A very common finding in patients is the “spontaneous” enlargement of fungiform papillae, called transient lingual papulosis. These enlargements are erythematous and develop 1-4 hours following a source of trauma, such as heat, spicy foods, or mechanical trauma. These cases are usually very painful. The good news is that they almost always resolve by themselves 1-4 days after their first occurrence.

Fun fact, transient lingual papulosis has traditionally been called “liar’s tongue,” forming after you have been caught in a lie. 🙂

Until 2012, there were never any recorded cases of a chronic variant of this type of papulosis. Here, we present those recorded cases, newly termed: “Chronic Lingual Papulosis (CLP).” These cases of papulosis have been present for many years, all of which are asymptomatic.

Diagnosis:

  • CLP appears typically to be a fibrous hyperplastic response of filiform and sometimes fungiform papillae to mild mechanical irritation, low-grade, long-term inflammation or chronic desiccation.
  • CLP duration is far too long, is not associated with change over time, and, moreover, none of the patients had ever painful papulosis.
  • Characterized by multiple (dozens, at least) asymptomatic, normal-colored, enlarged lingual papillae, composed microscopically of dense fibrous tissue with few, if any, inflammatory cells.
  • The abnormality may have an adult or childhood onset, perhaps with different etiologic factors at work, and the papules may be clustered or generalized.

CLP and General Health:

  • CLP is, by definition, not associated with any of the numerous systemic diseases or syndromes presenting with multiple lingual papules or nodules.
  • CLP appears to be innocuous in its biological behavior and requires no treatment, unless secondarily infected by Candida in the furrows surrounding the papules.
  • Biopsy should not be required unless the enlarged papillae appear atypical.

Today’s Morning Huddle was brought to you by Jerry E. Bouquot et al.