Geographic Tongue Migration — ORE Part 1 MCQ

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EasyOral MedicineGeographic Tongue MigrationORE Part 1

A patient presents with a well-demarcated erythematous lesion on the dorsum of the tongue, devoid of filiform papillae, that is oval in shape. The borders have raised white margins. One week later, the erythematous area has migrated to a different location on the tongue. What is the diagnosis?

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Correct answer: C — Geographic tongue (erythema migrans)

The diagnosis is geographic tongue (erythema migrans). The clinical presentation—smooth erythematous patches with raised white borders due to filiform papillae atrophy, combined with documented migration to a different location within one week—is pathognomonic for this condition. Geographic tongue is a benign, asymptomatic inflammatory condition affecting 1–2% of the population. Migration of lesions over days to weeks is the key discriminating feature. Erythroplakia and lichen planus are stationary lesions with malignant potential or erosive features respectively. Median rhomboid glossitis is a fixed midline lesion. Atrophic candidiasis may be erythematous and atrophic but does not migrate and would be associated with fungal culture evidence. UK NHS guidance and the British Society for Oral Medicine confirm diagnosis is clinical based on appearance and migratory history.

Reference: Ashford and St. Peter's Hospitals NHS Foundation Trust. Oral Surgery Leaflet: Geographic Tongue (April 2026). https://www.ashfordstpeters.nhs.uk/leaflets/3558-oral-surgery-leaflet-geographic-tongue