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Photo Essay

An Atlas of Lingual Lesions, Part 1

Volume 59 - Issue 5 - May 2019

  • Fissured Tongue

    Fissured tongue, also known as scrotal tongue, plicated tongue, lingua plicata, lingua fissurata, and groove tongue, is characterized by fissures and grooves that vary in depth along the dorsal and lateral aspects of the tongue (Figures 1 and 2).1,2 A central longitudinal fissure or groove is often noted (Figure 2).3 Fissured tongue is seen in 5% to 11% of the general population.4 The condition is not common before 10 years of age, and the prevalence increases with age.3 There is a predominance in the male population.3

    fig 1
    Figure 1.

    fig 2
    Figure 2.

    The exact etiology of fissured tongue is not known, and the condition is idiopathic in most cases. A polygenic or autosomal dominant mode of inheritance has been postulated due to clustering of the condition in families.3 Smoking is a known risk factor.3 Fissured tongue has been associated with geographic tongue, scrotal glans penis, pachyonychia congenita, psoriasis, Melkersson-Rosenthal syndrome, Down syndrome, Cowden syndrome, Moebius syndrome, Sjögren syndrome, Touraine Solente Gole syndrome, acromegaly, diabetes mellitus, pernicious anemia, and hypovitaminosis A.1,5-11

    The diagnosis of fissured tongue is mainly clinical. The condition is usually asymptomatic and is often an incidental finding. The tongue can be painful if it is inflamed. The fissures may collect food particles and debris, resulting in irritation, inflammation, and halitosis. Therefore, appropriate oral hygiene is essential. Gentle brushing of the tongue with a soft-bristled toothbrush deep into the fissures to remove food particles and debris after meals and before sleeping is recommended.2,3 

     

    REFERENCES:

    1. Järvinen J, Mikkonen JJW, Kullaa AM. Fissured tongue: a sign of tongue edema? Med Hypotheses. 2014;82(6):709-712.
    2. Mangold AR, Torgerson RR, Rogers RS III. Diseases of the tongue. Clin Dermatol. 2016;34(4):458-469.
    3. Feil ND, Filippi A. Frequency of fissured tongue (lingua plicata) as a function of age. Swiss Dent J. 2016;126(10):886-897.
    4. Rogers RS III, Bruce AJ. The tongue in clinical diagnosis. J Eur Acad Dermatol Venereol. 2004;18(3):254-259.
    5. Al-Maweri S-A, Tarakji B, Al-Sufyani GA, Al-Shamiri HM, Gazal G. Lip and oral lesions in children with Down syndrome. A controlled study. J Clin Exp Dent. 2015;7(2):e284-e288.
    6. Athappan G, Unnikrishnan A, Chengat V, et al. Touraine Solente Gole syndrome: the disease and associated tongue fissuring. Rheumatol Int. 2009;29(9):1091-1093.
    7. Cancian M, Giovannini S, Angelini A, et al. Melkersson-Rosenthal syndrome: a case report of a rare disease with overlapping features. Allergy Asthma Clin Immunol. 2019;15:1. doi:10.1186/s13223-018-0316-z.
    8. De Serpa Pinto MVX, De Magalhães MHCG, Nunes FD. Moebius syndrome with oral involvement. Int J Paediatr Dent. 2002;12(6):446-449.
    9. Fisher BK, Linzon CD. Scrotal glans penis (glans penis plicatum) associated with scrotal tongue (lingua plicata). Int J Dermatol. 1997;36(10):762-763.
    10. Masmoudi A, Chermi ZM, Marrekchi S, et al. Cowden syndrome. J Dermatol Case Rep. 2011;5(1):8-13.
    11. Picciani BLS, Teixeira-Souza T, Pessôa TM, et al. Fissured tongue in patients with psoriasis. J Am Acad Dermatol. 2018;78(2):413-414.

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