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Sloughing white lesions underneath tongue
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Sloughing white lesions underneath tongue

I have had a problem for about 9 months now with a sloughing lesion on the underside of my tongue. It started small but I have anxiety problems and picked at it. It grew and spread to the other side of the tongue. It is always painless, unless picked at. The lesions present as flattened white wrinkly patches, that can be rubber off with a paper towel exposing a red base underneath, that sometimes bleeds.
I am quite certain it is not thrush, as my mother is a pediatric nurse practitioner and assures me it couldn't be this. I have not been on any antibiotics for years and don't have a problem with being sick in general. I consider myself in good health otherwise besides this lesion and have more the ample energy.
The side that the lesion started on has 2 swollen lymph nodes: the sub mandibular lymph node, and one on the side of my windpipe. My mother believes this is because of me chronically irritating the offending site.
I have a history of dental decay and have had 4 chronic dental carries for over a year, herpes simplex since childhood, exposure to carcinogenic chemicals in a lab at work, don't smoke, dip, drink rarely, and a virgin, cheek biting, sleeping with mouth open, and switched from colgate, to sensodyne, to biotene with no relief. Lesions disappear sometimes, but leave a rough patch.
Also a small blister appears very rarely on the roof of my mouth right past the back of my gums. It pops easily and is always painless.
The tops of my feet have had very itchy rashes with purple scars on the tops of them for approximately as long as the lesions have persisted which led me to believe I could have lichen planus. I visited a dentist 2 days ago, and he believed this was the case. He referred me to an oral surgeon but I want to make sure that I don't need to have concern for squamous cell carcinoma which looks like it shares similar symptoms.

Please help. Thanks.
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373693_tn?1324489102
As always, it is best to see an Oral Surgeon in person as opposed to trying to get a diagnosis on the internet.

I am glad to hear your concerns have be explained.  You should try topical steriods such as Decadron elixir rinse first.  If you are still having problems a short course of system steriods may be required.

You may also want to consider keeping a diary of the foods you eat.  The condition is often may worse by certain substances.  Finally, certain toothpaste have been implicated so you may want to try a change in that too.

Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation.  This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
3 Comments
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Avatar_m_tn
Just got back from oral surgeon, and after a verrrrry quick check up, he believed if was a manifestation of geographic tongue. Lymph nodes weren't swollen, it was my spit glands that were swollen and slightly tender. He believes 100% that there is not a chance of it being squamous cell carcinoma, or that it will turn malignant.
It is important to understand however, that geographic tongue can occur pretty much anywhere in the mouth. It is the mechanisms behind it that need to be realized to be able to make a safe diagnosis. My oral surgeon told me that geographic tongue is an immune response against areas of the mouth.The antibodies in your mouth don't know what they are doing and attack the tongue. I have had very bad geographic tongue on the top of my tongue for years now, but only recently developed peeling mucosa underneath. It is easily treatable with some steriods.
All in all, huge crisis averted. I hope my anxiety will give someone else some relief. Also, if anyone has a differential diagnosis, let me know.
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Avatar_m_tn
Thanks for the reply. My Oral Surgeon put me on Dexamethasone. So far the dorsal side of my tongue appears to be healing fine, but the bottom portion of my tongue is still sloughing, though it appears to be getting slightly better.
What kind of foods would cause this condition? I did notice one time that after a big McDonald's meal, my mouth went haywire. I do eat fast food a lot. Could that have something to do with it?
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Avatar_m_tn
A related discussion, Geogrphic tongue??? was started.
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Dr. Michael H. Kirsch
Caldwell, NJ
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