1
|
Sun KW, Yang ZC. Long-term use of triple antibiotic-induced black hairy tongue: A case report. SAGE Open Med Case Rep 2023; 11:2050313X231204136. [PMID: 37799293 PMCID: PMC10548800 DOI: 10.1177/2050313x231204136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
Black hairy tongue is a rare condition, characterized by a black discoloration and hair-like structure appearing on the dorsal surface of the tongue. The mechanism of black hairy tongue remains unclear but could be predisposed by multiple factors. We described a case of a 53-year-old Chinese female with a diagnosis of bronchiectasis complicated with Mycobacterium abscessus infection, and a triple antibiotic regimen was prescribed for the infection. One month later, a black hairy tongue appeared. The clinical pharmacist was consulted to investigate the association of medication-related factors by the attending clinician, and the clinical pharmacist identified the potential cause and suggested an appropriate treatment for the black hairy tongue. The black hairy tongue disappeared and did not recur during subsequent treatment.
Collapse
Affiliation(s)
- Kin-Weng Sun
- Pharmacy Department, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Zhi-Cheng Yang
- Pharmacy Department, The University of Hong Kong Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
2
|
Kano Y. Black Tongue Discoloration. JAMA 2023:2805120. [PMID: 37171814 DOI: 10.1001/jama.2023.5894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
An 80-year-old man developed asymptomatic black discoloration of the dorsal surface of his tongue 1 week after hospitalization for surgical and antibiotic treatment of septic arthritis of the shoulder. He reported no prior lingual discoloration and did not smoke cigarettes, use chewing tobacco or illicit drugs, or drink alcohol. What is the diagnosis and what would you do next?
Collapse
Affiliation(s)
- Yasuhiro Kano
- Department of Emergency and General Medicine, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| |
Collapse
|
3
|
Mahadi AR, Majumder MI. Black‐brown hairy tongue: An unusual adverse effect of linezolid. PRECISION MEDICAL SCIENCES 2022. [DOI: 10.1002/prm2.12083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
|
4
|
Black Hairy Tongue Associated With Olanzapine Use in a Female Dementia Patient: A Case Report. J Clin Psychopharmacol 2022; 42:211-214. [PMID: 34935654 DOI: 10.1097/jcp.0000000000001503] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
5
|
Sivaraman S, Gomathi Radhakrishnan G, Manogaran R, Cheriyan BV. An uncommon side effect of linezolid: Black hairy tongue. PRECISION MEDICAL SCIENCES 2021. [DOI: 10.1002/prm2.12053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Shanmugapriyan Sivaraman
- Department of Pharmacology Meenakshi Medical College and Research Institute, MAHER Chennai India
| | | | - Rajesh Manogaran
- Department of Pharmacology Muthukumaran Medical College and Research Institute Chennai India
| | - Binoy Varghese Cheriyan
- Crescent School of Pharmacy B.S. Abdur Rahman Crescent Institute of Science and Technology Vandalur Chennai India
| |
Collapse
|
6
|
Diode Laser Surgery as a Conservative Management of Hairy Tongue Lesion Resistance to Treatment. Case Rep Dent 2021; 2021:5656884. [PMID: 34950519 PMCID: PMC8691999 DOI: 10.1155/2021/5656884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 12/05/2021] [Indexed: 11/29/2022] Open
Abstract
Hairy tongue is a furry appearance on the dorsum surface of the tongue with variable colors. This lesion is due to defective shedding of filiform papillae. Various treatments are proposed for this condition like keratolytic agents, surgical procedure with a scalpel, or laser application. In this case study, we reported successful treatment of hairy tongue with a diode laser. The diode laser with wavelength 810 nm, power of 4 watts, a pulse width of 20 milliseconds, and an interval of 20 milliseconds by a 400-micron optical fiber was selected for treatment of this lesion. There was no bleeding during this minimally invasive surgery, and the patient experienced a low level of pain. Loss of taste function was completely resolved. Based on the result of this study, a diode laser can be a good alternative for minimally invasive surgical treatment of hairy tongue.
Collapse
|
7
|
Lee J, Chung HS, Roh J, Oh Y, Mok J. Linezolid-induced black hairy tongue in a patient with multidrug-resistant tuberculosis: A case report. Sci Prog 2021; 104:368504211042982. [PMID: 34541939 PMCID: PMC10461435 DOI: 10.1177/00368504211042982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The revised World Health Organization guidelines on multidrug-resistant tuberculosis include linezolid in the core drugs group. Consequently, the use of linezolid for patients with multidrug-resistant tuberculosis is increasing. Common adverse events of long-term linezolid use include bone marrow suppression and neuropathies. However, there is limited information on a rare adverse event, black hairy tongue. Here, we report a case of linezolid-induced black hairy tongue in a patient with multidrug-resistant tuberculosis. The etiology, pathogenesis, diagnosis, and treatment of black hairy tongue are also discussed.
Collapse
Affiliation(s)
- Jaemin Lee
- Department of Internal Medicine, Busan Adventist Hospital, Republic of Korea
| | - Hyun Sung Chung
- Division of Pulmonology, Center for Lung
Cancer, National Cancer Center, Republic of Korea
| | - Jiyeon Roh
- Department of Internal Medicine, Pusan National University Hospital, Republic of Korea
| | - Yeseul Oh
- Department of Internal Medicine, Pusan National University Hospital, Republic of Korea
| | - Jeongha Mok
- Department of Internal Medicine, Pusan National University Hospital, Republic of Korea
- Pusan National University School of
Medicine, Republic of Korea
- Biomedical Research Institute, Pusan National University Hospital, Republic of Korea
| |
Collapse
|
8
|
Liu Y, Sung YF, Li SY. An Uncommon Case of Black Hairy Tongue Induced by Antibiotics. Am J Med Sci 2021; 362:e31-e32. [PMID: 33974853 DOI: 10.1016/j.amjms.2021.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 02/08/2021] [Accepted: 04/28/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Yi Liu
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Szu-Yuan Li
- Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| |
Collapse
|
9
|
Cecchi C, Mariniello A, Carnio S, Delcuratolo MD, Novello S. Black Hairy Tongue After Immune Checkpoint Inhibitors in NSCLC: A Case Report and Review of the Literature. Clin Lung Cancer 2021; 22:e804-e807. [PMID: 33903029 DOI: 10.1016/j.cllc.2021.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/27/2021] [Accepted: 03/18/2021] [Indexed: 12/29/2022]
Affiliation(s)
- Cristina Cecchi
- Department of Oncology at San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Annapaola Mariniello
- Department of Oncology at San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy.
| | - Simona Carnio
- Department of Oncology at San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Marco D Delcuratolo
- Department of Oncology at San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| | - Silvia Novello
- Department of Oncology at San Luigi Gonzaga University Hospital, University of Torino, Turin, Italy
| |
Collapse
|
10
|
Chen TH, Yu HT, Wu CH, Lin CC. Black hairy tongue in an end-stage renal disease patient. J Formos Med Assoc 2021; 120:1531-1532. [PMID: 33388236 DOI: 10.1016/j.jfma.2020.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022] Open
Affiliation(s)
- Tz-Heng Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital Fenglin Branch, Hualien, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Tzu Yu
- Department and Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Hsing Wu
- Department of Pharmacy, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Ching Lin
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| |
Collapse
|
11
|
Karthikeyan K, Iswarya A. Linezolid-induced black hairy tongue. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2021. [DOI: 10.4103/ijdd.ijdd_48_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
12
|
Owczarek-Drabińska JE, Radwan-Oczko M. A Case of Lingua Villosa Nigra (Black Hairy Tongue) in a 3-Month-Old Infant. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e926362. [PMID: 33361746 PMCID: PMC7774497 DOI: 10.12659/ajcr.926362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/05/2020] [Accepted: 09/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Black hairy tongue is a self-limiting, usually asymptomatic, benign lesion that most often affects men and people aged over 30-40 years. The lesion is extremely rare among newborns and infants. Lingua villosa nigra is characterized by the presence of elongated filiform papillae of the dorsum of the tongue, which gives a hairy appearance. The overgrown papillae can accumulate fungi, bacteria, pigments originating from food, or any other debris that can contribute to the discoloration of the tongue. The prognosis for black hairy tongue is positive. Gentle tongue brushing or scraping as well as the elimination of predisposing factors usually leads to cessation of the lesion. CASE REPORT A generally healthy, exclusively breastfed 3-month-old female baby was admitted to the Oral Pathology Department of Wrocław Medical University due to a persistent tongue lesion. Intraorally, dark, blackish, elongated tongue papillae were observed. Three weeks earlier, the baby's pediatrician had diagnosed thrush and prescribed systemic antifungal treatment with Nystatinum, without prior mycological examination. The lesion did not resolve and the girl was referred to the Department of Oral Pathology. A meticulous medical and dietary interview revealed that since the 28th day of life the baby had been supplemented with vitamin C. This, together with an intraoral examination, led to the diagnosis of black hairy tongue. The lesion disappeared partially after 4 weeks of tongue brushing. CONCLUSIONS To prevent infants from undergoing persistent and unnecessary treatment (topical or systemic drugs) or additional diagnostic procedures, such as biopsy, it is essential to be familiar with the characteristics of lingua villosa nigra as well as its origin and management. The consideration of this condition is invaluable for babies' health and safety.
Collapse
|
13
|
Politis C, Kalantary S, Van Snick E, Smeets M, Politis C. Lingua villosa nigra in a patient with a Zenker's diverticulum. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
14
|
Ren J, Zheng Y, Du H, Wang S, Liu L, Duan W, Zhang Z, Heng L, Yang Q. Antibiotic-induced black hairy tongue: two case reports and a review of the literature. J Int Med Res 2020; 48:300060520961279. [PMID: 33044871 PMCID: PMC7556181 DOI: 10.1177/0300060520961279] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Black hairy tongue (BHT) is characterized by a discolored, hairy tongue. We herein report two cases of BHT associated with antibacterial agents and review previous cases. In Case 1, a 17-year-old girl with a central neurocytoma was administered intravenous piperacillin–tazobactam for postoperative infection, and BHT developed 12 days later. Her symptoms resolved 8 days after she discontinued the piperacillin–tazobactam and brushed her tongue three times daily. In Case 2, a 65-year-old man was administered intravenous piperacillin–tazobactam and levofloxacin to treat multidrug-resistant Pseudomonas aeruginosa, and BHT developed 15 days later. The piperacillin–tazobactam was discontinued and the patient brushed his tongue, and the discoloration gradually subsided thereafter. However, the BHT reappeared after linezolid treatment. The patient had adverse drug reactions to both the piperacillin–tazobactam and linezolid treatments. The BHT might have been related to antibiotic use in both cases. We identified 19 cases of antibiotic-related BHT in a literature search, but none were related to piperacillin–tazobactam use. In all cases, symptoms resolved after discontinuation of the drug and brushing of the tongue. BHT may be a rare adverse effect of antibiotics. Treatment strategies include removal of the causative agents, mechanical debridement, and good oral hygiene.
Collapse
Affiliation(s)
- Jing Ren
- Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
| | - Yao Zheng
- Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
| | - Hui Du
- Xi'an Institute for Food and Drug Control, Xi'an, Shaanxi, China
| | - Shan Wang
- Department of Pharmacy, NYU Winthrop Hospital, Mineola, NY, USA
| | - Linna Liu
- Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
| | - Wanshi Duan
- Department of Thoracic surgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
| | - Zeping Zhang
- Department of Neurosurgery, Baoji Traditional Chinese Medicine Hospital, Baoji, Shaanxi, China
| | - Lijun Heng
- Department of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
| | - Qi Yang
- Department of Pharmacy, The Second Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China
| |
Collapse
|
15
|
Luo S, Luo Q, Gao X, Li J. Adverse reaction report and retrospective analysis of black hairy tongue caused by linezolid. Respir Med Case Rep 2020; 31:101159. [PMID: 32944496 PMCID: PMC7481254 DOI: 10.1016/j.rmcr.2020.101159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/16/2020] [Accepted: 07/03/2020] [Indexed: 11/19/2022] Open
Abstract
The adverse reaction of Black Hairy Tongue (BHT) caused by linezolid is rare. We reports a case of linezolid-induced BHT, and reviews relevant literatures at home and abroad. It aims to provide a safe and reasonable basis for clinical medication use. A 14-year-old adolescent with pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) developed a rash and pruritus due to Vancomycin. Instead, the patient was given linezolid 600mg q12h in injection during hospitalization and in tablet after discharge. On the 14th day after injection and the second day after oral administration the patient showed BHT without other abnormal taste symptoms. But all the symptoms could be tolerated and he completed the therapy course of linezolid. Tongue symptoms completely disappeared on the 8th day after drug withdrawal. Based on the Karch and Lasagna evaluation methods and the cause-and-effect evaluation methods of the WHO collaborating center for international adverse drug reaction (ADR) monitoring, it is likely that this patient had a BHT caused by linezolid. The mean time of occurrence of BHT was 14.36 days, and the mean time of symptom disappearance was 23.43 days after drug administration. When linezolid is prescribed to patients, especially those with atopy, the patient's tongue should be closely observed and good oral hygiene is recommended.
Collapse
Affiliation(s)
- Shaohua Luo
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
| | - Qian Luo
- Department of Pharmacy, The Fifth Affiliated Hospital of Guangzhou Medical University, China
- Corresponding author. 621 Gangwan Rd, Huangpu District, Guangzhou, 510700, Guangdong, China.
| | - Xinglin Gao
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
| | - Jing Li
- Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, China
| |
Collapse
|
16
|
Teoh L, Stewart K, Moses G. Where are oral and dental adverse drug effects in product information? INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2020; 28:591-598. [PMID: 32614498 DOI: 10.1111/ijpp.12650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Oral adverse drug reactions are common and are associated with some of our most frequently used medicines. It is important to identify and manage oral adverse drug effects promptly as they not only negatively impact dental health, but also adversely affect medication adherence, clinical outcomes and patient quality of life. This study assessed the location of oral drug-induced adverse effects in the registered drug company product information (PI) of the top 100 most commonly used drugs in Australia as dispensed on the Pharmaceutical Benefits Scheme in 2018. METHOD Publicly available data on dispensed medicines were accessed from the Australian Commonwealth Department of Health, to determine the top 100 medicines. The drug company PI for each of these drugs was manually searched to find their oral adverse effects. The number, type and location of the oral adverse drug reactions (ADRs) were recorded. KEY FINDINGS Oral ADRs were commonly found varying in nature and severity. However, they were difficult to find as there is no dedicated section for oral/dental adverse effects in the PI and the section they are in is inconsistently applied. CONCLUSIONS We recommend that regulatory authorities such as the Therapeutic Goods Administration in Australia create an additional section for oral/dental adverse effects so they are easier to find, which may assist health professionals detect recognise and report adverse drug effects manifesting in the oral cavity.
Collapse
Affiliation(s)
- Leanne Teoh
- Melbourne Dental School, University of Melbourne, Carlton, Vic., Australia
| | - Kay Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, Vic., Australia
| | - Geraldine Moses
- School of Pharmacy, University of Queensland, Brisbane, Qld, Australia
| |
Collapse
|
17
|
Sakaguchi K, Watari T. Tetracycline‐induced black hairy tongue. J Gen Fam Med 2020; 21:80-81. [PMID: 32489761 PMCID: PMC7260164 DOI: 10.1002/jgf2.300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/08/2020] [Accepted: 01/13/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Takashi Watari
- Postgraduate Clinical Training Center Shimane University Hospital Shimane Japan
| |
Collapse
|
18
|
Teoh L, Moses G, McCullough MJ. A review and guide to drug‐associated oral adverse effects—Dental, salivary and neurosensory reactions. Part 1. J Oral Pathol Med 2019; 48:626-636. [DOI: 10.1111/jop.12911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/07/2019] [Indexed: 12/26/2022]
Affiliation(s)
- Leanne Teoh
- Melbourne Dental School The University of Melbourne Carlton Victoria Australia
| | - Geraldine Moses
- School of Pharmacy University of Queensland Woolloongabba Queensland Australia
| | | |
Collapse
|
19
|
Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions. Head Neck Pathol 2019; 13:71-79. [PMID: 30693457 PMCID: PMC6405796 DOI: 10.1007/s12105-019-01001-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/02/2019] [Indexed: 12/20/2022]
Abstract
Excluding human papillomavirus (HPV)-driven conditions, oral papillary lesions consist of a variety of reactive and neoplastic conditions and, on occasion, can herald internal malignancy or be part of a syndrome. The objectives of this paper are to review the clinical and histopathological features of the most commonly encountered non-HPV papillary conditions of the oral mucosa. These include normal anatomic structures (retrocuspid papillae, lingual tonsils), reactive lesions (hairy tongue, inflammatory papillary hyperplasia), neoplastic lesions (giant cell fibroma), lesions of unknown pathogenesis (verruciform xanthoma, spongiotic gingival hyperplasia) and others associated with syndromes (for instance Cowden syndrome) or representing paraneoplastic conditions (malignant acanthosis nigricans). Common questions regarding differential diagnosis, management, and diagnostic pitfalls are addressed, stressing the importance of clinico-pathologic correlation and collaboration.
Collapse
|
20
|
Braggio C, Bocchialini G, Ventura L, Carbognani P, Rusca M, Ampollini L. Linezolid-induced black hairy tongue. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:408-410. [PMID: 30333468 PMCID: PMC6502130 DOI: 10.23750/abm.v89i3.7060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 01/31/2018] [Indexed: 02/08/2023]
Abstract
Black hairy tongue (BHT) is a self-limiting disorder characterized by abnormal hypertrophy and elongation of filiform papillae on the surface of the tongue. The exact mechanism of drug-induced BHT is unknown. Several factors have been implicated and included smoking or chewing tobacco, drinking alcohol, poor oral hygiene and antibiotics such as tetracyclines and penicillins. We report a quite uncommon case of Linezolid-induced BHT in a patient with a long-lasting history of chest wall infection.
Collapse
Affiliation(s)
- Cesare Braggio
- Thoracic Surgery, Department of Medicine and Surgery, University Hospital of Parma.
| | | | | | | | | | | |
Collapse
|
21
|
Affiliation(s)
- Lai Yi-Chun
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan, Republic of China; Division of Chest Medicine, Department of Medicine, National Yang-Ming University Hospital, Yilan, Taiwan, Republic of China
| |
Collapse
|
22
|
Schlager E, St Claire C, Ashack K, Khachemoune A. Black Hairy Tongue: Predisposing Factors, Diagnosis, and Treatment. Am J Clin Dermatol 2017; 18:563-569. [PMID: 28247090 DOI: 10.1007/s40257-017-0268-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Black hairy tongue (BHT) is a benign condition commonly found among people who smoke, have poor oral hygiene, are immunocompromised, or have a medical condition limiting their ability to practice good oral hygiene. Though this condition is harmless, patients need to be educated on etiology as many common medications are associated with this condition. Patients being placed on certain antibiotics or antipsychotics should be educated on the importance of good oral hygiene or cessation of habits that promote BHT. Similarly, those with medical conditions increasing the risk for the development of BHT should schedule routine visits with their dentist or dental hygienist. Prognosis is good, and treatment consists of gentle brushing of the tongue, but many anecdotal reports exist demonstrating the use of medications or other products to treat this condition. This review addresses the epidemiology, clinical presentation, pathophysiology, etiology, histology, differential diagnosis, and treatment of BHT and lists all of the medications reported to cause this condition.
Collapse
Affiliation(s)
- Emma Schlager
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Chelsea St Claire
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Kurt Ashack
- College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Amor Khachemoune
- Veterans Affairs Medical Center, 800 Poly Place, Brooklyn, NY, 11209, USA.
- SUNY Downstate, Department of Dermatology, Brooklyn, NY, USA.
| |
Collapse
|
23
|
Black Hairy Tongue Associated With Lorazepam Treatment of a Male Smoker With Major Depression. J Clin Psychopharmacol 2017; 37:261-263. [PMID: 28129309 DOI: 10.1097/jcp.0000000000000661] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
24
|
Black hairy tongue after chemotherapy for malignant brain tumors. Acta Neurochir (Wien) 2017; 159:169-172. [PMID: 27878617 DOI: 10.1007/s00701-016-3036-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/15/2016] [Indexed: 12/28/2022]
Abstract
Black hairy tongue (BHT) developed in five patients (2.6%) among 192 patients undergoing chemotherapy for malignant brain tumors. Three patients with a history of diabetes mellitus developed BHT within 10 days after the initiation of chemotherapy. The other two patients suffered more than 100 days after induction and lymphopenia of grade 3 or worse developed for more than 20 days, which was not observed in the three patients with diabetes. We found that BHT could develop after chemotherapy for malignant brain tumors. Patients with diabetes mellitus presented early after chemotherapy, while patients with longstanding severe lymphopenia presented in late phase.
Collapse
|
25
|
Jain AK, Puri MM, Sarin R. Black brown discoloration and hairy tongue - A rare linezolid side effect. Indian J Tuberc 2016; 64:44-46. [PMID: 28166916 DOI: 10.1016/j.ijtb.2016.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 06/24/2016] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Linezolid was approved for clinical use for methicillin resistant Staphylococcus aureus and vancomycin-resistant Enterococci. Additionally it is used in the management of drug resistant tuberculosis. It is well-tolerated however bone marrow suppression and neuropathies may occur in patients taking this antibiotic for more than 2 weeks. Black discoloration and black hairy tongue (BHT) due to linezolid is rarely reported. We report two cases of BHT. CASE REPORTS Two patients of drug resistant pulmonary tuberculosis developed benign hairy tongue with linezolid 600mg per day. In both the cases black colored/hairy tongue was reported within 2-3 weeks of linezolid treatment. Both patients improved after withdrawal of linezolid. Subsequent reintroduction of linezolid with good oral hygiene was well tolerated and both patients completed the treatment of 2 years duration without any recurrence. CONCLUSION Black discoloration and BHT is a rare but transient adverse reaction with linezolid. Reintroduction of linezolid with good oral hygiene is well tolerated.
Collapse
Affiliation(s)
- A K Jain
- Senior Consultant National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India.
| | - Man Mohan Puri
- Chest Physician (SAG), National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| | - R Sarin
- Director, National Institute of Tuberculosis and Respiratory Diseases, New Delhi, India
| |
Collapse
|
26
|
|
27
|
Erriu M, Pili FMG, Denotti G, Garau V. Black hairy tongue in a patient with amyotrophic lateral sclerosis. J Int Soc Prev Community Dent 2016; 6:80-3. [PMID: 27011938 PMCID: PMC4784070 DOI: 10.4103/2231-0762.175408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Black hairy tongue (BHT) is a condition characterized by the elongation of filiform papillae associated with a marked discoloration, from yellowish-brown to black, and a thick lingual coating. BHT is usually observed in the elderly and in patients with limited self-sufficiency, as a consequence of poor oral hygiene. In this perspective, the patients affected by amyotrophic lateral sclerosis (ALS) represent a high-risk category for the occurrence of BHT. The fast and inexorable loss of their self-sufficiency due to progressive muscle atrophy as well as the impropriate education of healthcare assistants have demonstrated to have significant reflection on the maintenance of an adequate standard of oral hygiene. This paper firstly described a case of BHT in a patient affected by ALS. A case of BHT in a patient (Caucasic, male, 63 years old) affected by ALS was described. The primary goal of the work was to teach and motivate the patient to the use of the tongue cleaner in association with the local application of chlorexidine 0.20%. Furthermore, in order to support the patient with accurate domiciliary oral hygiene, a proper training for his health-care assistant was provided. The maintenance of the oral health of ALS patient is fundamental to prevent systemic complications that could jeopardize the already fragile physical balance of these patients. The dedicated monitoring by a dentist or a dental hygienist would seem essential in order to achieve this objective.
Collapse
Affiliation(s)
- Matteo Erriu
- Department of Surgical Science, Cagliari University, Cagliari, Italy
| | | | - Gloria Denotti
- Department of Surgical Science, Cagliari University, Cagliari, Italy
| | - Valentino Garau
- Department of Surgical Science, Cagliari University, Cagliari, Italy
| |
Collapse
|
28
|
Williams M, Hatipoglu B. Development of Abnormal Pigmentation of the Oral Mucosa Following Adjuvant Radioactive Iodine Treatment. AACE Clin Case Rep 2016. [DOI: 10.4158/ep15670.cr] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
29
|
Affiliation(s)
| | - Teresa Lee
- Inova Children's Hospital, Falls Church, VA, USA
| |
Collapse
|
30
|
Balaji G, Maharani B, Ravichandran V, Parthasarathi T. Linezolid induced black hairy tongue. Indian J Pharmacol 2015; 46:653-4. [PMID: 25538341 PMCID: PMC4264085 DOI: 10.4103/0253-7613.144942] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 05/10/2014] [Accepted: 07/27/2014] [Indexed: 01/26/2023] Open
Abstract
Black hairy tongue (BHT) also called as lingua villosa nigra, is a self limiting benign condition characterized by hypertrophy and elongation of filiform papillae of tongue with brown or black discoloration. Smoking, poor oral hygiene, xerostomia, using peroxide containing mouth washes, substance abuse and drugs (steroids, methyldopa, olanzapine, etc) are the predisposing factors. However its occurrence in relation to linezolid ingestion among south Indians has not been reported in PubMed database. Here we report a case, where significant association of linezolid intake with BHT was found in a 10-year-old boy, who was treated with tablet linezolid for post surgical infection of left side radial neck fracture. This case is reported for the rarity of occurrence with linezolid therapy. According to Naranjo adverse drug reaction (ADR) causality scale, the association of BHT due to linezolid in our case was probable.
Collapse
Affiliation(s)
- Govindan Balaji
- Department of Dermato-Venereology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India
| | - B Maharani
- Department of Pharmacology, Annapoorana Medical College and Hospitals, Salem, Tamil Nadu, India
| | - Velappan Ravichandran
- Department of Dermato-Venereology, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India
| | - Thiyagarajan Parthasarathi
- Department of Orthopedics, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India
| |
Collapse
|
31
|
Vigarios E, de Bataille C, Boulanger M, Fricain JC, Sibaud V. [Normal variations in lingual soft tissue]. Ann Dermatol Venereol 2015. [PMID: 26195280 DOI: 10.1016/j.annder.2015.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- E Vigarios
- Médecine bucco-dentaire, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer de Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France; UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France.
| | - C de Bataille
- UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France; Médecine bucco-dentaire, hôpital Rangueil, CHU de Toulouse, 3, rue des Maraîchers, 31059 Toulouse cedex 9, France
| | - M Boulanger
- UFR d'odontologie, 3, rue des Maraîchers, 31062 Toulouse, France; Chirurgie orale, institut Claudius-Regaud, institut universitaire du cancer de Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| | - J-C Fricain
- Chirurgie orale, consultation pluridisciplinaire de pathologies de la muqueuse buccale, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France; UFR d'odontologie, 16-20, cours de la Marne, 33082 Bordeaux cedex, France
| | - V Sibaud
- Dermatologie, consultation pluridisciplinaire de pathologies de la muqueuse buccale, institut Claudius-Regaud, institut universitaire du cancer de Toulouse Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France
| |
Collapse
|
32
|
Nakajima M, Mizooka M, Tazuma S. Black hairy tongue treated with oral antibiotics: a case report. J Am Geriatr Soc 2015; 63:412-3. [PMID: 25688627 DOI: 10.1111/jgs.13260] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Masamitsu Nakajima
- Department of General Internal Medicine, Hiroshima University Hospital, Hiroshima, Japan; Faculty of Health Sciences, Hiroshima International University, Hiroshima, Japan
| | | | | |
Collapse
|
33
|
Madani FM, Kuperstein AS. Normal variations of oral anatomy and common oral soft tissue lesions: evaluation and management. Med Clin North Am 2014; 98:1281-98. [PMID: 25443677 DOI: 10.1016/j.mcna.2014.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Examination of the oral cavity can provide significant diagnostic information regarding the general health of the patient. The oral cavity is affected by a multitude of pathologic conditions of variable cause and significance; however, there are numerous normal variations of oral soft tissue structures that may resemble a pathologic state. Understanding these variations assists practitioners to discriminate between normal versus abnormal findings and determine the appropriate course of management, if necessary.
Collapse
Affiliation(s)
- Farideh M Madani
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Arthur S Kuperstein
- Oral Medicine Clinical Services, Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| |
Collapse
|
34
|
Gurvits GE, Tan A. Black hairy tongue syndrome. World J Gastroenterol 2014; 20:10845-50. [PMID: 25152586 PMCID: PMC4138463 DOI: 10.3748/wjg.v20.i31.10845] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 03/08/2014] [Accepted: 04/27/2014] [Indexed: 02/07/2023] Open
Abstract
Black hairy tongue (BHT) is a benign medical condition characterized by elongated filiform lingual papillae with typical carpet-like appearance of the dorsum of the tongue. Its prevalence varies geographically, typically ranging from 0.6% to 11.3%. Known predisposing factors include smoking, excessive coffee/black tea consumption, poor oral hygiene, trigeminal neuralgia, general debilitation, xerostomia, and medication use. Clinical presentation varies but is typically asymptomatic, although aesthetic concerns are common. Differential diagnosis includes pseudo-BHT, acanthosis nigricans, oral hairy leukoplakia, pigmented fungiform papillae of the tongue, and congenital melanocytic/melanotic nevi/macules. Clinical diagnosis relies on visual observation, detailed history taking, and occasionally microscopic evaluation. Treatment involves identification and discontinuation of the offending agent, modifications of chronic predisposing factors, patient's re-assurance to the benign nature of the condition, and maintenance of adequate oral hygiene with gentle debridement to promote desquamation. Complications of BHT (burning mouth syndrome, halitosis, nausea, gagging, dysgeusia) typically respond to therapy. Prognosis is excellent with treatment of underlying medical conditions. BHT remains an important medical condition which may result in additional burden on the patient and health care system and requires appropriate prevention, recognition and treatment.
Collapse
|
35
|
Kannan S, Muthusamy S, Chandrasekaran B, Gopal D, Sidhu P. Black Hairy Tongue in Older Edentulous Individuals. J Am Geriatr Soc 2014; 62:992-4. [PMID: 24828937 DOI: 10.1111/jgs.12813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Sathya Kannan
- Faculty of Dentistry; AIMST University; Kedah Malaysia
| | | | | | - Deepika Gopal
- Faculty of Dentistry; AIMST University; Kedah Malaysia
| | - Preena Sidhu
- Faculty of Dentistry; AIMST University; Kedah Malaysia
| |
Collapse
|
36
|
Khasawneh FA, Moti DF, Zorek JA. Linezolid-induced black hairy tongue: a case report. J Med Case Rep 2013; 7:46. [PMID: 23414605 PMCID: PMC3582625 DOI: 10.1186/1752-1947-7-46] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 11/16/2012] [Indexed: 02/07/2023] Open
Abstract
UNLABELLED INTRODUCTION Linezolid-induced black hairy tongue has been rarely reported. The purpose of this paper is to report a case of linezolid-induced black hairy tongue and review the literature. CASE PRESENTATION A 56-year-old Caucasian man was admitted with community-acquired pneumonia that failed to respond to levofloxacin 750mg daily. He was started on linezolid and meropenem and was subsequently discharged home on oral linezolid 600mg every 12 hours and intravenous ertapenem 1g daily. On a follow-up clinic visit, day 14 of linezolid therapy, he complained of dysgeusia and his tongue examination was consistent with black hairy tongue. After he finished his antibiotic course, his complaints resolved with regular tongue brushing. CONCLUSION Black hairy tongue is characterized by abnormal hypertrophy and elongation of filiform papillae. Five reported cases of linezolid-induced black hairy tongue were identified in a MEDLINE search (from January 2000 to June 2012). The Naranjo Probability Scale revealed a probable adverse drug reaction of linezolid-induced black hairy tongue. Potential contributing factors included other antibiotics, drug-drug interaction and poor oral hygiene. Health care professionals should be aware of the possibility of linezolid-induced black hairy tongue. Thorough history for other possible contributing factors should be obtained. Patients on linezolid should be counseled to perform good oral hygiene.
Collapse
Affiliation(s)
- Faisal Abdullah Khasawneh
- Section of Infectious Diseases, Department of Internal Medicine, School of Medicine, Texas Tech University Health Sciences Center, Amarillo, TX, USA.
| | | | | |
Collapse
|
37
|
[Black hairy tongue in an infant]. An Pediatr (Barc) 2012; 77:209-10. [PMID: 22421412 DOI: 10.1016/j.anpedi.2011.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Revised: 07/06/2011] [Accepted: 08/05/2011] [Indexed: 01/28/2023] Open
|
38
|
Affiliation(s)
- Andreas Körber
- Department of Dermatology, University of Essen, Essen, Germany.
| | | |
Collapse
|
39
|
Jeong JS, Lee JY, Kim MK, Yoon TY. Black hairy tongue associated with erlotinib treatment in a patient with advanced lung cancer. Ann Dermatol 2011; 23:526-8. [PMID: 22148027 PMCID: PMC3229953 DOI: 10.5021/ad.2011.23.4.526] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2010] [Revised: 12/18/2010] [Accepted: 12/18/2010] [Indexed: 12/15/2022] Open
Abstract
Erlotinib is a tyrosine kinase inhibitor that acts on the epidermal growth factor receptor (EGFR). There have been many reports of the mucocutaneous side effects related to several EGFR inhibitors (EGFRIs). However, no case of black hairy tongue (BHT) associated with EGFRI has been reported. Herein, we report the first case of erlotinib-induced BHT in a 61-year-old man with advanced lung cancer. Considering recent use of EGFRIs worldwide, dermatologists should recognize the possible occurrence of BHT associated with EGFRIs such as erlotinib.
Collapse
Affiliation(s)
- Jin Seob Jeong
- Department of Dermatology, School of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea
| | | | | | | |
Collapse
|