Internal Medicine

0521779407-08 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:47

622 Geographic Tongue Giant Cell Arteritis

■probably occurs in 10% of the population

■depapillated areas of tongue dorsum in variable sizes and shapes,

often with keratotic border (elongation of filliform papillae)

■not contagious

■often symptomatic

■chronic or cyclical signs/symptoms

tests

■biopsy if in doubt

■CBC to rule out anemia (extremely rare)

differential diagnosis

■candidiasis (antifungal trial-systemic or topical)

■allergic response (corticosteroid trial-systemic or topical)

management

■rule out potential causative/related conditions

■only treat if symptomatic (empirical use of analgesics, antidepres-

sants, mouth rinses)

specific therapy

■none

follow-up

■only as necessary for flares, symptoms

complications and prognosis

■pain is only complication (chronic life-long condition)

Giant Cell Arteritis...................................

ERIC L. MATTESON, MD

history & physical

History

■Age always > 50 years

■Female:male 2:1

■Associated with polymyalgia rheumatica

■Affects the aorta and branches, including temporal artery

Signs & Symptoms

■New onset headache, often unilateral (80%)

■Jaw claudication (40%)