Frequency of Lingual Lesions and Anatomical Variations and Their Comparison with Clinicopathological Characteristics and the Presence of Candida spp. in a Population from the University Clinic of IUCS-CESPU

Abstract

Introdução: As lesões linguais, como a língua geográfica (LG), a língua fissurada (LF) e a glossite romboidal mediana (GRM), são alterações frequentes da mucosa oral, associadas a fatores sistémicos e infecciosos, nomeadamente Candida spp. Objetivos: Determinar a prevalência destas lesões numa população clínica do IUCS-CESPU e analisar a sua relação com hábitos, comorbilidades, sintomas e presença de Candida spp. Materiais e métodos: Dados clínicos foram obtidos por exame intraoral, fotografia padronizada e culturas microbiológicas. Resultados: A prevalência global de lesões linguais foi de 8,4% (32/370): LG (3,5%), LF (3,2%) e GRM (1,9%). Os grupos foram demograficamente comparáveis (p > 0,05). Ardor e desconforto foram mais frequentes nos indivíduos com lesões (43,3% vs. 3,1%, p < 0,001), tal como fissuras (80,0% vs. 6,2%, p < 0,001). A colonização por Candida spp. foi superior nos pacientes afetados (50,0% vs. 29,0%), sendo significativa na GRM (85,7%, p = 0,011) e na LF (58,3% vs. 25,8%, p = 0,047). Diferenças por espécie foram relevantes apenas para Candida albicans na GRM, associada a crescimento fúngico intenso (p < 0,001). Na LG, C. albicans foi observada esporadicamente, sugerindo papel oportunista. Discussão: A GRM associou-se a elevada colonização fúngica, a LF a idade e prótese, a LG a fenómenos imunológicos. Estas lesões, embora benignas, mostraram impacto sintomático e funcional. Conclusões: LG, LF e GRM são prevalentes, sintomáticas e associadas a comorbilidades. O diagnóstico deve incluir avaliação local e sistémica, com atenção à colonização fúngica.

Introduction: Lingual lesions such as geographic tongue (GT), fissured tongue (FT), and median rhomboid glossitis (MRG) are common alterations of the oral mucosa, often linked to systemic or infectious factors, including Candida spp. Objectives: To determine the prevalence of these lesions in a clinical population at IUCS-CESPU and to assess their relationship with lifestyle habits, comorbidities, symptoms, and Candida spp. colonization. Materials and methods: Clinical data were collected through intraoral examination, standardized photography, and microbiological cultures. Results: Tongue lesions were detected in 8.4% (32/370) of patients: GT (3.5%), FT (3.2%), and MRG (1.9%). Demographic characteristics were similar between groups (p > 0.05). Burning sensation and discomfort were more frequent in patients with lesions (43.3% vs. 3.1%, p < 0.001), as were fissures (80.0% vs. 6.2%, p < 0.001). Candida spp. colonization was higher among affected individuals (50.0% vs. 29.0%), reaching significance in MRG (85.7%, p = 0.011) and FT (58.3% vs. 25.8%, p = 0.047). Species-specific significance occurred only for Candida albicans in MRG, associated with massive fungal growth (p < 0.001). In contrast, C. albicans was sporadic in GT, supporting an opportunistic rather than etiological role. Discussion: MRG correlated with extensive Candida colonization, FT with aging and prosthesis use, and GT with immunological predisposition. These lesions, though benign, had notable symptomatic and functional impact. Conclusions: GT, FT, and MRG are prevalent, symptomatic, and linked to comorbidities. Diagnosis should consider both local and systemic factors, particularly fungal colonization.