A patient presents with a map-like lesion on the dorsal tongue with red areas surrounded by white serpentine borders. The patient reports discomfort with spicy foods. What is the most likely diagnosis?

Correct answer: A. Erythema migrans (geographic tongue / benign migratory glossitis)

• A. CORRECT. Geographic tongue (erythema migrans / benign migratory glossitis) presents as smooth erythematous patches on the dorsal tongue, surrounded by white or yellowish serpiginous (snake-like) borders that migrate over time. Patients often report sensitivity to spicy, acidic, or hot foods. It is a benign, common inflammatory condition.
• B. Lichen planus of the tongue typically presents as white striae (reticular) or atrophic/erosive areas — not the migratory map-like erythematous patches with white serpentine borders.
• C. Atrophic (erythematous) candidiasis causes diffuse smooth red areas on the palate or tongue without the distinctive white serpentine borders and migratory pattern.
• D. Median rhomboid glossitis is a smooth red diamond-shaped lesion in the MIDLINE posterior dorsal tongue — it does not have the migratory map-like pattern.