to whom it may concern,
I am a medical student in columbia, sc and have a patient that is 80 yrs
old and has a problem with a black tongue that has decreased appetite.
no N/V/D. it began about 2 weeks ago and has no other associated symptoms.
she was just recently on abx for uti. could you at least provide a
differential diagnosis for me with this limited history.
Answer ------
Most likely, the condition described is known as "black hairy tongue". It is characterized by a black discoloration of the posterior 1/2 of the oral tongue and has the appearance of hair growth. It is a condition of unknown etiology but is innocuous. Microscopically it features hypertrophied papillae with keratinization. It is generally asymptomatic or patients will complain of a "coating" on their tongue. If bothersome the use of a worn toothbrush and a saline-baking soda solution can be used to gently scrub the area a couple times daily until gone.
Another less likely possibility is that is may be some type of fixed drug reaction to an antibiotic which would likely resolve with conclusion of the medication.
--
Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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