Transient Lingual Papillitis, also known as Lie Bumps is quite common but painful inflammation that affects a specific part of tongue. Find below all the features, causes and treatment options to get rid of them.
What’s Transient Lingual Papillitis?
Transient lingual papillitis is a painful inflammatory condition that affects one or several fungiform papillae on the tongue. papillae (plural of papilla) are basically nipple shaped protuberances and are found covering the entire surface of tongue.
These are also known as Lie Bumps that are known to exist in two forms. One is known as fungiform papillary glossitis and the other one is called eruptive (familial) lingual papillitis.
Although both of them happen to be painful inflammatory condition of tongue, there is another non-painful variant found which is called as papulokeratotic.
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What Are Fungiform Papillae?
Fungiform papillae happen to be one of the special types of Lie Bumps that are found scattered across the surface of the tongue. This is the area known as Fungiform papillae where taste buds (especially bitter taste) of tongue are found.
The above area of tongue also has a great blood supply along with having loads of temperature receptors.
Fungiform papillae are scattered over the top, sides and towards the tip of the tongue. Most of the time, they look like pink and flat.
Please note that the number and size of Fungiform papillae varies on the surface of the tongue.
- In cases of a nerve injury, it may reduce the number of Fungiform papillae on tongue that leads to the reduced taste sensation
- They are seen more abundant on the tongue surface after menopause
- Females have far more Fungiform papillae as compared to males.
In general, Fungiform papillae are not visible to the naked eyes as they are inclined inside the tongue. But still, they are slightly visible.
They can become more obvious in certain conditions like in the cases of strawberry tongue of scarlet fever. Recently, they have become recognizable in cases of early symptoms of COVID-19.
Who gets transient lingual papillitis and why?
There exists the classic form of transient lingual papillitis found over 50% of the population.
They are most commonly found among young women. But they are equally found among all age groups.
After a thorough study, it has been found that the most common cause of transient lingual papillitis or Lie Bumps due to a local irritation to a fungiform papilla.
This is not the only trigger to cause this type of papillitis. There can be some other triggers like some specific foods, gastrointestinal upset, hormone fluctuations, stress and more.
The other type, known as Eruptive (familial) lingual papillitis mostly affects children and are evident during spring season.
They can appear during the entire year as well. It can also happen in children after they come in contact with other children in school or elsewhere.
Similarly, the above condition of the tongue has been also seen after a viral infection in any one of the family members.
As per a theory, the most possible cause of Eruptive (familial) lingual papillitis can be due to the infection of a cold or herps virus in childhood which can cause recurrent episodes of the condition throughout the life.
Most recently, the episodes of Transient lingual papillitis have been found in patients suffering from COVID-19.
On the other hand, Fungiform papillary glossitis is found among patients having the history of hay fever, asthma or eczema.
Sometimes, transient lingual papillitis or Lie Bumps is also referred to the name as above. It’s seen most often occurring due to the increased environmental sensitivity of the tongue.
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Transient Lingual Papillitis Causes & Features
There are various forms of transient lingual papillitis. Out of these, 4 types have been recognized.
When you have the classic form of transient lingual papillitis, you will notice a single bump on the tongue which will usually last 1-2 days and then disappears automatically. It may take a few days, months or even years though.
In the cases of classic forms of transient lingual papillitis, there is no lymph gland swelling or associated illness found.
The lesions are more numerously present on the surface of the tongue. But they can also disappear within hours or days. Sometimes, they are associated with a tingling or burning sensation.
In any case, they don’t cause any type of symptoms. However, there are some reports that suggest association of scalloped markings on the sides of the tongue.
The above form represents the recurrent multiple white bumps all over the surface of the tongue. But these don’t cause any sort of symptoms. However, they may be persistent.
Eruptive lingual papillitis
It’s a type of systemic illness often associated with the swelling of lymph gland along with fever. The onset can be sudden. In most cases, it has been seen that the affected child becomes reluctant to eat and produces excessive saliva.
In such patients, tongue shows inflamed fungiform papillae mainly on the sides and tip of the tongue. But they are missing on the top.
In such cases, the illness generally lasts from 2-15 days or a week. In some cases, recurrences are also reported. In adults, the illness can be in the form of a sudden burning sensation of the tongue which often gets worsen with food.
Transient U-shaped Lingual Papillitis
Transient U-shaped lingual papillitis are found with the swelling of the tongue. This form is found to be the most commonly found among patients with symptoms of COVID-19.
It can be due to the presence of some kind of viral infection like SARS-CoV-2 infection of the mucosa. It can also appear due to poor oral hygiene or oxygen therapy.
How is transient lingual papillitis diagnosed?
Both eruptive lingual papillitis and Transient lingual papillitis or Lie Bumps are mainly diagnosed to be clinically based on some typical presentation.
When mucosal biopsy was done, it was found to have been accompanied with swelling and inflammation due to fungiform papilla. But this is not a confirmed case. It’s because special strains often fail to detect bacterial, fungal or viral infection.
In case of papulokeratotic variant, the biopsy showed the presence of mild chronic inflammation and severe hyperparakeratosis.
Treatment of transient lingual papillitis
In general, no treatment is offered to the classic form of transient lingual papillitis. It’s because the above condition generally resolves within hours or days.
However, in some cases, treatment is offered that gives great relief within some time:
- Topical steroids
- Antiseptic or local anesthetic mouthwashes
- Soothing foods like yoghurt
- Cold fluids
- Salt water mouth rinses
The majority of patients are found to have resolved the above nuisance after some time.
In the cases of patients suffering from eruptive lingual papillitis, certain medications like ibuprofen, paracetamol and topical antiseptics are not found to have altered the severity of illness among children.
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