Differential Diagnosis for Sensitive Tongue
The differential diagnosis for a sensitive tongue can be categorized into the following groups:
- Single Most Likely Diagnosis
- Geographic tongue: This is the most common cause of a sensitive tongue, characterized by the appearance of single or multiple, well-demarcated, smooth, red areas on the tongue surface, often accompanied by sensitivity or burning sensation.
- Other Likely Diagnoses
- Oral lichen planus: An autoimmune condition that can cause sensitivity, pain, and white patches on the tongue and other oral mucous membranes.
- Burning mouth syndrome: A condition characterized by a burning sensation on the tongue, lips, and palate, often without any visible lesions.
- Nutritional deficiencies (e.g., vitamin B12, iron, or zinc deficiency): Deficiencies in these nutrients can cause oral symptoms, including a sensitive tongue.
- Allergic reactions or irritations: Allergic reactions to food, medications, or oral care products can cause tongue sensitivity.
- Do Not Miss Diagnoses
- Oral cancer: Although rare, oral cancer can present with a sensitive tongue, and it is crucial to rule out this diagnosis, especially in patients with a history of tobacco or alcohol use.
- Infections (e.g., herpes simplex, candidiasis): Certain infections can cause tongue sensitivity and should be considered, especially in immunocompromised patients.
- Rare Diagnoses
- Erythema multiforme: A rare, immune-mediated condition that can cause oral lesions, including tongue sensitivity.
- Pemphigus vulgaris: A rare autoimmune disease that can cause blistering lesions on the tongue and other oral mucous membranes.
- Sjögren's syndrome: An autoimmune disorder that can cause dry mouth and tongue sensitivity, among other symptoms.
- Neurological disorders (e.g., multiple sclerosis, trigeminal neuralgia): Certain neurological conditions can cause abnormal sensations, including tongue sensitivity, although these are rare causes.