Dear Dr. Mujeeb,

This a typical case of "Sheikh's Syndrome". See the London Conference presentation of mine.

I am Prof. Dr. Shahid H. Sheikh, Sr. Research Scientist of NIDS Treatment & Research Center, Lahore Pakistan. Call me on my personal phone: 92300-481-6677

https://fbcdn-video-m-a.akamaihd.net/hvideo-ak-xfl1/v/t42.1790-2/11955130_870267759726607_1688029755_n.mp4?efg=eyJybHIiOjMwMCwicmxhIjoyNzMyfQ%3D%3D&rl=300&vabr=127&oh=90ead762a03839549f170528f6eaebca&oe=55EFFCE9&__gda__=1441791707_efb9d395e2567b5a8f9f709909f4237e

Then Run the following Blood Tests.

1. HSV   TyPe I   IgG & IgM

2. HSV- Type II   IgG & IgM

3. CMV                 IgG & IgM.

4. Lipids Profile

5. CBC

Then Call me.

Best Regards.

Dr. Sheikh

 Benign migratory glossitis

Dear Mujibur

I would be interested to know if a microbiological (includind viral etiology) and histopathological evaluation has been done? If so what were those reports saying?... very interesting case if none provide you a clue

It looks like geographic tongue (benign migratory glossitis). No labs are necessary. Some studies suggest possible relationship with psoriasis (more frequent in psoriatic patients). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4320844/

There is no established etiology and no standardized treatment. Avoid spicy foods.

 Benign migratory glossitis.

Dear Mujeeb,

The picture seems to be a classic case of geographic tongue, characterized by smooth, red, irregularly shaped patches with white border on the dorsum of the tongue, as well as frequent changes in the location, size and shape. Symptoms are not common and usually present mild intensity.

Management should include avoiding hot, spicy, or acidic foods or dried, salty nuts, and toothpaste with additives, whitening agents, or heavy flavoring. Cases with more intense symptoms may be treated with local measures including topic anti-inflammatories, such as benzydamine hydrochloride, mouth rinses with anesthetic or topical low-moderate potency corticosteroids.

Dear Mujeed

Benign migratory glossitis

Mujibur Rahman

It looks like geographic tongue or benign migratory glossitis. No labs are necessary.

Management should include avoiding hot, spicy, or acidic foods or dried, salty nuts, and toothpaste with additives, whitening agents, or heavy flavoring.

silvia

What is the disease condition of the tonge of a five yrs girl? - ResearchGate. Available from: https://www.researchgate.net/post/What_is_the_disease_condition_of_the_tonge_of_a_five_yrs_girl [accessed Sep 15, 2015].

Aggree with all the coleagues that diagnosed geographic tongue. Avoid spicy food, use mild tothpaste no mouthwashes. No tests necessary

Agree with coleagues. This is a poorly understood benign disease.

some authors estimate higher prevalence of psoriasis in these patients

Wandering Rash, Benign Migratory Glossitis, Geographic tongue

It is a classical presentation of a migratory erythema, commonly called as geographic tongue. Did you try to use lasertherapy for control the symptoms? 

Does anyone ever think beyond symptomatic relief? Why not try to find its etiology and

treat the root cause.

BMG, there is no underlying cause........

As everyone has answered this geographic tongue.  I suggest testing for serum zinc level

BENIGN MIGRATORY GLOSSITIS

Natrum muriaticum could be an option

Interestingly after about a week's treatment with B-Complex with Zinc her condition improves -please see in the picture. But after discontinuation of B- Complex it reappears in several days.

which dose was used?

We used B Complex : Dose -Thiamine Hydrochloride 5 mg, Riboflavin 2 mg, Pyridoxine Hydrochloride 2 mg, Nicotinamide 20 mg and elemental Zinc 10 mg/5 ml Syrup- daily 7.5ml. But today patient's father complains of  tendency to reappear the symptoms in spite of the continuing the drug.

Clinically it is consistent with BMG. It is a good practice to do culture to role out unusual fungal infections.

It is true burning sensation is related to vit B12 deficiency and other minerals .

Notice if the geography of the lesion changes overtime.

Symptomatic treatment remains the sole treatment until a cause is found!

Thanks for sharing

It is definitely geographic tongue. most probably administration of B12 did not offer anything to the pt. The improvement was incidental and it is within the course of the condition.