A 6-year-old child is brought by his new foster mother who was concerned that when she brushed his teeth last night she noticed that his tongue was red in certain distinct patterns. He has otherwise not been ill: The most likely diagnosis he has is:
Ans. C. Geographic tongueGeographic tongue can have a changing appearance, hence its alternative description, erythema migrans. It involves atrophy of the filiform papillae, usually on the dorsum of the tongue. It is harmless and common. Hairy tongue is usually dark colored; it is caused by excess keratin and hypertrophy and elongation of the filiform papillae. Usually these patients are asymptomatic. Patients with Kawasaki traditionally have "strawberry tongue," where the tongue is red and slightly swollen and the papillae appear white as a contrast. These patients are generally quite ill, with high fevers for several days and other symptoms. Pyogenic granulomas can grow on the tongue, although they would be more commonly found on the gingiva, as they are caused by the body's reaction to irritation. It is a painless mass that can be red, blue, or purple
Kawasaki disease
Pyogenic granuloma of the tongue
Geographic tongue
Hairy tongue
Miscellaneous