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Caviar tongue is a condition characterized by the purplish nodular swelling of veins found on the undersurface of the tongue. [1]It is normal for there to be veins visible underneath the tongue, partly because the mucous membrane is so thin and translucent in this region, but where these vessels become dilated and tortuous, they may appear round and black like caviar. [2]
The tongue is moved side to side and inspected; it should be pink, moist, smooth and glistening. Assessment of the ventral (bottom) surface of the tongue is done by having the patient touch the tip of their tongue against the roof of their mouth. If healthy, it should have prominent veins and be pink, smooth, moist, glistening and free of lesions.
The lingual veins are multiple veins of the tongue with two distinct courses: one group drains into the lingual artery; another group drains either into the lingual artery, (common) facial vein, or internal jugular vein.
The tongue may traumatized by mechanical, thermal, electrical or chemical means. A common scenario is where the tongue is bitten accidentally whilst a local anesthetic inferior alveolar nerve block is wearing off. The tongue may develop scalloping on the lateral margins, sometimes termed crenated tongue.
Varicose veins and reticular veins are often treated before treating telangiectasia, although treatment of these larger veins in advance of sclerotherapy for telangiectasia may not guarantee better results. [18] [19] [20] Varicose veins can be treated with foam sclerotherapy, endovenous laser treatment, radiofrequency ablation, or open
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Angioedema is an area of swelling of the lower layer of skin and tissue just under the skin or mucous membranes. [1] [3] The swelling may occur in the face, tongue, larynx, abdomen, or arms and legs. [1] Often it is associated with hives, which are swelling within the upper skin. [1] [3] Onset is typically over minutes to hours. [1]
However, cyanosis can still be diagnosed with careful examination of the typical body areas such as nail beds, tongue, and mucous membranes where the skin is thinner and more vascular. [1] As mentioned above , patients with severe anemia may appear normal despite higher than normal concentrations of deoxyhemoglobin.