What is the cause of tongue redness in an adolescent?

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Last updated: March 27, 2025 • View editorial policy

Differential Diagnosis for Tongue Redness in a Teenager

  • Single most likely diagnosis + Geographic tongue: This condition is characterized by the appearance of single or multiple, well-demarcated, red, depapillated areas on the tongue, often surrounded by a white border. It is a common and benign condition that can be caused by stress, hormonal changes, or nutritional deficiencies, making it a likely diagnosis in a teenager.
  • Other Likely diagnoses + Vitamin deficiency (e.g., vitamin B12, iron, or folate deficiency): Deficiencies in these vitamins can cause changes in the appearance of the tongue, including redness, inflammation, or atrophy of the papillae. + Allergic reaction or irritation: Exposure to certain foods, substances, or medications can cause an allergic reaction or irritation, leading to tongue redness. + Oral candidiasis: A fungal infection that can cause redness, swelling, and white patches on the tongue and other oral mucous membranes.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.) + Kawasaki disease: A rare but serious condition that can cause tongue redness, swelling, and cracking, as well as other systemic symptoms such as fever, rash, and lymphadenopathy. + Stevens-Johnson syndrome: A life-threatening condition that can cause severe tongue redness, blistering, and ulceration, as well as other mucocutaneous symptoms. + Acute leukemia: Although rare, acute leukemia can cause tongue redness, swelling, and bleeding due to thrombocytopenia or bone marrow infiltration.
  • Rare diagnoses + Pernicious anemia: A rare autoimmune disorder that can cause tongue redness, atrophy of the papillae, and other oral mucous membrane changes. + Sjögren's syndrome: A rare autoimmune disorder that can cause tongue redness, dryness, and other oral mucous membrane changes due to decreased salivary gland function. + Erythema multiforme: A rare condition that can cause tongue redness, blistering, and ulceration, as well as other mucocutaneous symptoms.

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