?apthous ulcer 15yr old boy taking Tab Mosiba (OD pcx30days),Kenacort oral paste and mouth wash already The improvement is not significant Further advice Kindly guide

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The improvement is not significant @Dr. Narayana S , as nicely pointed out by @Dr. Amar Jyoti Deka is suggestive of Oral Candidiasis. Advice : - 1 ) Tongue Swabs for : Gram's stain, KOH Preparation, Aerobic, Anaerobic C / S and fungal culture SOS. 2 ) CBC, Anti HIV 1&2 Ab test,...and related tests if any.... Rx :- 1 ) Please omit Kenacort oral paste and add Emoform tooth paste instead, which is bactericidal as well as fungicidal..... 2 ) Clotrimazole mouth paint - To apply locally TDPC. 3 ) Multivitamins 4 ) If difficulty in taking food, Zytee / Clenora gel may be added - TDPC.... 5 ) Maintenance of good oral and personal hygiene. After getting all the reports, please reassess the patient and treatment plan will be accordingly. Systemic Antifungals may be added on the basis of Gram's stain report; if it shows yeast cells, Budding yeast cells and Pseudohyphae. Presence of Pseudohyphae is suggestive of Invasive Candidiasis...... Thank you all for giving me the opportunity to participate in this discussion.

Thanks Doc.. Respects
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@Dr. Anil Sonara ....at a very similar post by @Dr. Lalchand Sublania ....very emininent doc @Dr. Puranjoy Saha has given an excellent & elaborate answer....pls refer once. Looks superimposed candidiasis. If pt is immunosuppred or long term use of steroids...it's seen. In one slide( next I shall post & tag u)...hairy white lekoplakia( together with candida) if seen suspect HIV.... For me it's not just geographic tongue.

Oh! thanks @Dr. Puranjoy Saha for approving by agreeing...it's your shared knowledge that I have learnt a lot..priorly I too used go with text book pictures without practical application. Respects
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It appears to be Geographical tongue which will persist for life long may some time to be associated with Psoriasis .Condition will be worsened during illness. Oral hygiene to be maintained regular cleansing with clean water to apply local anesthetic durig flare up .To maintain proper nutrition .Avoid too hot too cold drink and food .To avoid all kind of tobacco etc

Geographic tongue or migratory benign glossitis. Due to loss of papillary. Generally no treatment is required. Self limited. Advice not to eat spicy food. Stop using any known irritant like some toothpaste etc. Nsaids for pain control and corticosteroids would do.

Thanks Sir
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Geographical glossitis. It is self limiting.only local mouth paint.

Geographic tongue- Self limiting benign condition. Drugs are unnecessary.

It's geographic tongue also known as benign migratory glossitis due to papillary atrophy of tongue. It's self limiting condition.

Geographic tongue with superadded candidiasis

Geographical tongue

Dx-ziographical tongue(glossitis migrans) Rx-taraxacum 30 tds

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