Geographical language (desquamative glossitis)

Description:

Geographical language is the inflammatory and dystrophic disease of actually mucous membrane of language which is shown formation of the sites of desquamation of an epithelium of bright red color on it surrounded with a white rim of the exfoliating epithelium. The disease is preferential localized on a back and side surfaces of language in the form of focal disturbance of processes of keratinization of an epithelium and dystrophic changes of nipples of language.

E. V. Platonov considered a glossitis as neurodystrophic process; A. I. Rybakov and G. V. Banchenko carry it to group of acute inflammatory diseases of language. G. V. Lukomsky does not consider geographical language a true disease, and considers it as norm option. Rayer (1831) described this disease as pityriasis, Moller (1851) - as chronic exfoliating of an epithelium. Also other names of process meet: "exfoliatio areara linguae", "geographical language".

Reasons of geographical language (desquamative glossitis):

The reason and pathogeny are finally not found out. The assumption of a specific infection (specific streptoissledovatel are considered that developing of a disease can be connected with many factors.

The most often desquamative glossitis meets at various gastrointestinal diseases and circulatory system. Also vegetative and endocrine frustration, acute infectious diseases, collagenoses can be the cause of its development. According to N. N. Vazhanov (1974), the frequency of development of geographical language at various collagenoses (hard currency, rheumatism, etc.) fluctuates from 16 to 42%. There is an opinion that "geographical language" is one of displays of exudative diathesis. So, it was found out that at the children having exudative diathesis, the frequency of a desquamative glossitis makes 65%. At children's age in development of a disease the essential role belongs to also helminthic invasion. Assume also that in developing of a disease infections, a giperergichesky condition of an organism, hereditary factors are of great importance.

Symptoms of geographical language (desquamative glossitis):

Process begins with emergence of the whitish-gray site of opacification diameter in several millimeters. Then it bulks up and in the center its threadlike nipples are exfoliated, baring the bright pink or red site of rounded shape which is allocated against the background of slightly raised zone of opacification of an epithelium surrounding it.
The site of exfoliating quickly increases, keeping equal roundish outlines, but intensity of desquamation decreases. The zone of desquamation can be a different form and size and represents spots of red color. Sometimes sites of desquamation have the form of rings or half rings. In the field of desquamation the fungoid nipples having an appearance of bright red points are well visible. When the center of desquamation reaches the considerable sizes, its borders blur in a surrounding mucous membrane, and in the center after desquamation will read it to be recovered normal keratinization of threadlike nipples, in sites of keratinization, on the contrary, there comes desquamation. The centers of desquamation can be single, but is more often multiple, and as a result of constantly replaced processes of keratinization and desquamation the picture changes even at survey next day. The centers of desquamation are localized on a back and side surfaces of language, extending usually to the lower surface.

At most of children of change in language proceed without any subjective feelings and come to light accidentally, during survey of an oral cavity. Only some of them complain of burning, a pricking, paresthesias, pain from the irritating food. Children are also disturbed by a strange type of language. Emotional stressful states promote heavier course of process; the desquamative glossites arising against the background of pathology of a GIT and other general diseases can periodically become aggravated that is caused by a frequent recurrence of somatopathies. The aggravation of a desquamative glossitis is followed by increase in intensity of desquamation of an epithelium of a mucous membrane of language. The desquamative glossitis approximately in 50% of cases is combined with folded language.

The disease lasts long vaguely, without causing disturbances to patients, sometimes disappears for long term, then again develops on the same or other places. Cases when desquamations arise preferential on the same place meet.

"Geographical language" can be shown by the erythematic sites surrounded with white border of a hyperkeratosis with a diameter from several millimeters to several centimeters on a mucous membrane of language, and also cheeks, the sky and gums. Folded language comes to light in this case at 41% of children, at 17% - symptoms in the form of easy burning, discomfort, sensitivity disturbance. At most of sick children symptoms are absent. Duration of a disease is from 2 weeks up to 10 years.

Treatment:

In case of lack of complaints and unpleasant feelings treatment is not carried out. At emergence of burning sensation, pain sanitation of an oral cavity, elimination of various irritants, rational hygiene of an oral cavity are recommended.
Hygienic recommendations in case of a combination of a desquamative glossitis to folded language at which anatomic features of a structure create favorable conditions for reproduction of microflora pleated that can serve as the reason of the inflammation bringing pain are especially urgent. In the presence of burning sensation, pains are reasonable easy antiseptic rinsings, irrigations and oral trays with citral solution (25-30 drops of 1% of solution of citral on a half-glass of water), applications of 5-10% of a suspension of anaesthesin in Solutio oleosa of vitamin E, application of keratoplastichesky means (vitamin A Solutio oleosa, oil of a dogrose, a karotolin, etc.). Good results are yielded by treatment by calcium pantothenate (on 0,1-0,2 g 3 times a day inside within 1 month). At some patients the positive effect is noted from use of novocainic blockade in a lingual nerve (on a course of 10 injections). At the expressed morbidity appoint the local anesthetizing drugs. Identification and treatment of associated diseases is obligatory. The specified treatment is symptomatic, it is directed to elimination or reduction of painful feelings, decrease in frequency of a recurrence. However still there are no means of full elimination of a recurrence of a disease.

The forecast for life favorable, a possibility of a malignancy of a desquamative glossitis is excluded.