Answer to Medical Challenge
This tongue shows atrophic glossitis. Notice that the taste buds (papillae) in the center of the tongue are gone. This is most often associated with vitamin deficiency like folic acid and vitamin B. Celiac Disease causes inability to absorb certain vitamins in the gut and pernicious anemia is often the result.
In third-world countries where protein calorie malnutrition is present, atrophic glossitis is very common.