Geographic tongue is a common name for benign migratory glossitis also known as annulus migrans, erythema migrans, benign wandering glossitis, exfoliatio areata linguae, or transitory benign plaque of the tongue. Benign migratory glossitis is an inflammatory disorder of unknown aetiology that usually appears on the top and sides of the tongue. Many cases are asymptomatic but for symptomatic cases as wide range of treatment modalities have been employed

The aim of this review was to assess treatments for the management of symptomatic benign migratory glossitis.

Methods

Searches were conducted in the Cochrane Library, Medline, Embase, LILACS, Scopus, Web of Science and Google Scholar databases. Studies reporting on treatment of symptomatic BMG in children and adults published in English were considered.

Two reviewers independently selected studies with one reviewer extracting data for verification by a second reviewer. Risk of bias was assessed by one reviewer using the Meta-Analysis of Statistics Assessment and Review Instrument (MAStARI).  The GRADE approach was also used to assess study quality. A narrative summary of the findings was presented.

Results

• 11 studies involving a total of 150 patients were included.
• 8 studies were considered to be of very low quality, 1 low quality,1 moderate quality and 1 high quality.
• A wide range of treatment were employed; topical triamcinolone acetonide 0.1% (n = 2), topical tacrolimus 0.1% (n = 2), topical diphenhydramine (n = 2), and nutritional supplements (n = 2) were the most frequently used.
•  6 of the studies reported significant improvement or resolution of the symptoms.

Conclusions

The authors concluded: –

There is a very low level of evidence for the treatment of symptomatic benign migratory glossitis, with substantial methodological heterogeneity among the evaluated studies. In summary, we could identify no specific treatment for symptomatic benign migratory glossitis.

Comments

7 major databases were searched for this review although restricting the included studies to those published in English may have excluded relevant paper.  Only a small number of small studies were identified and only one of the studies was a randomised trial. A wide range of treatment approaches were described and limited data on treatment schedules and duration of follow up is provided.  So while BMG is essentially an asymptomatic condition there is very little evidence on how to manage the condition for symptomatic cases.

Links

Primary Paper

de Campos WG, Esteves CV, Fernandes LG, Domaneschi C, Júnior CAL. Treatment of symptomatic benign migratory glossitis: a systematic review. Clin Oral Investig. 2018 Sep;22(7):2487-2493. doi: 10.1007/s00784-018-2553-4. Epub 2018 Jul 7.Review. PubMed PMID: 29982968

Original review protocol on PROSPERO