Comments on atrophic lingual papillae and candidiasis in Sjögren syndrome

We read with interest the article in the June issue by Yamamoto et al.,1 in which they compared the occurrence and morphology of atrophic lingual papillae to stimulated salivary flow rate, sialography, and minor salivary gland histopathology.

Unfortunately, they did not also compare the lingual changes to the presence of Candida species, which were shown 20 years ago2 to have a clear role in producing lingual papillary atrophy in patients with Sjögren syndrome. That study reported that complete reversal of the atrophy with reduction or elimination of oral symptoms is possible by antifungal treatment alone, in spite of continuing salivary hypofunction. Such antifungal treatment is now a standard component of guidelines for managing patients with chronic salivary hypofunction and such oral mucosal lesions.