Atrophic glossitis (smooth tongue, bald tongue) can occur due to a number of underlying conditions.


Clinical features:

(1) The tongue is smooth, red and glossy without the usual rough dorsal surface.

(2) The tongue is often painful or it may have a burning sensation.

(3) Biopsy of the tongue shows atrophy of the papillae.

(4) Treatment of the underlying cause usually results in regeneration of the papillae.


Risk factors:

(1) nutritional deficiencies or malabsorption (celiac disease, etc):

(1a) iron

(1b) folic acid

(1c) vitamin B12

(1d) riboflabin

(1e) niacin

(2) Riley-Day syndrome (Familial Dysautonomia, hereditary sensory and autonomic neuropathy)

(3) syphilis

(4) amyloidosis

(5) cardiac failure

(6) Sjogren's syndrome


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