geographic tongue

This is a harmless and very common condition in which you will notice one or more irregularly shaped patches on the tongue of your child (or you). It's called "geographic tongue" because the lesions look like the map of that country you totally forgot on your geography test. The center area is redder than the rest of the tongue and the edges of the patch are whitish in color. The patient may complain of slight irritation there but usually is blissfully unaware of the patch.

No one really knows where these patches come from, nor where they go. It is assumed as usual that if there is an infectious cause it must be viral, but really we don't know what the cause is; geographic tongue is associated with a variety of inflammatory or allergic conditions as well. We just know it's harmless and goes away without treatment. Or with treatment - I had it in medical school and the dermatologist gave me some really obnoxious steroid stuff - Kenalog in Orabase¨ - which kept me from bothering him about it ever again. Another treatment I have read about for children old enough to swish and spit without swallowing is an equal mixture of diphenhydramine syrup (Benylin®) or elixir (Benadryl®), 12.5 mg per 5 mL, in combination with Kaopectate or unflavored Maalox. The instructions are to swish around 1 teaspoonful in the mouth every 2 hours and then spit it out. This can be used for mouth sores or ulcers in general, by the way.

This is also known as "benign migratory glossitis" or "erythema migrans."

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