Differential Diagnosis for Sudden Onset of Geographic Tongue
- Single most likely diagnosis
- Benign migratory glossitis (geographic tongue): This is the most common cause of geographic tongue, characterized by the sudden onset of irregular, well-demarcated areas of depapillation on the tongue surface, often accompanied by a sensation of burning or discomfort.
- Other Likely diagnoses
- Psoriasis: Geographic tongue can be associated with psoriasis, an autoimmune skin condition. The presence of skin lesions and a family history of psoriasis may support this diagnosis.
- Vitamin deficiencies (e.g., vitamin B12, iron, or folate deficiency): Deficiencies in these vitamins can cause changes in the tongue, including geographic tongue.
- Allergic reactions or irritants: Exposure to allergens or irritants, such as certain foods, medications, or oral care products, can trigger geographic tongue.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Lichen planus: A chronic autoimmune condition that can cause oral lesions, including geographic tongue-like changes. It is essential to rule out lichen planus, as it can be associated with an increased risk of oral cancer.
- Oral cancer: Although rare, geographic tongue can be a presenting feature of oral cancer. A thorough examination and biopsy (if necessary) can help rule out this life-threatening condition.
- Rare diagnoses
- Pemphigus vulgaris: A rare autoimmune blistering disease that can affect the oral mucosa, including the tongue, and cause geographic tongue-like lesions.
- Erythema multiforme: A rare skin condition that can cause oral lesions, including geographic tongue, often in response to infections or medications.