Lengua vellosa negra en lactante

RESUMEN Introducción: La lengua vellosa negra es un trastorno benigno adquirido, de presentación inusual en pediatría. Consiste en una glositis benigna caracterizada por una hipertrofia de las papilas filiformes linguales, con aumento de su queratinización, lo cual condiciona que la superficie adquiera un aspecto velloso con un color que varía de pardo negruzco a negro, debido a la presencia de microorganismos productores de sustancias cromógenas. Objetivo: Describir las principales características de esta entidad y revisar los conceptos más actuales. Presentación del caso: Lactante de 10 meses que es llevado a consulta al notar la madre que el niño presentaba una lengua de color negro, con antecedentes de haber sido tratado con cefalexina debido a un impétigo contagioso 10 días antes. El examen físico mostró un aumento de volumen de las papilas filiformes linguales, posiblemente vinculada al uso del antibiótico, asociada a una defectuosa limpieza de la lengua. En el estudio microbiológico se aisló Cándida albicans, que se consideró como hallazgo concomitante. El tratamiento consistió en medidas de limpieza de la lengua con buena respuesta. Conclusiones: La lengua vellosa negra es una enfermedad autolimitada rara en lactantes, de diagnóstico clínico y buen pronóstico. El tratamiento debe ir encaminado al empleo de medidas higiénicas, como terapéutica de primera línea. El tratamiento antifúngico por lo general es innecesario. Hasta donde conocemos, este es el primer caso en Cuba, documentado en la literatura médica.

ABSTRACT Introduction: Black hairy tongue is an acquired benign disorder, of unusual presentation in pediatrics. It consists of a benign glossitis characterized by a hypertrophy of the lingual filiform papillae, with increased keratinization, which conditions that the surface acquires a hairy appearance with a color that varies from blackish brown to black, due to the presence of microorganisms that produce chromogenic substances. Objective: Describe the main characteristics of this entity and review the most current concepts. Case Presentation: A 10-month-old infant who is taken to the consultation when the mother notices that the child had a black tongue, with a history of having been treated with cephalexin due to a contagious impetigo 10 days before. Physical examination showed an increase in volume of the lingual filiform papillae, possibly linked to the use of the antibiotic, associated with a defective cleaning of the tongue. In the microbiological study, Candida albicans was isolated, which was considered as a concomitant finding. The treatment consisted of tongue cleaning measures with good response. Conclusions: Black hairy tongue is a rare self-limiting disease in infants, with a clinical diagnosis and a good prognosis. Treatment should be aimed at the use of hygienic measures, as first-line therapy. Antifungal treatment is usually unnecessary. As far as we know, this is the first case in Cuba, documented in the medical literature.

An Overview on Developmental Disturbances of the Tongue

Tongue is a vital organ present in the oral cavity. Besides the important functions of speech and deglutition, it may act as an index for underlying systemic diseases. Although it is easy to examine the various developmental anomalies of the tongue clinically still some anomalies may present a diagnostic and therapeutic dilemma

Lengua negra pilosa asociada a carcinoma escamocelular de esófago / Black hairy tongue associated with squamous cell carcinoma of the esophagus

Resumen La lengua negra pilosa (LNP) es una alteración benigna caracterizada por coloración oscura e hipertrofia con hiperqueratosis en las papilas filiformes de la superficie de la lengua. Han sido implicados varios factores intrínsecos y extrínsecos como causales, entre ellos la pobre higiene dental, el tabaquismo, la ingesta de bebidas oscuras, el uso de antibióticos y algunas patologías malignas. Reportamos el caso de un paciente con carcinoma escamocelular avanzado de esófago medio conjunto con LNP, asociación no encontrada previamente en la literatura.

Abstract Black hairy tongue (BHT) is a benign disorder characterized by dark coloration and hypertrophy with hyperkeratosis in filiform papillae on the surface of the tongue. Several intrinsic and extrinsic factors, including poor dental hygiene, smoking, drinking dark beverages, indiscriminate use of antibiotics, and some malignant diseases, have been proposed as potential causes. This is the case of a patient with advanced squamous cell carcinoma of the mid esophagus in conjunction with BHT, a previously unknown association.

Hairy tongue: differential diagnosis by use of widefield optical fluorescence

Abstract Hairy tongue is a benign pathology, characterized clinically by hyperkeratinized plaques on the dorsal surface of the tongue, hairlike, whose coloration ranges from unpigment, whitish, yellowish, green, brown to black. Diagnosis is clinical, and, in cases of whitish plaques, it may be difficult to differentiate between oral hairy leukoplakia, potentially malignant leukoplakia or squamous cell carcinoma. Thus, widefield optical fluorescence complementary examination may allow a better visualization of the local hairlike pattern of hyperkeratinization, typical of the hairy tongue, facilitating the diagnosis. In this work, a 57-year-old man was referred to the Dental Specialties Department of the Divinópolis Health Department (MG, Brazil) by a general dental practitioner, aiming a differential diagnosis of possible malignant lesion on the dorsal tongue surface. The complementary examination by wide-field optical fluorescence was performed. For this, it was employed a device with high-power light-emitting diode emitting light centered at a wavelength of (400±10) nm and maximum irradiance of (0.040±0.008) W/cm2 was used for fluorescence visualization. Fluorescence images showed projections of hairlike appearance in tongue dorsal surface with no aspects of malignancy. Hairlike appearance is the principal feature of hairy tongue. In this way, the final diagnosis was established. In conclusion, in this case, the use of widefield optical fluorescence in oral diagnostic routine provided a differential diagnosis, with no need of an incisional biopsy.

Resumo A língua pilosa é uma patologia benigna, caracterizada clinicamente por placas hiperqueratinizadas na face dorsal da língua, semelhante a pelos, cuja coloração varia de despigmentada, esbranquiçada, amarelada, verde, acastanhada a preta. O diagnóstico é clínico, e em casos de placas esbranquiçadas, pode ser difícil diferenciar entre leucoplasia pilosa oral, leucoplasia potencialmente maligna ou carcinoma de células escamosas. Assim, o exame complementar de fluorescência óptica de campo amplo pode permitir uma melhor visualização do padrão local de hiperqueratinização semelhante à pelos, os quais são característicos de língua pilosa, facilitando o diagnóstico. Neste trabalho, um paciente do sexo masculino, 57 anos, foi encaminhado ao Departamento de Odontologia da Secretaria de Saúde de Divinópolis (Minas Gerais) por um clínico geral, visando o diagnóstico de uma possível lesão maligna na face dorsal da língua. O exame complementar por fluorescência óptica de campo amplo foi realizado. Para isso, foi empregado um dispositivo com diodo emissor de luz de alta potência, com luz centrada em um comprimento de onda de (400±10) nm e irradiância máxima de (0,04 ±0,008) W/cm2 para visualização de fluorescência. As imagens de fluorescência mostraram projeções de aparência semelhante à pelos na superfície dorsal da língua, sem aspectos de malignidade. A aparência similar à pelos é a principal característica da língua pilosa. Dessa maneira, o diagnóstico final foi estabelecido. Em conclusão, neste caso, o uso da fluorescência óptica de campo amplo permitiu um diagnóstico diferencial, sem a necessidade de uma biópsia incisional.

Tongue lesions and anomalies in a sample of Yemeni dental patients: a cross-sectional study

Background: Tongue examination helps considerably in diagnosing the underlying health state of the patient, especially in the cases of chronic diseases. The aim of this study is to determine the prevalence and association of tongue lesions with risk factors among Yemeni dental patients. Materials and methods: An oral medicine specialist examined all 713 patients attending the dental polyclinics at the University of Sciences and Technology (Sana’a, Yemen). The examination sheet was designed to include information related to patient characteristics, medical history, dental history, habits, and tongue lesions. Results: The prevalence of tongue lesions among the examined participants was 76.5 percent. The prevalence rate was 83.4 percent for males and 69.2 percent for females. Fissured tongue was the most common condition. Logistic regression analysis indicated that older age (p<0.001), gender (p=0.007), khat chewing (p<0.001), and smoking (p=0.001) were associated with fissured tongue; gender (p<0.001), khat chewing (p<0.001), and smoking (p<0.001) were associated with hairy tongue; and older age (p<0.001), khat chewing (p=0.001), and smoking (p=.021) were associated with coated tongue. Conclusion: The prevalence of tongue lesions among this sample of Yemeni population was 76.5 percent; fissured tongue and hairy tongue were the most prevalent lesions. Khat chewing, smoking, and older age were the associated risk factors for many of studied lesions and anomalies.

Black-Tongued Witch – Really?

Black hairy tongue (BHT) also known as Lingua villosa nigra is an acquired, benign condition which is characterized by abnormally hypertrophied and elongated papilliform papillae on the dorsal surface of the tongue. Apart from black; it may also appear brown, yellow, green or blue. BHT typically causes aesthetic concerns to the patient. Gagging, nausea, dysgeusia, xerostomia, burning mouth syndrome and halitosis can be the very rare presenting complaints in some patients. In India, however, black tongue is believed to associate with witches and unfortunate doom spellers. We are reporting a case of olanzapine induced BHT who became a victim of very popular but irrational myth in Indian society.

Lengua negra vellosa / Beautiful black tongue

La lengua negra vellosa es una patología benigna relativamente frecuente, caracterizada por una coloración pardo-negruzca de la superficie lingual asociada a hipertrofia de papilas filiformes dando aspecto de vellosidades. Los factores de riesgo son amplios y de exposición cotidiana (antibióticos, alcohol, tabaco, higiene dental deficiente). Entre sus diagnósticos diferenciales es útil recordar aquellos asociados con neoplasias o inmunocompromiso (acantosis nigricans oral, leucoplasia vellosa, etc.). Su diagnóstico es clínico; sin embargo, cuando las causas o historia no son claras, la exploración clínica es atípica o hay refractariedad sistemática a los tratamientos habituales, se debe plantear un estudio ampliado (AU)

Black hairy tongue is a relatively common benign disease, characterized by brown-black discoloration and hypertrophic tongue surface, giving aspect of villi. Risk factors are broad and from daily exposure (antibiotics, alcohol, tobacco, poor dental hygiene). Among its differential diagnoses it is useful to recall those associated with malignancies or immunocompromise (oral acanthosis nigricans, hairy leukoplakia, etc.). Diagnosis is clinical, but when the causes are unclear, history or clinical examination is atypical, or treatment is refractory, it should be considered an extended study (AU)

Black Hairy Tongue Associated with Erlotinib Treatment in a Patient with Advanced Lung Cancer

Erlotinib is a tyrosine kinase inhibitor that acts on the epidermal growth factor receptor (EGFR). There have been many reports of the mucocutaneous side effects related to several EGFR inhibitors (EGFRIs). However, no case of black hairy tongue (BHT) associated with EGFRI has been reported. Herein, we report the first case of erlotinib-induced BHT in a 61-year-old man with advanced lung cancer. Considering recent use of EGFRIs worldwide, dermatologists should recognize the possible occurrence of BHT associated with EGFRIs such as erlotinib.

A Case of Black Hairy Tongue / 대한피부과학회지

Black hairy tongue occurs on the dorsum of the tongue, and is characterised by a black, yellowish, or brown plaque with hairlike structures which result from benign hyperkeratosis of the filiform papillae. It may be associated with several conditions such as smoking, oral antibiotics or candida infection. However, the definite etiology is unknown. We report a case of black hairy tongue without any associated condition.

A Case of Black Hairy Tongue following the Use of Psychotropic Agents / 대한피부과학회지

Black hairy tongue is a benign skin condition characterized by dark brown or black patches on the tongue, due to hypertrophied filiform papillae. Although the cause of the disease is uncertain, there are several predisposing factors such as poor oral hygiene, smoking and medication. Herein, we report a case of black hairy tongue that developed after the use of psychotropic agents

A Case of Black Hairy Tongue Associated with Minocycline / 대한피부과학회지

Black hairy tongue is the name given to the appearance of an abnormal coating of the tongue and occurs in adults. It is the result of hyperkeratosis of the filiform lingual papillae which, on gross examination appear hair-like with a variable tinctorial aspect from yellow-brown to black. The pathogenesis is unknown. A number of etiologic factors have been implicated including the administration of topical or systemic antibiotics, poor hygiene, smoking, alcohol and the use of mouthwashes. We report a case of black hairy tongue that may be associated with oral administration of minocycline.

A Case of Black Hairy Tongue / 대한피부과학회지

Black hairy tongue is a benign disorder characterized by hypertrophy of the filiform papillae of the tongue. A brownish-black discoloration of papillae occurs. the etiology is unclear, but the disorder has been associated with numerous predisposing conditions such as poor oral hygiene, medication, and smoking. Herein we report a case of black hairy tongue and it was successfully treated with simple brushing.