Herpetic Geometric Glossitis

 

Clinical features:

(1) The patient is typically immunocompromised.

(2) The patient develops painful, tender linear fissures on the dorseum of the tongue, usually in the center of the tongue.

(3) Usually herpetic lesions are absent elsewhere on the oral mucosa.

(4) The lesions may be chronic and/or recurrent.

(5) The lesions heal with oral antiviral agents, usually within 1-2 weeks. Repeated courses of therapy may be needed for recurrent infections.

 

Laboratory findings:

(1) A Tzanck smear or lesional biopsy may be positive for epithelial cells with intra-nuclear inclusions.

(2) A viral culture of an lesion may be positive for Herpes simplex virus if properly collected.

(3) PCR is the most sensitive way to demonstrate the virus.