Say Ahh … Part 3

Spots and dots on the tongue—sometimes they’re benign, sometimes not. Can you tell which is which?

Text for case 1 courtesy of Richard P. Usatine, MD. This case was adapted from Hitzeman N. Hereditary vascular lesions in adults. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. The Color Atlas of Family Medicine. New York, NY: McGraw-Hill; 2009:865-868.

To learn more about The Color Atlas of Family Medicine, see www. You can now get the second edition of The Color Atlas of Family Medicine as an app by visiting

Text for case 2 courtesy of Amor Khachemoune, MD, CWS.

Question 1 of 4

Red spots on the patient’s lips and tongue Courtesy of Richard P. Usatine, MD

A 56-year-old woman sought care for a nosebleed that was difficult to stop. She reported recurrent nosebleeds since childhood. The clinician noted red spots on the patient’s lips and tongue. The patient indicated that her mother also had recurrent epistaxis and red spots on her lips and tongue.

Match the diagnosis to the photo by letter

Chronic hyperplastic candidiasis

Oral lichen planus

Hereditary hemorrhagic telangiectasias

Herpetic glossitis

Clinician Reviews. 2019 November;29(11):9e-10e

This quiz is not accredited for CME.

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