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Median rhomboid glossitis  

Median rhomboid glossitis is a benign condition clinically characterized by a red, usually smooth, sometimes elevated rhomboid shaped lesion on the central part of the dorsum of the tongue just anterior to the circumvallate papillae. The size of the lesion may vary from a few millimeters to a few centimeters. It is often asymtomatic, but may cause soreness while taking spicy food. This is more common among males. Traditionally, this condition is considered as a developmental defect involving the tongue. However, recently chronic candida infection has been implicated in the causation of these lesions. The diagnosis is mainly based on clinical examination. However, if there is any suspicion, a biopsy may be recommended. No treatment except reassurance is required for these lesions. Local antifungal therapy can reduce erythema and soreness due to candida infection.

Differential diagnosis:

• Lingual thyroid
• Tuberculosis of tongue
• Granular cell tumour
• Squamous cell carcinoma

Image	Caption
	Figure 1: Median rhomboid glossitis and fissured tongue: A raised, ovoid lesion with surface granularity of median rhomboid glossitis can be seen posteriorly. Extending anteriorly, there is a slough-covered longitudinal groove with multiple horizontal fissures on the dorsum of the tongue in a 50–year-old man. Scraping from the dorsum tongue was positive for candidal hyphae.
	Figure 2: Median rhomboid glossitis. Two lesions of chronic candidiasis of the median rhomboid glossitis form. The one on left is flat and more typical, while the one on the right is more nodular and irregular.