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Diabetic And Have Migraine. Suspected To Have Median Rhomboid Glossitis, Tongue Has White Patch. Using Arsenic. Suggest?

Posted on Mon, 7 Oct 2013

Question: Hello Doc. Seems I have Median rhomboid glossitis Got this after drinking hot coffee for a week while travelling This condition is there for last 3 years.Initially had difficulty to eat spich food for 3-4 months but now its getting over but still not cleared.I am using Arsenic Alb once a day.Have diabetes and migraine.Tongue little white patch disappearing at times.Please advise

Answered by Dr. Johny Chacko (2 hours later)

Brief Answer:
median rhomboid glossitis

Detailed Answer:
Hello XXXXXXX
I wanted to know how you diagnosed median rhomboid glossitis ? Did you see a doctor ?
Can you send me a photo of your tongue ? You have a feature to upload the images by yourself at the right side of the query page, please utilize that so that I can answer your query better. You can also send the image as attachment to YYYY@YYYY , with the subject as 'Attn: Dr. Johny Chacko'.
Median rhomboid glossitis is caused by a fungus called candida. Oral candidiasis is common in diabetics and in smokers and people with dentures. Do you smoke ?
Is your sugar level under control ?
I usually treat Median rhomboid glossitis with oral antifungal tablet like fluconazole 100 mg once a day for a week along with local application of clotrimazole (candid) mouth paint thrice a day after food.
Kindly get back with the details.
Hope this helped
Take care

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Johny Chacko (4 days later)

Dear Doctor

I am attaching herewith picture of my tongue.

Also would like to share few important points

I had a pancreasis attack in 2009 and after that I had the sugar detected.At the moment it keeps fluctuating and is not fully normal.Also I was using pain killers (ibu-para/nimesulide + tizanidine)for Migraine which I discontinued after I read that it may create median rhomboid glossitis.

Lastly I also was using omeprazole/rabeprazole for acidity which I have discontinued since last 4 months.

I used to smoke sometimes which I have quit since last 6 months.

Answered by Dr. Johny Chacko (9 minutes later)

Brief Answer:
Did not get picture

Detailed Answer:
Hello XXXXXXX
Median rhomboid glossitis is related to your sugar control. Adequate control of sugars are important for cure of this condition.
I do not think that it is connected to pancreatitis, pain killers and migraine medication.
The photo you uploaded is out of focus. Can you upload another clearer one.
Hope this helped
Take care.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Johny Chacko (21 minutes later)

Dear Doctor

I am mailing you another pictures.

Would like to inform you that these spots are prominent after I condume food,tea or coffee .Other times they nearly fade out or are very small.

can you prescribe some medicene for the same

Answered by Dr. Johny Chacko (14 minutes later)

Brief Answer:
Saw the pictures.

Detailed Answer:
Hello XXXXXXX
Saw the pictures.
It looks like oral candidiasis. Treatment of oral candidiasis is with oral antifungal tablet like fluconazole 100 mg once a day after food for a week along with local application of clotrimazole (candid) mouth paint thrice a day after food. These are prescription medicines. Kindly get it prescribed by your doctor.

Hope I have answered your query. If you do not have any clarifications, you can close the discussion and rate the answer.
Wish you good health.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Johny Chacko (23 minutes later)

Dear Doctor

Thanks a lot.I will surely start the treatment.Can this be cured permamenetly or do I need to repeat the medicines after some time.

Alternatively can it be cured permanently thru surgery /surgical process??

Answered by Dr. Johny Chacko (17 hours later)

Brief Answer:
It can be cured permanently with medicines

Detailed Answer:
Hello XXXXXXX
This condition requires medical treatment. Surgical modality is not useful. It can be cured permanently. But your diabetic control is very important to prevent a relapse. There is a chance of relapse if sugars go up.
Hope this helped.
Take care

Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Shanthi.E