Benign migratory glossitis — ORE Part 1 MCQ

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ModerateOral Medicine and Oral PathologyBenign migratory glossitisORE Part 1

A 31-year-old patient presents with recurrent red depapillated patches on the dorsum of the tongue bordered by serpiginous white margins. The patches change location over days and weeks, causing mild sensitivity to citrus foods. There is no ulceration or systemic illness. What is the most likely diagnosis?

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Correct answer: D — Benign migratory glossitis

Explanation lettering: C = shown as A · A = shown as C · E = shown as D · D = shown as E

The correct answer is E: Benign migratory glossitis (BMG). The key diagnostic feature is the migratory nature of the lesions – red depapillated patches with serpiginous (whitish) borders that change location over days. This ephemeral, position-changing characteristic is pathognomonic for BMG. The patient's age, mild sensitivity to irritants (citrus), and absence of systemic signs are all typical. Median rhomboid glossitis (A) is ruled out because it presents as a fixed, symmetrical, midline lesion that does not migrate. Erosive lichen planus (B) presents with reticular white patterns and erosions, typically on buccal mucosa and gingiva, and is not migratory. Oral hairy leukoplakia (C) presents as white patches on lateral tongue surfaces and is not migratory. Squamous cell carcinoma (D) would present as a fixed ulcerative lesion with features of malignancy, not a benign migratory pattern.

Reference: Campos WGD, et al. Treatment of symptomatic benign migratory glossitis: a systematic review. Clin Oral Investig. 2018;22(7):2487–2493. PMID:29982968; and Orban's Oral Pathology (contemporary literature on BMG diagnostic criteria). https://pubmed.ncbi.nlm.nih.gov/29982968/