Psychotropic agent-induced black hairy tongue

Black hairy tongue is characterized by an abnormal coating of the dorsal surface of the tongue. Although the cause is unknown, several precipitating factors may be implicated in the pathogenesis of this disorder. A case is presented in which black hairy tongue appeared subsequent to the administration of fluoxetine hydrochloride, thiothixene hydrochloride, benztropine mesylate, and clonazepam for bipolar affective disorder.     

Hairy lesions of the oral cavity. Clinical and histopathologic differentiation of hairy leukoplakia from hairy tongue

Hairy leukoplakia and hairy tongue are the two most common hairlike lesions of the human tongue. Despite their hairlike appearance, the two conditions are very different clinically, histopathologically, and biologically. Those differences are the concern of this article.     

Hairy tongue and hairy oral leukoplakia--a differential histopathologic diagnosis

10 specimens taken from oral hairy leukoplakia were compared to 8 histological preparations from hairy tongue. We found 9 criteria helpful concerning the histopathologic differential diagnosis of these entities. Oral hairy leukoplakia shows a gently papillated surface, a prominent horny layer with confluent bacterial overgrowth, and ballooned epithelial cells with a distinct perinuclear halo in a bandlike arrangement. Hairy tongue, in contrast, grows exophytically with a digitiform surface, the horny layer is rather thin, and the microorganisms are confined to the ends of the digitations; the ballooned epithelial cells show pale cytoplasm. Considering the growing incidents of HIV infection, the dermatologist should be familiar with the characteristics of oral hairy leukoplakia and its histopathological differential diagnosis.     

Topical tretinoin: a new treatment for black hairy tongue (lingua villosa nigra)

Black hairy tongue is the name given to the appearance of an abnormal coating of the tongue and occurs only 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 and often no definite cause can be identified. A number of aetiologic factors have been implicated including the administration of topical or systemic antibiotics, poor oral hygiene, smoking, alcohol and the use of mouthwashes. Often there are no symptoms other than the aesthetic or anxiety over its aetiology. Some patients complain of gagging, nausea, alteration of taste or halitosis. The condition may be very persistent and recognized treatments include brushing with a soft tooth brush which is enhanced by the prior application of a 40% solution of urea, scraping, topical triamcinolone acetonide, gentian violet, thymol, salicylic acid, vitamin B complex, and surgical excision of the papillae.     

Chondroma of the tongue

Chondroma is a remarkably rare lesion of the oral soft tissues. Most previously reported chondromas of this area have been associated with varying percentages of fibrous, adipose or bone tissues, and the occurrence of such neoplasms exclusively composed of chondromatous tissue is exceedingly rare. We report the clinicopathological features of a pure chondroma of the dorsum of the tongue, occurring in a 51-year-old woman and discuss the possible origin of the tumour.     

Sarcoidosis of the tongue

A 43-year-old man with an 8-month history of swelling of the tongue is described. Biopsy of the tongue revealed numerous epithelioid cell granulomata. A positive Kveim test, elevated angiotensin converting enzyme level and bilateral hilar lymphadenopathy confirmed the diagnosis of sarcoidosis. Sarcoidosis presenting in the tongue is extremely rare.     

Eosinophilic ulcers of the tongue

A case of eosinophilic ulcer of the tongue is presented. Although the entity is rarely described, the distinctive histopathologic pattern featuring the remarkable presence of eosinophils in the superficial corium and in between muscle bundles, together with the benign clinical course, make a diagnosis possible.     

Embryonal rhabdomyosarcoma of the tongue

We report a 10-month-old girl who, at 4 months, developed a small, reddish, plaquelike lesion on her tongue. This lesion began to enlarge rapidly, resulting in difficulty in swallowing and breathing. On physical examination, there was a large, red, friable, hard in consistency, irregular tumor over the distal portion of her tongue. The histopathology and immunohistochemical findings were consistent with an embryonal rhabdomyosarcoma. The patient was assigned clinical stage I, group III, and began treatment according to the Intergroup Rhabdomyosarcoma Study guidelines, on triple-agent chemotherapy consisting of vincristine, actinomycin D, and cyclophosphamide. She only received four cycles because her parents then refused this treatment. After the tumor size was reduced by chemotherapy, a partial anterior glossectomy was performed. After 30 months of follow-up she has had no recurrences.     

Leprosy of the tongue.

Ten out of the twenty-five lepromatous leprosy patients studied showed clinical evidence of involvement of the tongue, and they presented with various symptoms like loss of taste, stiffness of tongue, bleeding, pain etc. Various types of lesions ranging from small nodule to granuloma formation, ulceration, macroglossia and fissured cracked tongue were noted. The tongue lesions were found to be related to the severity of leprosy.