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Mark Bornfeld
Mark Bornfeld, Dentist (DDS)
Category: Health
Satisfied Customers: 5989
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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I have had a sore, hemicircular red area on the tip of my tongue

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I have had a sore, hemicircular red area on the tip of my tongue for about two weeks, now. It began with a rather unsightly fissure running down the center of my tongue, from the median to the front, a little over a month ago. I scrape my tongue regularly, so at first, I thought I had just irritated the tip by scraping too hard, but even as I began to pay more attention to how I was using my tongue, so as to avoid exacerbating it, the issue got worse. I saw my primary care physician on Wednesday and he prescribed a Nystatin swish and spit, although he admitted that the red spot did not quite resemble erythematous candidiasis. There is a layer of white, pustulated papillae surrounding the red spot, and the papillae seem to be inflamed throughout the area, although it is not raised. I also do not think the area looks "depapillated," as it would in geographic tongue. I'm worried about the spot potentially being cancerous. Are there any thoughts you might be able to offer besides advising that I see my doctor again? I've taken pictures that I can show if that would be helpful.
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Would you be able to provide a photograph of the affected area? You may use the "paper clip" icon on the text entry form toolbar to upload a digital picture. Alternatively, you can upload your picture to a photo hosting site, such as Flickr or Photobucket, and provide a link to the photo in a reply to this information request. This will allow me to provide a more accurate and relevant response.
Customer: replied 5 years ago.
You're right-- this is definitely neither geographic tongue, nor is it candidiasis. This looks more like a bacterial infection, although the tissue response is non-specific and the precise type of bacterium and an appropriate treatment would need to be identified by culture and sensitivity testing. This is not a malignancy, although this could be anything form a strep infection to an STD to TB.

You need a formal diagnostic protocol, and you should have this done by either your primary care physician, an oral surgeon, or an oral pathologist.

You can find contact information for an oral surgeon or an oral pathologist by consulting the online directories of the American Association of Oral and Maxillofacial Surgeons or the American Academy of Oral & Maxillofacial Pathology respectively.

Hope this helps...
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