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Pernicious anemia is characterized by a red beefy tongue due to the lack of intrinsic factor, which is necessary for the absorption of vitamin B12. This deficiency leads to a reduction in red blood cell production and can manifest in various ways, including glossitis, which presents as a swollen, inflamed, and sometimes red and smooth tongue. The changes in the tongue's appearance are often due to atrophic glossitis, where the papillae of the tongue are lost.

In contrast, iron deficiency anemia typically presents with other symptoms such as pallor and fatigue, and the tongue may appear smooth but is not specifically described as red and beefy. Chronic myelogenous leukemia is more related to blood cell production issues but does not typically cause changes like a beefy tongue. Folate deficiency anemia may sometimes lead to a smooth or sore tongue, but it is not characterized specifically by a red beefy appearance.

Understanding the specific signs associated with pernicious anemia helps in identifying this condition in clinical practice, making it an essential detail for dental hygiene professionals to recognize.