Introduction
Signs and symptoms
Causes
Complications
Diagnosis
Treatment
Fissured tongue is also known as ‘scrotal tongue’ or ‘lingua plicata’. It is a benign condition characterised by one or more shallow or deep grooves or furrows (fissures) on the top surface of the tongue.
Fissured tongue affects the top surface of the tongue and often extends out to the edges of the tongue. The size and depth of the fissures vary and when particularly large and deep the fissures or grooves may be interconnected, separating the top surface of the tongue into what may look like several lobules.
The condition is not usually painful unless debris such as food gets trapped within the grooves or when it occurs in association with geographic tongue.
The cause of fissured tongue is not clearly defined but it may occur with certain underlying syndromes or may be an inherited condition. It is sometimes seen in orofacial granulomatosis, Melkersson-Rosenthal syndrome and Down syndrome. It is frequently associated with geographic tongue and psoriasis, especially pustular psoriasis.
Although fissured tongue may be evident at birth or early childhood, the signs and symptoms of the condition tend to become more frequent and severe in adulthood. The prominence of the condition appears to increase with increasing age.
The main complication of a fissured tongue is the development of orofacial granulomatosis (facial swelling) or Melkersson-Rosenthal syndrome (a triad of a fissured tongue, orofacial swelling and facial palsy). A fissured tongue can be the first sign.
Diagnosis is usually made by clinical assessment. A biopsy is seldom necessary because of its characteristic diagnostic clinical appearance. Patients should also be assessed for possible associated conditions.
Fissured tongue is a benign condition that does not require any specific treatment. Patients should be encouraged to brush the top surface of their tongue to remove any debris that may cause irritation or infection when lodged between the grooves.
