or tropical canker sores), secondary to nutritional deficiency
• Crohn's disease
• Whipple's Disease
• Glucagonoma syndrome
• Cowden's Disease
• Acquired immunodeficiency syndrome (AIDS)
• Carcinoid syndrome
• Kwashiorkor amyloidosis
• Veganism and other special diets,
• Bad hydration and low saliva in the mouth, allowing bacteria to grow faster
• Mechanical irritation or injury from burns, teeth edges or rough teeth, or other trauma
• Tongue piercing Glossitis can be caused by constant irritation by ornaments and by colonization of Candida albicans on site and on ornaments
• Exposure to irritants such as tobacco, alcohol, hot food, or spices
• Allergic reactions to toothpaste, mouthwash, breath freshener, dye in confectionery, plastic on dentures or followers, or certain blood pressure medications (ACE inhibitors)
• Administration of ganglion blockers (eg, Tubocurarine, Mecamylamine).
• Oral lichen planus, erythema multiforme, aphthous ulcer, pemphigus vulgaris
• Kewage
• Albuterol (bronchodilator medicine)

A painful tongue may be an indication of a serious underlying medical condition and almost always requires assessment by a doctor or dental surgeon.

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Diagnosis

Classification

Glossitis can be classified as a group of tongue disease or gastrointestinal disease. This may be primary, where there is no underlying cause, or secondary where it is a sign or symptom of another condition. May be acute or chronic. In general, there are several clinical patterns of glossitis, some more common than others.

Glacial atrophy

Atrophic glossitis, also known as tongue bald, smooth tongue, Hunter glossis, Moeller glossis, or MÃÆ'¶ller-Hunter glossis, is a condition characterized by subtle smooth tongue that is often painful, caused by complete atrophy of lingual papilla (depapillation). The surface of the dorsal tongue may be affected entirely, or in patches, and may be associated with burning, pain and/or erythema sensations. Atrophic glossitis is a non-specific finding, and has many causes, usually associated with iron-deficiency anemia, pernicious anemia, vitamin B complex deficiency, unrecognized and untreated celiac disease (often without gastrointestinal symptoms), or other factors such as xerostomia (dry mouth). Although the terms MÃÆ'¶ller and Hunter glossitis were originally used to refer specifically to glossitis that occurs in vitamin B12 deficiency secondary to pernicious anemia, they are now used as a synonym for common atrophic glisia. In this article, the term glossitis, unless otherwise specified, refers to atrophic glossitis.

Candidiasis may be a co-finding or an alternative cause of erythema, arson, and atrophy.

Median rhomboid glossitis

This condition is characterized by persistent, rhomboidal, depapilated erythematous lesions in the midline of the dorsum of the tongue, right in front of the circumferential papilla. Median rhomboid glossitis is a type of oral candidiasis, and rarely causes symptoms. It is treated with antifungal drugs. Predisposing factors include the use of corticosteroid spray or inhaler or immunosuppression.

Benign migratory glossitis

The geographical tongue, also called benign migratory benign, is a common condition that usually affects the dorsal surface of the tongue. It is characterized by patches of depapillation and erythema bounded by a white peripheral zone. These patches give the tongue a map view, hence its name. Unlike glossitis due to nutritional deficiency and anemia, the lesions of the geographic tongue move around the tongue from time to time. This is because in geographic tongue, new areas of the tongue become involved with the condition while the affected area previously recovered, giving the appearance of a moving lesion. The cause is unknown, and there is no curative treatment. There are rarely any symptoms associated with lesions, but occasionally a burning sensation may be present, which is exacerbated by eating hot, spicy or acid foods. Some people consider the geographical tongue as an initial stage of cracked tongue, since both of these conditions often occur in combination.

Geometric glossitis

Geometric glossitis, also called herpes geometric glossitis, is a term used by some to refer to chronic lesions associated with type I herpes simplex virus (HSV) infection, where there is deep fissure in the midline of the tongue, which secretes several branches. Lesions are usually very painful, and there may be erosion in the depth of the gap. Similar fissured lesions unrelated to HSV, as may occur on cracked tongue, do not tend to be painful. The name comes from a geometric pattern of elongated, crossed or branched slits. This is described as occurring in people who are immunocompromized, such as those suffering from leukemia. However, the association between herpes simplex and geometric glossitis is debated by some due to the lack of standard gold techniques for the diagnosis of intraceric herpes lesions, and the high prevalence of asymptomatic viral shedding in individuals with the immune system. Treatment with systemic acyclovir.

Strawberry tongue

The tongue of strawberries (also called raspberry tongue), refers to the glossitis that manifests with hyperplastic fungiform papillae (enlarged), giving the appearance of strawberries. The white strawberry tongue is the place where there is a white coating on the tongue lining the hyperplastic fungiform papillae. The tongue of red strawberries is where the white layer is lost and the dark red, erythematous surface is revealed, tangent to hyperplastic fungiform papillae. White strawberry tongue seen at the beginning of red-blooded fever (systemic infection group A - hemolytic streptococcus), and strawberry red tongue occur later, after 4-5 days. Strawberry tongue is also seen in Kawasaki disease (vasculitis disorders occur mainly in children under 5 years), and toxic shock syndrome. This may mimic other types of glossitis or Vitamin B12 deficiency.

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Prevention

Good oral hygiene (thorough brushing and cleaning of teeth and regular professional cleaning and examination) can help to prevent this disorder. Drink plenty of water and adequate saliva production, helping to reduce bacterial growth. Minimizing irritation or injury in the mouth whenever possible can help prevent glossitis. Avoiding overuse of foods or substances that irritate the mouth or tongue can also help.

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Treatment

The goal of treatment is to reduce inflammation. Treatment usually does not require hospitalization unless the tongue is severe swelling. Good oral hygiene is necessary, including brushing teeth thoroughly at least twice a day, and flossing at least daily. Corticosteroids such as prednisone can be given to reduce glossitis inflammation. For mild cases, topical applications (such as an unswept prednisone mouth rinse) may be recommended to avoid side effects of swallowed or injected corticosteroids. Antibiotics, antifungal drugs, or other antimicrobials may be prescribed if the cause of glossitis is infection. Anemia and nutritional deficiencies (such as lack of niacin, riboflavin, iron, or Vitamin E) should be treated, often with dietary or other supplemental changes. Avoid irritation (such as hot or spicy foods, alcohol, and tobacco) to minimize discomfort. In some cases, tongue swelling may threaten the airway, a medical emergency that needs immediate attention.

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Epidemiology

One review reported an overall prevalence range of 0.1-14.3% for geographic tongue, 1.3-9.0% for "atrophic tongue" (atrophic glossitis), and 0.0-3.35% for median rhomboid glucose.

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References

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External links

Source of the article : Wikipedia