Which condition is characterized by a red beefy tongue?

Pernicious anemia is characterized by a red beefy tongue primarily due to vitamin B12 deficiency, which occurs as a result of impaired absorption. This condition is often associated with autoimmune gastritis, leading to a decrease in intrinsic factor production, which is necessary for vitamin B12 absorption in the intestines. As vitamin B12 levels drop, it impacts the production of red blood cells, and this deficiency can lead to changes in the mucosal appearance of the tongue, resulting in a bright red, smooth, and sometimes painful tongue.

While vitamin B12 deficiency can also relate to folate deficiency, it is distinct in how it presents with the tongue's morphology. A beefy red tongue is a classic finding in pernicious anemia due to its specific pathophysiology linked to the lack of intrinsic factor and subsequent vitamin B12 deficiency. Iron deficiency and other forms of anemia typically associate with other symptoms and changes in the oral cavity, such as a pale tongue or angular cheilitis, rather than the characteristic beefy red tongue seen in pernicious anemia.