Black hairy tongue

Source: Wikipedia, the free encyclopedia.
Not to be confused with Hairy leukoplakia.
Black hairy tongue
Other namesLingua villosa nigra[1][2] or Melanoglossia.[3]
A patient displaying characteristic dark bumps of black hairy tongue
SpecialtyDermatology
Risk factorsSmoking, poor oral hygiene, soft diet
Diagnostic methodBased on clinical appearance
Differential diagnosisHairy leukoplakia
TreatmentReassurance

Black hairy tongue syndrome (BHT

small bumps on the tongue elongate with black or brown discoloration, giving a black and hairy appearance. The appearance may be alarming, but it is a harmless condition. Predisposing factors include smoking, xerostomia (dry mouth), soft diet, poor oral hygiene and certain medications. Management is facilitated by improving oral hygiene, especially scraping or brushing the tongue.[5]

Signs and symptoms

Hairy tongue largely occurs in the central part of the dorsal tongue, just anterior (in front) of the

halitosis).[6]

The term "melanoglossia' is also used to refer to there being black discolorations on the tongue without "hairs", which are also harmless and unrelated to black hairy tongue.[7]

Causes

The cause is uncertain,

niacin (vitamin B3) deficiency, may cause a thick greyish fur to develop on the dorsal tongue, along with other oral signs.[9]

Transient surface discoloration of the tongue and other soft tissues in the mouth can occur in the absence of hairy tongue. Causes include smoking (or

betel chewing),[8] some foods and beverages (e.g., coffee, tea or liquorice),[8] and certain medications (e.g., chlorhexidine,[8] iron salts,[8] or bismuth subsalicylate (Pepto-Bismol)).[10]

Diagnosis

Diagnosis is usually made on the clinical appearance without the need for a tissue biopsy.[6] However, when biopsies have been taken, the histologic appearance is one of marked elongation and hyperparakeratosis of the filiform papillae and numerous bacteria growing on the epithelial surface.[6]

Hairy tongue may be confused with

human immunodeficiency virus infection but rarely other conditions which suppress the immune system).[6]

Classification

Hairy tongue (lingua villosa) refers to a marked accumulation of keratin on the filiform papillae on the dorsal surface of the tongue, giving a hair-like appearance.[6] Black tongue (lingua nigra) refers to a black discoloration of the tongue, which may or may not be associated with hairy tongue. However, the elongated papillae of hairy tongue usually develop discoloration due to growth of pigment producing bacteria and staining from food.[6] Hence the term black hairy tongue, although hairy tongue may also be discolored yellow or brown. Transient, surface discoloration that is not associated with hairy tongue can be brushed off.[8] Drug-induced black hairy tongue specifically refers to BHT that develops because of medication. [11] Black hairy tongue can also be caused by antibiotics e.g., (penicillins, cephalosporins, tetracyclines, clarithromycin and linezolid).[12]

Treatment

Treatment is by reassurance, as the condition is benign, and then by correction of any predisposing factors.

podophyllin are successful, but carry safety concerns.[6] Other reported successful measures include sodium bicarbonate mouthrinses, eating pineapple, sucking on a peach stone and chewing gum.[8]

Prognosis

BHT is a benign condition,[6][13][14] but people who are affected may be distressed at the appearance and possible halitosis, and therefore treatment is indicated.

Epidemiology

Hairy tongue occurs in about 0.5% of adults.[6] However, the prevalence is variable depending on the population studied.[11]

References

  1. ISBN 978-81-312-1570-8
    . Retrieved 16 November 2010.
  2. PMID 5340144
    .
  3. doi:10.1016/S0140-6736(00)55600-1
    .
  4. PMID 25152586
    .
  5. PMID 2190456
    .
  6. ^
    ISBN 978-0-7216-9003-2
    .
  7. PMID 29002878
    .
  8. ^
    ISBN 978-0-443-06818-8
    .
  9. ISBN 978-0-443-07105-8
    .
  10. PMID 20027942
    .
  11. ^
    S2CID 24501452
    .
  12. PMID 33044871
    .
  13. PMID 25152586
    .
  14. PMID 15679200
    .

External links

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