MEDIAN RHOMBOID GLOSSITIS
Median Rhomboid Glossitis (MRG) is an atrophic lesion in the center of the tongue caused by Candida infection. It used to be considered a developmental abnormality, but this idea has been discarded. (Interestingly, a survey of more than 10,000 children was unable to record a single case of MRG [OSOMOP 1971;31;56].) It has been found in higher frequency in patients with diabetes.
Clinical
A rhomboid shaped, atrophic red area in the middle of the tongue is characteristic. It is usually asymptomatic although the patient may note some sensitivity when eating spicy foods. Palatal inflammation above the involved part of the tongue has been noted in HIV-positive patients.
Treatment
- Look elsewhere in the oral cavity for candida.
- Since low iron has been associated with candidiasis, the ferritin should be checked.
- Clotrimazole troche dissolve in mouth 5 times a day for 14 days.
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