Fissured tongue

Fissured tongue (also known as "scrotal tongue," "lingua plicata," "Plicated tongue," and "furrowed tongue") is a benign condition characterized by deep grooves (fissures) in the dorsum of the tongue. Although these grooves may look unsettling, the condition is usually painless. Some individuals may complain of an associated burning sensation.

Prevalence

It is a relatively common condition, with an estimated prevalence of 2-5% of the general population. Males are more commonly affected. The condition may be seen at any age, but generally affects older people more frequently. The condition also generally becomes more accentuated with age.

Clinical features

The clinical appearance is considerably varied in both the orientation, number, depth and length of the fissure pattern. There are usually multiple grooves/furrows 2-6mm in depth present. Sometimes there is a large central furrow, with smaller fissures branching perpendicularly. Other patterns may show a mostly dorsolateral position of the fissures (i.e. sideways running grooves on the tongue's upper surface). Some patients may experience burning or soreness.

Cause

The cause is unknown, but it may be partly a genetic trait. Aging and environmental factors may also contribute to the appearance.

Associated conditions

Fissured tongue is seen in Melkersson-Rosenthal syndrome (along with facial nerve paralysis and granulomatous cheilitis). It is also seen in most patients with Down syndrome, in association with geographic tongue, in patients with oral manifestations of psoriasis, and in healthy individuals. Fissured tongue is also sometimes a feature of Cowden's syndrome.

Treatment

If the fissures are causing halitosis, then mechanical tongue cleansing should be introduced to the patient's oral hygiene routine.

Since the condition is otherwise entirely benign, no treatment is indicated and the patient should be reassured that it is a common variance of the normal appearance of the tongue.