Dental OSCE (Objective Structured Clinical Examination) Practice Exam

What condition is diagnosed when a patient presents with a sore tongue and a raised red lesion in the middle?

1. Median rhomboid glossitis

2. Candidiasis

3. Angular cheilitis

4. Herpes simplex virus infection

The correct answer is: Median rhomboid glossitis

The diagnosis of median rhomboid glossitis is characterized by a sore tongue and a distinct raised red lesion that typically appears in the midline of the dorsal surface of the tongue. This condition is often associated with a lack of papillae in the affected area, giving it a smooth and glossy appearance, which can contribute to discomfort and soreness. Median rhomboid glossitis is commonly linked to chronic fungal infections, particularly from Candida species, but it primarily manifests as a smooth red lesion without a white coating, which can differentiate it from candidiasis, which generally presents with a white coating on the tongue or other oral surfaces. In comparing other conditions, candidiasis would typically exhibit a white appearance due to the fungal growth. Angular cheilitis affects the corners of the mouth rather than the tongue, and herpes simplex virus infections often present with painful vesicles or ulcers rather than a single raised red lesion. Thus, the characteristics of median rhomboid glossitis are aligned with the clinical features described in the question, making it the most accurate diagnosis.