RT Book, Section
A1 Jauch, Edward C.
A1 Valdez, J. Amadeo
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181040735
T1 Black Hairy Tongue
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1181040735
RD 2024/04/20
AB Black  hairy  tongue  (BHT)  represents  a  benign  reactive  process  characterized  by  hyperplasia  and  dark  pigmentation  of  the  tongue’s  filiform  papillae.  The  elongated  filiform  papillae  may  reach  up  to  2  cm  in  length  and  vary  in  actual  degree  of  pigmentation  from  light  tan  to  black.  Predisposing  factors  include  excessive  smoking,  gastroesophageal  reflux,  poor  oral  hygiene,  chemotherapy,  and  the  use  of  broad-spectrum  oral  antibiotics.  Pigment  from  consumed  food,  beverages,  and  tobacco  products  stains  the  entrapped  food  debris  and  desquamated  papillary  keratin.  Some  antibiotics  may  alter  normal  oral  microflora  and  promote  the  growth  of  chromogenic  organisms,  also  contributing  to  the  tongue’s  discoloration.  The  darkly  pigmented  filament-like  papillae  give  the  tongue  a  black,  hairy  appearance.  Males  are  more  often  affected  than  females;  this  condition  very  rarely  occurs  in  children.  Patients  with  BHT  frequently  note  alterations  of  taste  perception  and  fetid  breath.