Dear Dr. Roach: I am generally healthy, but my one problem is my tongue. I have a condition called geographic tongue, and it is white, patchy and with gashes. Some days it is fine and normal. Why is this happening?


Dear A.P.: While geographic tongue, also called benign migratory glossitis, is not as uncommon as you might think, it’s a complete mystery as to why it occurs. The lesions on the tongue can look like ulcers, and they come and go over hours or even minutes. Many people have exacerbations and remissions of the lesions, but they usually are asymptomatic, or may have some discomfort or burning sensation.

Geographic tongue can be misdiagnosed as a fungal infection, which can lead to ineffective and unnecessary treatment. Most people need nothing more than reassurance that it is both common and benign.

Dear Dr. Roach: Our over-55 community has a fitness center that is well-attended. Management provided spray bottles containing water and hydroxyalkyl amine oxide. We are encouraged to spray (soak) and wipe down each machine, the backrest, seat, handholds and weight-pin changers after use. Sweat stains are not an issue in most cases. Is this sanitation effort really necessary to maintain good health?


Dear G.D.: I would consider the risks of using the product against the risks of not using the product. Hydroxyl amine oxides are common detergents used in many cleaning products. Although they are classified as skin irritants, at low concentration, such as from a spray bottle, most people do not have a skin reaction to them. They are effective at killing most germs.

However, there just aren’t a lot of germs capable of causing disease that we carry around with us and could spread through sweat. If I were about to use the exercise equipment, I think I would prefer a wipe-down from a clean towel in between users, and reserve the spray detergent for the end of the day.

Dear Dr. Roach: I was diagnosed with pancreatic cysts. A recent MRI scan showed that they are less than 2 cm and have been stable for a year. My doctor tells me these are benign and don’t need any more follow-up. Could these cysts become cancerous later on?


Dear K.: The medical term “cyst” means any fluid-filled, walled structure. They can occur in practically any anatomic location you can think of. In the pancreas, there are several types of cysts, as well as pseudocysts (fluid collections, usually as a result of pancreatitis, that develop a wall after some weeks), and cystic neoplasms, which have the potential to become cancerous.

You didn’t tell me how you were diagnosed. Very often, these are found incidentally when a CT scan is obtained for some other reason. In this case, when there are no symptoms present, the only concern is whether they can grow and cause symptoms later on, or worse yet, could become cancerous. Since pancreatic cancer is justifiably feared, I understand your reasons for asking the question.

Fortunately, I agree with your doctor completely. The likelihood of a small cyst (your largest cyst is 1.4 cm) being cancer is less than 5 percent. Since it hasn’t changed in a year of follow-up, your risk for cancer is very, very low.

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