33 yo male who smokes hookah presents with a irritation of the tongue for the past 3 days. He stated that he had a sensation that something was on his tongue and he needed to swallow. He decided to brush his tongue a couple days ago which is when he stared noticing the above lesion. PMH is significant for melanoma in the mother. Patient is worried about oral cancer. What are the differentials?

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Cancerophobia & a bit oral candidiasis. Quite delicate situation, but common in our practice. Need reassurance & little councelling. Topical Antifungal twice daily for 6 weeks & quit deleterious oral habits without making the patient more apprehensive.

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Median rhomboid glossitis (MRG, also known as central papillary atrophy, or glossal central papillary atrophy. ) is a condition characterized by an area of redness and loss of lingual papillae, situated on the dorsum of the tongue in the midline immediately in front of the circumvallate papillae. Treatment may involve smoking cessation and prescription of topical or systemic antifungal medication. Usually the mucosal changes resolve with antifungal therapy, but sometimes the lesion is resistant to complete resolution.

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Advise... Maintenance of proper and good oral hygiene.. Quit deleterious habit... Tab B Complex... Orasep gum paint Chlorhexidine MW

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Median rhomboid glossitis

Patient give H/o brushing his tongue.it might be due to hard brushing. Warm saline rinses twice daily and application of antifungal mouth paint may help.

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Median rhomboid glossitis

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Oral candidiasis Quit bas habit Multivitamins Ointments Mouthwash

Median Rhomboid Glossitis

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Candidiasis. . ....candid gum paint .

Ask to stop hukka and improve hygiene,saline gargle and candid oral lotion application.

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