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Mouth Diseases

Red Circle Tip of Tongue

02/04/2010

Question:

Since last month around christmas, I have been getting one or two of these red circular lesions at the very tip of my tongue. They would show up one day and after 3 to 4 days, they disappear. Last time it showed up was last weekend and even now that I type this one came back. There is no pain, though a very very mild tingle, with this. There is also no white center, so nothing that can puss open.

I did perform oral sex 17 days prior to the first time I noticed this happening but wasn`t sure if it was herpes since it does not last long nor does it hurt or show up anywhere else in my mouth. I have also been tested back in May 09 and was negative for both HSV 1 and HSV 2.

I do take vitamins so I ruled out vitamin deficiency.

I do have geographic tongue but it does not look like that either. Also, I have been diagnosed with ulcerative colitis in 08 and wasn`t sure if that caused anything to do with it. I do get canker sores and had one recently along with this on my tongue, but the canker sore (being on my gum near my lip) hurt way more and was redder than what is on my tongue and also lasted longer.

Right now, my fear is herpes since that is uncurable. Though, from the pictures I have seen online (the very few that I can even find) it does not look like that, and defenitely not that many lesions. Of course, I am unsure since I am not a doctor and everyone is different. I did see a doctor last week but by time I got to see him, it went away the night before.

I am just wondering if you can maybe think of something else that maybe I haven`t thought of.

Answer:

You mentioned the fact that you have been diagnosed with IBD (Irritable Bowel syndrome) - Ulcerative Colitis (UC). That may be related to the oral exacerbations you are describing. I realize that you are concerned about contracting an STD on the tip of your tongue, but the timeline and presentation does not correspond to the frequency and remission of the “red circles” (Syphilis, Gonorrhea, HSV). If you are concerned, you can be tested and have your primary care provider evaluate the lesion.

Tip of tongue lesions usually occur secondarily to trauma, pizza burn, allergic reaction, facial abrasion, rubbing it on the anterior teeth, and/or biting it. Geographic tongue would be high on my list of probable causes as would oral manifestations of IBD. UC can involve both cutaneous and mucous membrane sites. Oral involvement includes and is not limited to the following:
 
 -glossitis (inflamed tongue),
 -stomatitis (generalized inflamed oral cavity),
 -aphthous ulceration (burning ulcers that occur on the unattached mucosa),
 -chelitis (inflammation of the lip), and
 -pyostomatitis vegitans (PV).

PV is a descriptive term that describes the occurrence of multiple, friable pustules/ulcerations in the oral cavity and has been linked to active UC disease. In fact, there are reports that the oral presentation precedes the diagnosis of UC.

I hope this helps, and I strongly suggest that you get evaluated by your Primary Care Provider in order to limit complications associated with your gastrointestinal disease.

   

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Response by:

Richard J Jurevic, DDS, PhD Richard J Jurevic, DDS, PhD
Formerly, Assistant Professor of Biological Sciences
School of Dental Medicine
Case Western Reserve University