Median Rhomboid Glossitis — MFDS Part 1 MCQ

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ModerateOral PathologyMedian Rhomboid GlossitisMFDS Part 1

A 52-year-old patient has an asymptomatic, well-demarcated, smooth erythematous rhomboid area in the midline of the posterior dorsal tongue. It is clinically diagnosed as median rhomboid glossitis. Which classification best reflects current understanding of this lesion?

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Correct answer: D — Localised chronic erythematous candidosis

The lesion is median rhomboid glossitis, classically presenting as a smooth or depapillated erythematous rhomboid area in the posterior midline of the tongue. Current UK clinical teaching classifies it as a localised chronic candidal infection, usually within the spectrum of chronic erythematous candidosis; therefore D is correct. Persistence of the tuberculum impar is the historical developmental theory and is no longer the preferred explanation. Median rhomboid glossitis is not itself an oral potentially malignant disorder. HPV-associated squamous papilloma is typically an exophytic, papillary lesion rather than a smooth red patch. Its characteristic localised appearance is also inconsistent with an autoimmune inflammatory disorder.

Reference: Staines K, Sims C, Gibb J. Practice Pointer: Assessing oral ulcers and patches in primary care. BMJ 2026;393:2025-085204. Published 28 May 2026. https://www.bmj.com/content/393/bmj-2025-085204.full