The smooth areas in the typical “mapping” of geographic tongue, shown here, represent flattened or denuded filiform papillae. The cause of this common condition is unknown. The case of this 5-year-old girl is unusual because the geographic mapping—usually appearing only on the dorsum of the tongue—extends to the ventral surface. According to the patient’s mother, the child’s tongue had always had this appearance. The only symptom was an occasional burning sensation when she ate ketchup.
Geographic tongue is usually asymptomatic, but sour or salty foods may cause burning or pain. This can be relieved with application of a 0.1% triamcinolone