Geographic Tongue

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Geographic Tongue

• http//www.drgreene.com/21_784.html
• http//www.nlm.nih.gov/medlineplus/ency/article/00
  1049.htm

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www.sameint.it/eular_images/ clinical/0001NIAB.jpg

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• Geographic tongue Glossitis areata exfolviativa
  - a condition of the tongue marked by numerous
  denuded patches on the dorsal surface coalescing
  into freeform shapes similar to the geographic
  areas on a map. Denuded areas may persist for
  more than a month.
• Glossitis - an inflammation of the tongue
• Alternative names Patches on the tongue Tongue
  - patchy Benign migratory glossitis

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• One of the most common medical conditions of the
  tongue. Parents usually are the ones to notice
  several large, red, slightly depressed, unusually
  smooth patches on the surface of their child's
  tongue -- when nothing was there hours before.
  Often the red areas are bordered with distinct
  white bands. The sharp borders of these
  irregularly shaped lesions give the surface of
  the tongue the appearance of a map, perhaps a map
  of a group of uncharted islands. The rather
  dramatic appearance of geographic tongue looks to
  many like a burn, or like some kind of nasty
  infection. In geographic tongue, the filiform
  papillae are missing in the reddish areas and are
  overcrowded in the gray-white borders.

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Incidence

• The exact prevalence varies widely from study to
  study, but at any given time, somewhere between
  0.1 percent and 14.3 percent of otherwise healthy
  people have it.

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Etiology

• The specific cause of geographic tongue is
  unknown, although allergies may be involved.
  Other causes may include irritation from hot or
  spicy foods, alcohol, or tobacco.
• We still do not know exactly what causes
  geographic tongue, but we do know that it
  strongly tends to run in families (Oral Surgery,
  Oral Medicine, and Oral Pathology, Nov 1976).
  Geographic tongue has polygenic inheritance -- it
  is associated with several different genes. We
  also know that it is associated with a number of
  other genetic medical conditions. It has been
  most closely linked to psoriasis, and is notably
  more common in those who have psoriasis (British
  Journal of Dermatology, Sep 1996). The two
  conditions have been linked to the same gene and
  are probably produced in the same manner
  nevertheless the great majority of those with
  geographic tongue do not go on to develop
  psoriasis.

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• Geographic tongue is also significantly more
  common in people who are sensitive to the
  environment -- those with allergies, eczema,
  and/or asthma (Oral Surgery, Oral Medicine, and
  Oral Pathology, Aug 1984).
• It is also four times more common in those with
  diabetes (Oral Surgery, Oral Medicine, and Oral
  Pathology, Jan 1987). But a great many conditions
  are more common in those with diabetes, and
  geographic tongue has never been noted as an
  early warning of diabetes.
• In young women with geographic tongue who are
  also taking oral contraceptives, the geographic
  tongue is worst on day 17 of the cycle (British
  Dental Journal, Aug 1991). This suggests that
  hormone levels probably play a role. Perhaps
  there is even some truth to the unproven belief
  that stress can trigger geographic tongue.
• Weaker links have been reported to anemia,
  seborrhea, and eating spicy foods.

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• Most people with geographic tongue are otherwise
  healthy. The condition is usually entirely
  painless. While it can produce a burning
  sensation in the mouth, this is very rare in
  children. If there is any pain or burning, this
  usually can be successfully controlled with
  antihistamines (Pediatric Dentistry, Nov 1992).
• There is no loss of the sense of taste (hurrah
  for the glorious sense of taste!), nor is there
  any loss of the dexterity of the tongue. There
  is, however, a measurable decrease in the
  tongue's sense of touch. This was studied by
  carefully assessing response to mechanical
  vibration (Journal of Laryngology and Otology,
  Mar 1984).

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• Symptoms   
• a map-like appearance to the surface of the
  tongue
• smooth, beefy red patches and lesions on the
  tongue
• patches that change location from day to day
• soreness and burning pain (in some cases)
• Signs and tests    Your doctor will usually
  diagnose this condition based on an examination
  of your tongue. Tests are usually not necessary.

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Treatment

• No treatment is currently recommended, however,
  for this benign, self-limited condition.

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• Geographic tongue heals spontaneously. The
  individual lesions often heal at the same time
  new ones are forming, changing the appearance of
  the tongue over hours or days. This gives rise to
  the appearance that the map is migrating across
  the face of the tongue. Thus, geographic tongue
  is also called benign migratory glossitis.
  Although benign, this condition may last for
  months -- or even longer -- and often recurs.
• The same pattern holds true for the rare, but
  real variation -- geographic lip.

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Prevention

• Avoid irritating your tongue with hot or spicy
  food, alcohol, or tobacco if you are prone to
  this condition

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Tinnitus

• MelinePlus
• American Tinnitus Assocsiation
• Tabers Cyclopedic Medical Dictionary

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• Tinnitus the perception of noise in the ears or
  head when no external sound is present. sound in
  the ear.
• People hear whooshing or ringing or tinkling or
  buzzing or chirping or pulsing.
• Tinnitus (ringing in the ears) is a common
  problem, affecting about 17 of the general
  population around the world (44 million people in
  the USA). It causes significant suffering in
  about 4 of the general population (10 million in
  the USA). Typically patients are told "to learn
  to live with it." The development of a
  neurophysiological model of tinnitus (Jastreboff,
  P.J. Phantom auditory perception (tinnitus)
  mechanisms of generation and perception.
  Neurosci.Res.221-254, 1990)

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Etiology

• Found in certain diseases of the exterior, middle
  or inner ear.
• Etiology may be caused by impacted cerumen,
  myringitis, otitis media, labyrinthitis,
  Ménières symptom complex, otosclerosis, or
  hysteria
• The most common cause is damage to the auditory
  cells in the inner ear. This is due to
  age-related hearing loss or exposure to very loud
  noises.

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• It may also follow prolonged treatment with drugs
  such as quinine and salicylates, including
  aspirin more than 200 medications can cause
  tinnitus
• Injury to the head or neck
• Stiffening of the bones in the middle ear
• Tumors in the brain or ears
• Can also be due to sound of blood flow in
  hypertension objective tinnitus

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Treatment

• Depends on cause
• Stop medications
• Remove ear wax or treat infection
• Treat tumor or blood vessel problems
• Damage to hearing cells cannot be cured
• Treatments may include hearing aids or maskers
• Some medications (also have side effects)
• Tinnitus retraining therapy