A woman reports two years of burning tongue pain, with red patches surrounded by white borders that change location over time. What is the diagnosis?

Correct answer: B. Erythema migrans (geographic tongue)

• A. Incorrect. Oral lichen planus produces fixed bilateral reticular Wickham striae, most often on the buccal mucosa, and does not migrate.
• B. Correct. Erythema migrans presents as well-demarcated erythematous patches of filiform papillae atrophy with raised serpiginous white borders, MIGRATING over days to weeks. Burning with spicy or acidic foods is characteristic. It is benign and requires only reassurance.
• C. Incorrect. Median rhomboid glossitis is a single fixed rhomboid area of papillary atrophy at the midline posterior dorsum, associated with Candida.
• D. Incorrect. SCC presents as a persistent, non-migrating indurated ulcer or mass, typically on the lateral border of the tongue.