CHALLENGES IN DIAGNOSING DESQUAMATIVE GLOSSITIS

Abstract

Diseases of the tongue are quite common in outpatient dental visits, exhibiting a wide variety of etiologies, pathogeneses, and clinical manifestations, making them difficult to standardize. The varying interpretations of some terms in existing classifications of tongue diseases have prompted us to clearly distinguish, within the current definition of a specific form of glossitis, the variants of its course depending on the etiologic factor. The aim of this study is to identify etiologic factors, distinguish between independent and symptomatic forms of desquamative glossitis based on the analysis of literature and clinical data. The study used the data from the consultation visit to the regional scientific and practical center for diseases of the oral mucosa (Poltava), which was visited by 418 patients with tongue diseases. To establish the diagnosis, we were guided by the classification of diseases of the oral mucosa by M.F. Danilevsky. It has been found that desquamative glossitis is the most commonly diagnosed (91.63%). In the literature, it is referred to by several synonymous terms: geographic tongue, exfoliative glossitis, atrophic glossitis, etc. In our study, geographic tongue was diagnosed in 31 (7.41%) patients, and a combination of folded and geographic tongue in 5 (1.19%) patients. Desquamative glossitis was detected in 355 (84.32%) patients; however, this is only a preliminary diagnosis based on the presence of lesion elements (desquamation) and patient complaints. Further examination allowed us to identify the primary or symptomatic causative factors and to establish the final diagnosis. Thus, the variation in interpreting clinical diagnoses highlights the need for further clarification in terms of linguistics and a unified understanding of the diagnostic process for tongue diseases. The term "desquamative glossitis" defines the general clinical symptoms that lead to a preliminary diagnosis and prompts investigation into the causes of its occurrence.