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A woman with a funny looking tongue.  What is your diagnosis? 

What is your diagnosis?

scrotal tongue

A 20-year-old woman presents with multiple dermatologic concerns including an odd looking tongue.  She reports that she has had this as long as she can remember.  She reports no complications such as burning or dysesthesias with her tongue.  She is of normal development and does not have Down syndrome.  She also denies any lip swelling or facial dysesthesia/paralysis. 


Lingqua  Plicata (Plicated tongue, also known as scrotal tongue)

The cause of a fissured tongue is unclear, but it is a common condition affecting approximately 5% of the population.  It can be associated with Down syndrome, and it is also a rare feature of the Melkersson-Rosenthal syndrome, which includes hemifacial paralysis and lip swelling.  It can also be associated with geographic tongue, although the number and severity of plications can complicate that diagnosis.  However, if you look closely in this picture, it does appear that she does have a mild manifestation of geographic tongue located near the distal central edge.  In this particular case, nothing else was needed except reassurance that this is a somewhat common finding and in her particular case is of no significant consequence. 


Charles E. Crutchfield III, MD



  1. Kullaa-Mikkonen et al.  Morphologic Variations on the Dorsal Surface of the Human Tongue.  Proceedings of the Finnish Dental Society 1985; 81:  104-110
  2. Rook Textbook of Dermatology, Chapter 66, the Oral Cavity. 


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