Multiple Clinical Findings on The Tongue: Variants of Normal or Pathologic Condition? (A Case Report) Temuan Klinis Multipel pada Lidah: Variasi Normal atau Kondisi Patologis? (Sebuah Laporan Kasus) Yurina Alhayu, Febrina Rahmayanti, Ambar Kusuma Astuti Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jl Salemba Raya no. 4, Jakarta 10430, Indonesia Corresponding email: febrina_r@ui.ac.id Abstract A variety of normal and pathologic findings are occasionally found on the tongue and might confuse some patients and clinicians due to its atypical presentation. Therefore, this study aims to present a case of multiple oral findings related to variants of normal and pathological on the tongue including geographic and fissured tongue, as well as central papillary atrophy. A 53-year-old male patient came to Universitas Indonesia Dental Hospital for a dental check-up. The tongue examination showed depapilated areas surrounded by keratinized lining in the ventral and lateral left and right part of the tongue, multiple fissures over the dorsum, and an ovoid redness area in the middle of 2/3 posterior dorsum. All these findings were asymptomatic and were diagnosed as geographic and fissured tongue, as well as central papillary atrophy. Consequently, oral health professionals need to understand and recognize the normal anatomy, along with variants of normal and pathological lesions. Patients are then informed and educated about normal variations in the oral mucosa and related clinical findings to avoid unnecessary anxiety. Keywords: central papillary atrophy, fissured tongue, geographic tongue, normal variations Abstrak Berbagai variasi normal maupun lesi patologis dapat ditemukan di lidah, namun sebagian besar pasien dan klinisi mengalami kebingungan karena adanya gambaran klinis yang tidak khas. Laporan kasus ini bertujuan untuk memaparkan beberapa tampilan di lidah yang berhubungan dengan variasi normal dan patologis, yakni geographic tongue, fissured tongue dan central papillary atrophy. Seorang laki-laki berusia 53 tahun datang ke RSKGM FKG UI untuk memeriksakan giginya. Pada pemeriksaan objektif ditemukan area depapilasi dikelilingi batas berkeratin pada ventral dan lateral lidah kiri dan kanan, fisur multipel di seluruh dorsum lidah, dan area merah oval pada 2/3 posterior dorsum lidah. Seluruh tampilan tersebut tidak bergejala. Diagnosis tampilan tersebut adalah geographic tongue, fissured tongue dan central papillary atrophy. Penting bagi professional kesehatan gigi dan mulut untuk memahami dan mengenali anatomi normal, variasi normal dan keadaan patologis dari suatu tampilan klinis. Pasien harus diberikan informasi dan edukasi terkait variasi normal rongga mulut serta tampilan klinis terkait untuk menghindari kecemasan yang tidak diharapkan. Kata Kunci: central papillary atrophy, fissured tongue, geographic tongue, variasi normal INTRODUCTION Normal variations of oral healthy tissues are com- monly found on the hard and soft palates, tongue, la- bial, as well as buccal mucosa. Although the lo- cations are predictable for dentists, most people are not familiar with normal variations. In the oral cavity, the tongue is a visible organ that indicates certain sys- temic conditions, hence, a variety of normal and pathologic lesions might incidentally be found on the tongue. 1-3 There are numerous normal variations of the tongue, such as geographic (GT), fissured (FT), and hairy tongue, pigmented fungiform papillae, lateral lingual tonsil, oral varicosities, as well as the crenated and accessory tongue. 1,2 These lesions might be symptomatic, but most are often asymptomatic. 1,3 An