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Llus Nisa, MD
, Roland Giger, MD
Department of Otolaryngology, Hpital de Sion, Sion, Switzerland
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DOI: http://dx.doi.org/10.1016/j.amjmed.2011.01.029
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A 62-year-old man, known for alcohol and tobacco abuse, was diagnosed with laryngeal squamous cell carcinoma in
2008. He underwent curative radiotherapy (70 Gy), delivered to the laryngeal and oropharyngeal area as well as the neck.
Follow-up 4 months after this treatment showed recurrence, for which we performed total laryngectomy and bilateral neck
dissection.
Eight months after surgery he was doing well and presented no recurrence, but physical examination showed thick black
hairy lesions on the back of his tongue (Figure). These lesions had appeared and quickly evolved 4 weeks before the
consultation, with no associated symptoms such as pain, dysphagia, or dysgeusia. The patient had not received
antibiotics in the last months. Bacterial and fungal cultures of tongue swab were negative. Basic blood tests showed no
particularity. Thus, we diagnosed the patient with black hairy tongue.
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Figure
Black hairy tongue, poor oral hygiene.
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Because hairy tongue is a benign and self-limiting disorder, the first therapeutic action consists of eradicating
predisposing factors. Mechanical removal of the lesions, by brushing or scraping, can be very effective. Finally, some
medications such as retinoids, urea solutions, and keratolytic agents can be efficiently used to treat hairy tongue.3, 7
References
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Villosa Nigra
Marwan Refaat, Emily Hyle,
Rajeev Malhotra, Dominika
Seidman, Bimalangshu Dey
The American Journal of
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3. McGrath, E.E., Bardsley, P., and Basran, G. Black hairy tongue: what is your call?. CMAJ. 2008; 178: 11371138
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5. Redman, R.S. Prevalence of geographic tongue, fissured tongue, median rhomboid glossitis, and hairy tongue
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6. Kullaa-Mikkonen, A., Mikkonen, M., and Kotilainen, R. Prevalence of different morphologic forms of the human
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7. Poulopoulos, A.K., Antoniades, D.Z., Epivatianos, A. et al. Black hairy tongue in a 2-month-old infant. J Paediatr
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