Geographic Tongue — MFDS Part 1 MCQ
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Correct answer: B — Irregular smooth red patches with pale borders that change position over time
Geographic tongue is characterised by irregular, smooth erythematous areas caused by loss of filiform papillae, usually surrounded by a pale, white or yellowish serpiginous border. The lesions characteristically change shape and location over days or weeks, accounting for the term benign migratory glossitis. A persistent adherent lateral white plaque suggests leukoplakia rather than geographic tongue. Palatal vesicles are more consistent with recurrent intraoral herpes, while a brown-black coating with elongated filiform papillae describes hairy tongue. A fixed painful ulcer at the tongue tip is more likely traumatic or aphthous and lacks the migrating, map-like pattern.
Reference: Ashford and St Peter's Hospitals NHS Foundation Trust, Oral Surgery Leaflet: Geographic Tongue, updated 30 April 2026. https://www.asph.nhs.uk/leaflets/3558-oral-surgery-leaflet-geographic-tongue