Geographic tongue that responds to the treatment of pregabalin: Can it be a new treatment choice?

Abstract

Geographical tongue, also known as benign migratory glossitis or erythema migrans, is a benign dermatosis whose specific etiology is not known due to the disappearance of central erythematous and filiform papillaries surrounded by a hyperkeratotic ring forming the geographical shape on the tongue. The disease causes pain and burning sensation in patients particularly when they intake acidic and hot food.Nutritional deficiencies were rarely encountered in the research. In treatment, topical corticosteroids may be recommended for symptomatic relief (Jacob, 2016;Khan, 2018).It was determined that the 55-year-old female patient, who was diagnosed polymyositis and prescribed systemic corticosteroids and azathioprine, started at the same time, applied to our clinic with the complaints of centralized, peripheral hyperkeratotic white plaques that give a feeling of burning against widespread, erythematic, hot, and acidic food. It did not benefit from the topical treatments that she used from time to time for a long time. In the dermatological examination of the patient, the widespread periphery, starting from the ventral to the dorsal root, surrounded by white hyperkeratotic rings, consisting of plaques characterized by the disappearance of erythematous, filiform papillaries were seen (Figure 1). The nutritional tests of the patient were evaluated as normal. There was emotional stress that due to the role of chronic illness in the patient. Initially 2 × 25 mg pregabalin treatment started. In the first month of the treatment the lesions recovered 80-90%, and burning sensation diminished too (Figure 2). The treatment of the patient was readjusted to 1 × 25 mg/day. In the second month of the treatment, there was no increase in lesions; it was observed that there was some new healing and total regression of the subjective symptoms (Figure 3). Pregabalin, is an analogue of gamma amino butyric acid (GABA). It is the calcium canal ligand of pregabalin α2-δ and it is strongly attached to FIGURE 1 Geographical tongue before treatmentFIGURE 2 The first month of pregabalin treatment FIGURE 3 The second month of pregabalin treatment