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Acta Otorrinolaringológica Española
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Inicio Acta Otorrinolaringológica Española Black hairy tongue
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Vol. 68. Núm. 6.
Páginas 374 (Noviembre - Diciembre 2017)
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Vol. 68. Núm. 6.
Páginas 374 (Noviembre - Diciembre 2017)
Images in Otorhinolaryngology
DOI: 10.1016/j.otorri.2016.10.002
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Black hairy tongue
Lengua vellosa negra
Kenta Watanabe
Department of Otolaryngology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan
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We herein present a typical image of the black hairy tongue in a patient who had been given an anticancer agent for an extended period of time.

A 71-year-old man was referred to our department for the evaluation of a black lesion of the tongue that was found incidentally during a periodic fiberoptic gastroscope examination. The patient had undergone distal gastrectomy for gastric cancer two years prior and had been given a combination drug of tegafur, gimeracil, and oteracil potassium for multiple liver metastases for one year and ten months. Although he had no oral symptoms, the central part of his dorsum linguae appeared to be blackly carpeted (Fig. 1). Black hairy tongue was diagnosed. Oral care with tongue brushing and quitting smoking were indicated. Without withdrawal of the anticancer drug, collutorium with amphotericin B was also prescribed because a culture of the smeared specimen from the tongue had grown Candida glabrata. At a 4-week follow-up visit, the black lesion had dramatically attenuated.


Black hairy tongue, which is asymptomatic in many cases, is characterized by hypertrophy, elongation, and hyperpigmentation of the filiform papillae of the tongue surface. It is suggested that this condition can occur in patients with poor oral hygiene, tobacco use, excessive alcohol intake, and chronic dry mouth. Although the exact etiology is unclear in this case, it is also reported that antibiotics and drugs causing xerostomia can induce black hairy tongue.

Copyright © 2016. Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello
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