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Ulcer and blister formation on the tongue is not uncommon. Since the tongue is an extremely important structure with a number of anatomic and physiological connections to nearby structures, it is imperative that any possible infection or disease be nipped in the bud and not allowed to spread.

Some reasons for the formation of ulcers, blisters and other growths on the tongue are:

1.Canker sores: Often confused with cold sores/herpes infection, canker sores are an extremely common cause of ulcers and blisters on the tongue.

These are shallow ulcers that appear in clusters in the mouth, causing pain and discomfort. They can be found on the tongue, cheek, lip and the gums. Most commonly self limiting, these ulcers require only symptomatic treatment with topical anesthetic and analgesic agents.

Canker sores can be of two types:

  1. Simple
  2. Complex

The simple type of canker sores are found in patients of a younger age and can occur as often as three to four times a year. The complex type comes with a genetic predisposition, and it will occur well into the later years of life. The frequency of outbreaks is much lower.

The causes of canker sores are unknown, however a number of risk factors have been identified. These include stress, smoking, hormonal changes and nutritional deficiencies of Vitamin B12, folic acid and iron.

2. Viral Diseases: These are also called cold sores or fever blisters. The causative agent of this disease is a herpes simplex type 1 viral infection. This virus is so common that the majority of people in the world have been exposed to it although not everyone has the same degree of severity of clinical symptoms.

A typical kind of blister formation is seen which is quick to form and then bursts with some amount of ooze that is yellowish to brownish in color. The blisters can be found intra-orally or on other parts of the body.

This is a self-limiting disease with a 7-10 day symptomatic appearance. The virus can lie dormant for many years and then can cause a secondary infection at a time when the body's immune function has been compromised.

3.Oral Cancer: The incidence of oral cancer is rising rapidly all over the world and because of the nature of structures involved, it can be very debilitating if it is allowed to grow and spread.

The ulcers and blisters seen in this type of disease do not heal themselves and will remain festering for a long period of time. There may also be an increase in the size and spread of these blisters. If any such change is noticed then it should be brought to the attention of your doctor immediately.

A cancerous ulcer can be acutely painful and will have raised borders with a degenerating centre.

4.Inflamed Papillae: An allergy to a certain food type or additive can cause the papillae on the tongue to get inflamed, painful and rise up prominently above the surface. Since these papillae are distributed all over the tongue, it can cause a lot of pain and discomfort to the patient.

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