Geographic Tongue Diagnosis — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyOral MedicineGeographic Tongue DiagnosisORE Part 1

A 45-year-old patient presents with erythematous patches on the dorsum of the tongue. Over several weeks, the patches change shape and move to different areas. Each patch has a pale raised border. The patient is otherwise well and reports mild sensitivity when eating spicy food. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Geographic tongue

The diagnosis is geographic tongue. Its characteristic appearance is irregular erythematous depapillated areas with a pale or white raised border that change shape and migrate around the dorsum of the tongue. Mild soreness or sensitivity to spicy or acidic foods may occur. Oral lichen planus more typically causes persistent lace-like white striae, often on the buccal mucosa and tongue. Oral candidiasis causes white plaques or patches, which may wipe away leaving an erythematous surface, rather than migrating bordered lesions. Median rhomboid glossitis is a fixed central posterior dorsal lesion. Squamous cell carcinoma does not characteristically resolve and recur at changing sites; persistent ulceration, induration or a mass would be concerning features.

Reference: British and Irish Society for Oral Medicine. Geographic Tongue, October 2019 (review date October 2022). https://www.qvh.nhs.uk/wp-content/uploads/2020/09/Geographic-Tongue.pdf