The name Benign migratory glossitis is not much familiar as geographic tongue. Does the term remind you of the world map? Yes, you guessed it right. Geographic tongue is a term coined because of its resemblance to a world map or pattern like that in clinical presentation. As you have already guessed, the pattern appears on the tongue. It looks like red patches with irregular white margins defining a smooth reddish area inside. The red areas show that they are devoid of very small round structures called papillae that is found naturally on the tongue surface.
This condition is not contagious. It is not microbial or does not contract from person to person or to other parts of the body. It is usually benign in nature. It is usually harmless other than the appearance. But in some people, it causes burning sensation or stinging sensation in the area which gets triggered by some specific food items. Pain killers are found beneficial to reduce the discomfort.
The characteristic features of Benign migratory glossitis include:
- Red spots or patches on the tongue – they appear as an irregular map like pattern that is defined by grey or white borders. They are mostly many in number or spread on a large area. It can happen on any part of the tongue including top, sides or bottom. The patches can be shifting in nature as they can be seen here one day and there after some days. The spots or patches may appear and disappear in some days. They can change size, site ad shape at any time.
- Absence of papillae – The inner part of these patches is considerably red and abnormally smooth because they don’t have the normal papillae on the surface. Papillae being very small bumps that completely cover and protect the entire tongue, help us chew and swallow the food. Some of the papillae have taste buds in them helping us differentiate and feel the various tastes.
- Burning sensation – Some patients complain about a tingling, pricking or burning pain on their tongue mostly during eating food. It is mild in most cases and not continuous. The discomfort appears and disappears along with the shape shifting red patches.
- Patches in other areas of the mouth – Very rarely, similar reddish skin patches are observed on other parts of the mouth like the gums, the palate or the cheeks. They are known as geographic stomatitis or erythema migrans. These patches of erythema migrans are very different from those that are observed in the first stages of Lyme’s disease. This is a different disease and should not be diagnosed as Lyme’s disease.
Causes of Benign migratory glossitis
Underlying conditions or diseases are observed mostly with geographic tongue. They include:
- Psoriasis – In most cases of geographic tongue, the patient is presented with associated with psoriasis, an inflammatory skin condition.
- Hormonal surges – Women who are taking oral contraceptives or birth control pills are observed developing geographic tongue. It may be because of the female hormones in the pills.
- Deficiencies – Not having enough zinc, iron, folic acid, vitamin B6 and Vitamin B12 are more prone to geographic tongue.
- Fissured tongue – a genetic link between geographic tongue and fissured tongue is hypothesised, the latter being a condition with deep grooves on the tongue.
- Diabetes – especially type 1 diabetes, have a higher chance of geographic tongue.
- Allergies – People with eczema, hay fever and other allergies may be presented with a higher chance of having the condition.
- Emotional stress – there is a link between increased stress and geographic tongue.
Treatment of Benign migratory glossitis
Usually, any medicine or treatment is not required for geographic tongue.
If there is burning sensation or similar discomfort, the following measures are suggested:
- Mouthwash with an anti-histamine
- Topical application of analgesics
- Non-steroidal anti-inflammatory drugs or NSAID s
Complications of medicine & treatment
Medicines and treatment used in severe cases of geographic tongue may cause discomforts like:
- gastric irritation
- Stomach pain
- Stomach ulcers.
- Headaches
- Light headedness.
- High blood pressure or hypertension.
Preventive measures of Benign migratory glossitis
Avoid any food items or drinks that causing irritation of the tongue.
Hot and spicy foods must be avoided.
Quit tobacco chewing
Ayurvedic Concept of Benign migratory glossitis
Ayurveda explains Jihwaroga or diseases of the tongue comes under Mukharoga or diseases of the mouth. Ayurveda explains head as Uttamanga or most important part of the body as it is the seat of all the sense organs other than skin. Diseases of each part of the head are narrated in very detail in Susrutasamhita Uttaratantra. The branches of Ayurveda dealing with diseases of the head include Salakya tantra (diseases above neck). Diseases of tongue are classified according to doshic predominance, like most of other diseases. The identification is done based on the clinical presentation. Benign migratory glossitis can be compared to Paittika jihwa roga. It is explained as red tongue with burning sensation.
Ayurvedic Nidana of Benign migratory glossitis
Causative factors that cause aggression of Pitta like :
hot, spicy food
Late night sleep
Anger
Exposure to heat & Sun
Ayurvedic treatment for Benign migratory glossitis
Management of Paittika jihwa roga aong with necessary internal medicines to manage any associated gastric complaints is found most beneficial in the management of Benign migratory glossitis. The therapies to be done on the tongue include :
Gharshana or Tongue scraping
Raktasruti or Bloodletting
Pratisarana or sprinkling of herbal powders
Gandoosha or gargling with medicated liquids
Navana or nasal drops
For the last three procedures drugs with sweet taste are prescribed. Eg: Yashtimadhu
Herbal Preparations for Benign migratory glossitis
Rajanyadi choornam
Avipathy choornam
Nalpamarakwatham
Sariba kwatham
Yashtimadhu choornam
Side effect management of Benign migratory glossitis by Ayurveda
Many medicines taken for chronic diseases may cause gastric irritation including glossitis. In cases of Benign migratory glossitis associated with gastric or systemic compalints, many medicines given for symptomatic relief may cause giddiness, nausea or further mucosal erosion. Ayurvedic medicines like drakshadi kashayam can be used to manage
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