(Pityriasis linguae; Glossitis areata exfoliativa; Erythema migrans; Annulus migrans; Circinate eruption of the tongue).
This rare and strange affection manifests itself as one or several, pin-head- sized, well-defined, grayish spots of a vesicular appearance, usually on the dorsal and lateral surfaces of the tongue and often toward the tip. The initial lesions spread peripherally and form desquamating, reddened patches. The borders are often redder than the center and present the pseudovesicular aspect of the initial lesions. A patch may become half an inch in diameter or even larger and then disappear, first clearing in the center, all in the course of five to fifteen days. There may be one or more patches present at the same time; they may remain round or become irregular, gyrate, segmented or half-moon shape, depending on their proximity, coalescence or location. The so-called geographic tongue (lingua geographical) represents the appearance noted from extensive development and coalescence of patches. Ordinarily subjective sensations are absent or very slight.
Etiology. Children under four years of age are more often afflicted but these plaques may be seen at any age and in either sex. A few cases have been regarded as syphilitic, others as parasyphilitic, but many do not present the slightest suspicion of such an origin. It can safely be said that the cause is unknown.
Prognosis and Treatment. This disease is benign, persistent with a tendency toward spontaneous disappearance in children as they grow older, and rebellious to treatment. Physiological measures, including the proper dietary, improved digestion and normal excretion, are most important. Mildly astringent and antiseptic mouth washes containing such substances as boric acid or myrrh, or sulphur in the form of an ointment, in an emulsion or as a natural sulphur water may be serviceable.