Ulcerated White Lesion of Tongue in a 7-Year-Old Child: A Diagnostic Dilemma

Royasa Shakya,Bandana Koirala,Sneha Shrestha,Mamta Dali

doi:10.3126/jnapd.v2i1.41604

Abstract

Tongue is a complex organ associated with functions of taste, speech, mastication, deglutition, and development of jaws. It is considered the mirror of physical health as it can be the site of infections, immunological and drug-induced reactions, neoplasms and systemic diseases. This paper aims to present challenges in diagnosing a case of a 7-year-old male child who presented with ulceration and extensive white coating on the dorsum of tongue accompanied by fever, chills, tonsillitis, and submandibular lymphadenopathy. Despite symptomatic treatment done, the white coating with patches of depapillation lasted for a relatively long time. This may be the first reported case in the literature with such unusual tongue lesions in a child till date. Thus, pediatric dentists should have sound knowledge of the commonly encountered oral soft tissue lesions along with the rarer lesions and unusual presentation of common lesions for timely diagnosis, appropriate treatment, and referral if necessary.

Highlights

The prevalence of tongue lesions as reported by various epidemiological studies conducted in different parts of the world and approximately up to 18.5% has been found.1 Tongue ulceration can be seen as the manifestation of a spectrum of conditions
These ranges from infectious diseases such as herpesviruses, Human Immunodeficiency Virus (HIV), tuberculosis, candidiasis; dermatological diseases as lichen planus, pemphigus, pemphigoid; some gastrointestinal diseases; nutritional deficiencies; drug-induced reactions, and traumatic ulcers
Oral candidiasis and the oral manifestation of HIV were ruled out based on clinical examination and laboratory investigations

Summary

Introduction

The prevalence of tongue lesions as reported by various epidemiological studies conducted in different parts of the world and approximately up to 18.5% has been found. Tongue ulceration can be seen as the manifestation of a spectrum of conditions. The prevalence of tongue lesions as reported by various epidemiological studies conducted in different parts of the world and approximately up to 18.5% has been found.. Tongue ulceration can be seen as the manifestation of a spectrum of conditions. These ranges from infectious diseases such as herpesviruses, HIV, tuberculosis, candidiasis; dermatological diseases as lichen planus, pemphigus, pemphigoid; some gastrointestinal diseases; nutritional deficiencies; drug-induced reactions, and traumatic ulcers.. White coated tongue is usually associated with local factors such as poor oral hygiene and the character of diet. It may appear in systemic diseases with associated fever and dehydration.. It may appear in systemic diseases with associated fever and dehydration. CASE DESCRIPTION

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