Lichenoid Reaction in Benign Migratory Glossitis

Introduction: Geographic tongue is a benign pathology in lesions with shapes, sizes, and varied colors. They have different etiologies and characteristics with periods of crises and remissions with spontaneous improvement.

Objectives: We present a case of geographic tongue with nonspecific etiologic agent, evolving a lichenoid reaction.

Case Report: A 26-year-old female patient (C.D.F.M.)started with acute edema of the tongue, face, and perioral region 2 months ago. She sought an emergency department where she was treated with corticosteroids, with considerable improvement. After 5 days, she showed a similar framework but of greater intensity, being admitted to the intensive care unit because of poor response to medication and the risk of upper airway obstruction. Then she was transferred to our clinic for investigation and diagnosis. At admission, she showed perioral and tongue edema with aspect of geographic tongue. She was treated with corticosteroids and analgesics. She denied the use of any medication, injuries to other body parts, or similar family history. During hospitalization, serological tests for infectious diseases were performed and markers of autoimmune diseases were all negative. It was decided for biopsy tongue which revealed epithelial hyperplasia and chronic inflammation as seen in lichenoid drug reactions.

Conclusion: The geographic tongue often presents as a challenge to the medical staff by difficulty in defining the etiologic agent, and one should perform a detailed history to clarify about the benign nature of the case.

Keywords: diseases of the tongue; geographic tongue; lichenoid reaction; edema of the tongue; benign migratory glossitis.