A median round lesion located directly anterior to the circumvallate papillae accompanied by epithelial hyperplasia is diagnosed as___________?
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Answer: A. Median rhomboid glossitis
Explanation
Median rhomboid glossitis presents as a well-demarcated red depapillated area on the tongue. The lesion is located directly anterior to the circumvallate papillae along the dorsal midline. Epithelial hyperplasia and chronic candidal colonization are typical histological features of this condition. Median rhomboid glossitis was formerly considered a developmental defect from persistent tuberculum impar. Current evidence indicates it represents a localized chronic erythematous candidiasis infection. The affected area lacks normal filiform papillae, resulting in a smooth, shiny red surface.
Patients are typically asymptomatic, discovering the red midline tongue patch during self-examination. Antifungal medication therapy often reduces redness and restores normal mucosal architecture partially. Clinicians must differentiate this benign finding from other more serious conditions affecting the tongue. Erythema migrans presents as multiple shifting red patches with white borders across the tongue. Aphthous ulcers are painful, recurring ulcerated mucosal lesions surrounded by erythematous inflammatory halos. Chemical burn causes localized mucosal necrosis and sloughing following contact with caustic substances.
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