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"textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with considerable interest the systematic review published by González-Álvarez et al. on geographic tongue or benign migratory glossitis.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> However, the review omitted cases of geographic tongue associated with drugs and specifically those related to angiogenesis inhibitors. We believe it is important to alert physicians as to this relationship, which is not widely known despite having been reported some time ago.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2–4</span></a> This iatrogenic form appears to be more symptomatic than the classical form and affects women more than men.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We observed a case of a 75-year-old woman with a history of acute urticaria following colorectal cancer surgery in 2013. In 2016, the patient experienced a relapse. In February 2018, we started treatment with FOLFOX-bevacizumab (Avastin<span class="elsevierStyleSup">®</span>). Bevacizumab is a class IgG<span class="elsevierStyleInf">1</span> recombinant humanized monoclonal antibody whose target is the vascular endothelial growth factor protein (VEGF-A). After the second cycle, the patient reported the onset of a number of lesions consistent with the diagnosis of geographic tongue. The images show the changing characteristics of the lesions (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). At first, the lesions were asymptomatic; however, they resulted in discomfort and severe anxiety, which ultimately led to the treatment being discontinued. The symptoms persisted despite treatment with nystatin, lidocaine, sodium hyaluronate and triamcinolone. The patient reported some improvement 8 weeks after the last dose of bevacizumab. The development of geographic tongue in patients treated with bevacizumab can be an effect of the mechanism of action due to the crucial role of VEGF in maintaining homeostasis of the oral mucosa. This diagnosis does not require biopsy or specific treatment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">These lesions have also been reported in relation to treatments with other multitarget kinase inhibitors that act on angiogenesis, such as sunitinib, sorafenib or axitinib.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3,4</span></a> The growing use of these drugs will likely result in many general practitioners finding these lesions, which do not need a specific treatment.</p></span>"
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