Differential Diagnosis

In addition to the clinical symptoms of anemia, iron deficiency produces a microcytic, hypochromic anemia. Serum iron is low. Total iron-binding capacity is elevated. A similar clinical appearance of the tongue mucosa may be seen in Vitamin B complex deficiencies and pernicious anemia (Fig. 43). Atrophic candidiasis (Fig. 45) may also produce a sensitive, erythematous, depapillated lingual mucosal surface. In severe xerostomia, the tongue may exhibit atrophy of the lingual papillae and erythema that is frequently secondary to atrophic candidiasis. Central papillary atrophy is a localized form of depapillation secondary to candidiasis (Fig. 46).

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