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What causes lesions on the tongue?

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Posted on Thu, 2 Jun 2016
Question: I am 25 year old male with lesion on tongue. Non smoker. Just noticed today went to Family Doctor who is reffering me to ENT. Want to know your opnion on it.
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
Tongue ulcer.

Detailed Answer:
Hi,

Thank you for your query.

1. Such tongue ulcers should be treated medically at first. It is not clear whether there are ulcers on both sides or have you flipped the close-up images? In the first image the ulcer and a smaller lesion anterior to it is seen on the left. In the close-up images, the ulcer is seen on the right.

2. A tongue swab should be done along with routine blood tests. Neck examination should be done for lymph node enlargement.

3. If this does not heal in a couple of weeks, a biopsy from the edge is recommended. Routine medication and local application gels are advised.

4. If there are multiple ulcers, it reduces the chance of this being cancer.

5. Upload reports and clinical examination notes as they are done.

I hope that I have answered your query. If you have any more questions I will be be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (2 minutes later)
It is the same ulcer. It's on my right side of tongue. It might of just been different angles. I'm only 25 non smoker and I don't drink heavy. Does this look like a possible oral cancer? I went to a dentist for a cleaning a month ago and he didn't notice anything he did a filling on that side. I am just worried could it be benign? Thank you
doctor
Answered by Dr. Sumit Bhatti (1 hour later)
Brief Answer:
There is no cause for worry.

Detailed Answer:
Hi,

Thank you for writing back.

1. The possibility of cancer is remote, given your history and profile.

2. It looks benign, not malignant.

3. Since it has recently appeared, medication should be tried.

4. There is no cause for worry.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (9 minutes later)
Okay thank you very much I do have a smaller ulcer not far from it I just noticed i do eat a lot of spicy foods. I will go to my ENT appointment next week to be safe and update thank you again.
doctor
Answered by Dr. Sumit Bhatti (7 hours later)
Brief Answer:
Thank You.

Detailed Answer:
Hi,

Thank you for writing back.

Wishing you good health and a speedy recovery.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (7 hours later)
Thank you why does it look benign and not malignant? Is oral thrush a possibility I finished a ten day course of Amoxcillin a month ago.


Also I was considering that it looked possibility like geographic tongue although I know that occurs more in the dorsal areas. I can't help to note though that it looks very similar to all the pictures of geographic tongue I've seen online. It has a white border it appears around the whole ulcer.
doctor
Answered by Dr. Sumit Bhatti (5 hours later)
Brief Answer:
Yes, fungal infection is a possibility, with history of recent antibiotics.

Detailed Answer:
Hi,

Thank you for writing back.

1. The possibility of oral thrush exists if you have had antibiotics recently.

2. Clotrimazole mouth paint will help.

3. This does not look like a Geographic Tongue. This would be a diagnosis of exclusion.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Sumit Bhatti (20 hours later)
I uploaded a few more photos that show the front of my tongue a little better there does seem to be a light white film on it. I did finish a ten day course of Amoxcillin within the past month. My front lesion appears to be a little larger then the other day as you can see.
doctor
Answered by Dr. Sumit Bhatti (2 hours later)
Brief Answer:
Yes, the tongue lesion in the front is larger now.

Detailed Answer:
Hi,

Thank you for writing back.

1. The lesion in the front is definitely larger.

2. This is an active process, mostly a fungal infection.

3. Start treatment and revert.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (2 minutes later)
I have begun 3 percent hydrogen peroxide rinses diluted with water. I am taking acidophilus capsule and a yogurt daily. I see ENT tomorrow should I suggest to him possible fungal infection. Is there any other thing I should do. Thank you
doctor
Answered by Dr. Sumit Bhatti (2 hours later)
Brief Answer:
You can continue the medication.

Detailed Answer:
Hi,

Thank you for writing back.

1. The peroxide rinse and probiotics are fine, but do use the clotrimazole mouth paint.

2. Mention the tongue swab, routine blood tests and biopsy, if required.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2662 Questions

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What causes lesions on the tongue?

Brief Answer: Tongue ulcer. Detailed Answer: Hi, Thank you for your query. 1. Such tongue ulcers should be treated medically at first. It is not clear whether there are ulcers on both sides or have you flipped the close-up images? In the first image the ulcer and a smaller lesion anterior to it is seen on the left. In the close-up images, the ulcer is seen on the right. 2. A tongue swab should be done along with routine blood tests. Neck examination should be done for lymph node enlargement. 3. If this does not heal in a couple of weeks, a biopsy from the edge is recommended. Routine medication and local application gels are advised. 4. If there are multiple ulcers, it reduces the chance of this being cancer. 5. Upload reports and clinical examination notes as they are done. I hope that I have answered your query. If you have any more questions I will be be available to answer them. Regards.