Geographic tongue; Developmental anomalies; Ectopic

Oral cavity has always been a victim of many developmental and acquired disorders and few of them known and few unknown. Inspite of many theories proposed mystery continues. Tongue the muscular organ of oral cavity undergoes various physiologic and pathologic changes. Ectopic geographic linguais one amongst the many changes documented.

Geographic tongue was first described by Rayer in the year1831. It is a benign condition that occurs in up to 3% of the generalpopulation. Lesion is asymptomatic in nature however, some patientsreport increased sensitivity to hot and spicy foods, etiology for whichis still unclear [1-3]. Inspite of many terminologies a self-explanatoryname based on pathophysiology and clinical presentation “Ectopicgeographic lingua” or EGL was considered, were ectopic means andabnormal place, geographic means appearance of map and lingua is alatin meaning of tongue. Here in we report a case of EGL in a femalepatient.

A 21 year old female patient reported to the department with a chief complaint of deposits on her teeth. Past medical and dental history was non-contributory. Patient gave no history of deleterious habits. Extra oral examination revealed no significant changes. Intra oral examination revealed deposits on the surfaces of teeth. Dorsal aspect of the tongue revealed mapping on the surface with well demarcated areas of depapillation. Surface of the lesion is raised with evidence of migration to the tip of the tongue (Figure 1). Considering the history and clinical examination a provisional diagnosis of ectopic geographic lingua was considered. Scaling was done and oral hygiene instructions were given. Candid mouth paint application twice daily was recommended to prevent opportunistic infections.

EGL is an inflammatory condition of the mucous membrane of the tongue, usually seen on the dorsal surface. The etiology and pathogenesis of EGL are still poorly understood, yet psychological stress, vitamin deficiency, hormonal imbalance and other factors like smoking and tobacco use are considered to be the possible cause for this benign lesion. EGL affects males and females and is noted to be more prominent in adults than in children [1,3,4].

EGL is usually asymptomatic in nature. Asymptomatic presentation of the lesion makes treatment simpler. Reassurance to the patient should be of great importance, Psychological monitoring also plays a major role. In case of burning sensation on consumption of spicy food, as reported in few reports, topical anaesthetics should be prescribed [4,5].

Educating the patient is of utmost importance in treating the patients with EGL. More and more researches should be carried out by health care professionals with regular follow up so that exact etiology could be ruled out and accurate treatment can be provided. As of now Ectopic geographic lingua remains to be a harmless mystery.