A 61-year-old man was referred for treatment of painless white lesions on his tongue that had appeared 1 month earlier. He had been treated with topical and systemic antifungal drugs for presumed oral candidiasis, but the lesions remained unchanged. The patient reported that a similar episode 1 year earlier had resolved spontaneously. Lingual examination revealed multiple erythematous patches with an annular, well-demarcated white border. A diagnosis of geographic tongue was made. Geographic tongue (benign migratory glossitis) is a benign inflammatory condition that affects approximately 2% of the world's population. The classic manifestation is a maplike distribution of erythema caused by atrophy of the filiform papillae of the tongue, surrounded by a white hyperkeratotic rim. The lesions typically resolve spontaneously without sequelae but can develop quickly in other areas of the tongue.
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