Kissing lesion-from tongue to the palate Submit Manuscript | http://medcraveonline.com Abbreviations: MRG, median rhomboid glossitis; CPA, central papillary atrophy of the tongue; LAT, localized atrophy of the tongue papillae; ATP, atrophy of the tongue papillae Case report A medically ft 62-year-old male patient walked into the OPD for a routine dental check up. Patient gave history of burning sensation over the posterior region of palate while eating spicy food since seven years. History of chewing paan masala with tobacco since three years 3-4 times per day. There was no relevant family history and no known history of allergies and medication. Patient was moderately built and nourished and his vital signs were within normal limit. Intraoral examination revealed well demarcated, red, depapillated, rhomboid lesion approximately 3x2 cms in size present on the dorsal surface of the tongue on midline just one cm anterior to the circumvallate papillae (). On palpation the lesion was non tender, non-fuctuant and frm in consistency. Similar erythematous lesion approximately 3x2 cm in size with ill defned margins was present over the posterior part of the hard palate just opposite to the lesion present on the dorsal surface of the tongue. Lesion was non tender on palpation, soft in consistency and bleeding was absent (Figure 2). Based on history and clinical examination, a diagnosis of median rhomboid glossitis was made, and as this entity was concomitant with the palatal infammation so a diagnosis of kissing lesions was given for the palatal lesions. Cytology and PAS staining confrmed the presence of Candida hyphae. Laboratory exams did not reveal anemia, diabetes, or HIV infection. Treatment with oral miconazole 20 mg gel, TID, during four weeks, resolved signifcantly both lesions. The patient was advised to maintain proper oral hygiene. MOJ Surg. 2018;6(1):17-18 Volume 6 Issue 1 - 2018 Reshma Suvarna, Prasanna Kumar Rao, Raghavendra Kini, Gowri P Bhandarkar, Roopashri Rajesh Kashyap,Vidya holla Department of Oral Medicine and Radiology, AJ Institute of Dental Sciences, India Correspondence: Reshma Suvarna, Postgraduate student, Department of Oral Medicine and Radiology, AJ Institute of Dental Sciences, Kuntikana, NH-66, Mangaluru, PIN– 575004, Karnataka, India, Tel +919449966216, Email itsreshma_11@yahoo.co.in Received: December 01, 2017 | Published: March 02, 2018 Abstract Median rhomboid glossitis presents as a well-defined erythematous area seen along the midline towards the posterior aspect of dorsal surface of the tongue. It may have a “kissing lesion”, in the area of the hard palate as a result of constant contact. Here is a case of 62 year old male patient having median rhomboid glossitis and kissing lesions on the hard palate. Keywords: oral candidiasis, median rhomboid glossitis, kissing lesion, OPD, Candida hyphae © 2018 Suvarna et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 17 Figure 1 Red, depapillated lesion in the dorsal surface of the tongue (Median Rhomboid Glossitis). Figure 2 Kissing lesion on the posterior part of hard palate. Discussion Median rhomboid glossitis (MRG) is defned as the central papillary atrophy of the tongue affecting 0.01%–1.0% of the total population. 1 It was earlier thought to be a congenital abnormality related to the persistence of an embryonic midline tongue structure, the tubercular impar. However, the lesion is now believed to be a localized chronic infection by Candida albicans. Glossite lasangigue mediane de la face dorsal langue was the name given initially by Brocq and Pautrier. 2 Other names given to the lesion are Central papillary atrophy of the tongue (CPA), localized atrophy of the tongue papillae (LAT), and atrophy of the tongue papillae (ATP). MRG is typically located around the midline of the dorsum of the tongue MOJ Surgery Case Report Open Access