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Median rhomboid glossitis - Oral Mucosal Lesion
Other Resources UpToDate PubMed

Median rhomboid glossitis - Oral Mucosal Lesion

Contributors: Rajini Murthy MD, Carl Allen DDS, MSD, Sook-Bin Woo MS, DMD, MMSc, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Median rhomboid glossitis, or central papillary atrophy, is a condition that, in most cases, represents chronic infection of the mid-posterior dorsal tongue by Candida albicans. It may also occur as a result of minor trauma or irritation. While originally thought to be a developmental anomaly, median rhomboid glossitis is not typically seen in children.

It is found in 1% of adults. No significant sex predilection is noted.

In most instances, the condition is asymptomatic, although some patients may report a mild burning or itching sensation of the mid-posterior dorsal tongue.

The condition affects immunocompetent patients but can also present in the setting of immunosuppression, such as from HIV or diabetes.

Most examples are chronic, lasting months.

Codes

ICD10CM:
K14.0 – Glossitis

SNOMEDCT:
7522008 – Median rhomboid glossitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Oral squamous cell carcinoma – While the micronodular, erythematous surface of median rhomboid glossitis may appear ominous, squamous cell carcinoma is quite rare on the dorsal tongue.
  • Oral hemangioma / Oral lymphangioma – These vascular malformations can occasionally involve the dorsal tongue mucosa, although a more vesicle-like appearance is typically noted with careful observation.
  • Oral erythroplakia
  • Migratory glossitis
  • Granular cell tumor

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:12/16/2023
Last Updated:12/21/2023
Copyright © 2024 VisualDx®. All rights reserved.
Median rhomboid glossitis - Oral Mucosal Lesion
A medical illustration showing key findings of Median rhomboid glossitis : Atrophic patch tongue, Dorsal tongue, Oral erosions
Clinical image of Median rhomboid glossitis - imageId=273225. Click to open in gallery.  caption: 'A smooth red patch with overlying white flecks on the central dorsal tongue.'
A smooth red patch with overlying white flecks on the central dorsal tongue.
Copyright © 2024 VisualDx®. All rights reserved.