Steroid Inhaler Therapy and Oral Manifestation Similar to Median Rhomboid Glossitis (Case Report)

Abstract

One of the oral manifestations in the use of a steroid inhaler is Median Rhomboid Glossitis (MRG). It is a benign condition that is asymptomatic and appears as central papillary atrophy of the tongue. This case report presents the use of a steroid inhaler in an asthma patient with manifestation in the oral cavity similar to MRG. A 27-year-old woman came to Academic Dental Hospital Universitas Muhammadiyah Yogyakarta with a complaint of discomfort on her tongue because it looked whiter than usual. The patient had an asthma attack 3 days before a complaint appeared on the tongue. The intraoral examination shows white plaque that easily rubbed without leaving the reddish area. Another finding in the middle of the tongue appears reddish areas that are similar to MRG. Treatments that have been given are instruction to brush the tongue using a tongue scraper, gargle using water shortly after the use of a steroid inhaler when the asthma attack subsides, administer the mouthwash containing povidone-iodine 1%, and control 1 week later. The evaluation for 6 weeks long gave quite a good result related to white lesions diagnosed as a coated tongue, while the red area in the median dorsal tongue similar to MRG is another finding as an oral manifestation of the use of a steroid inhaler. Steroid inhaler for the treatment of asthma can trigger several lesions such as MRG. Confirmation of MRG by mycological examination is needed to ensure the presence of fungal colonization.