Black Hairy Tongue Syndrome: Case Report and Review of the Literature
Abstract
1. Introduction
1.1. Pathogenesis
1.2. Epidemiology-Causes
1.2.1. Poor Oral Hygiene
1.2.2. Dry Mouth
1.2.3. Tobacco Use
1.2.4. Frequent Consumption of Certain Foods and/or Beverages
1.2.5. Antibiotics and Other Medications
1.2.6. Immune Suppression
1.2.7. Individual Risk
1.3. Management
- Mouth rinses and light scraping with diluted hydrogen peroxide or other antiseptic agents. These rinses can help reduce the bacterial load and remove the hyperkeratotic papillae. Care is necessary, as excessive use of local agents can cause oral irritation, damage to oral tissues, or disturbance in the natural oral microbial balance [7].
- Topical antifungals. In some cases, topical antifungal medications may be used if an overgrowth of fungi, such as Candida, is suspected or confirmed. However, it should be noted that only a small proportion of cases are directly associated with fungal infection.
2. Case Presentation
3. Discussion
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Author, Year | Cases (n) | Presentation | Comorbidities | Exposures | Culture Results | Treatment | Resolution |
---|---|---|---|---|---|---|---|
Bedford P.D., 1946 [8] | 2 | Sore throat, dry cough, hoarseness, malaise | NA | Tobacco smoking Penicillin topical | NA | None | Resolution |
Wolfson S.A., 1949 [9] | 4 | Tongue discoloration, Bronchitis | NA | Penicillin topical and systemic | Candida spp. (1 case) | Penicillin discontinued, Mouth rinses | Resolution |
Langtry J.A., 1992 [10] | 3 | Tongue discoloration, Dysgeusia | Cystitis 6+ months ago | Tobacco smoking Antibiotics | NA | Nystatin suspension, Miconazole oral gel, Hexetidine mouthwash, Topical tretinoin 0.025% | Resolution |
Greco S., 1997 [11] | 3 | Glossitis with associated black tongue | Helicobacter pylori infection, peptic ulcer disease | Lansoprazole (60 mg/d) Clarithromycin (1 g/d) | NA | Antibiotic treatment discontinued | Resolution |
Akay B.N., 2010 [12] | 15 | Xerostomia | AML, NHL, Primary myelofibrosis, ALL, HL, MDS, CLL | Bu-Cy, CsA, MTX SCT, MMF, sertraline, TMP-SMX, UDCA | Negative | NA | NA |
Kannan S., 2014 [13] | 5 | Asymptomatic | Edentulism | Tobacco smoking | NA | Dentures | Improvement |
Jain A.K., 2017 [14] | 2 | Tongue discoloration | TB infection | Injection capreomycin, cycloserine, moxifloxacin, linezolid, ethionamide, PAS | NA | Linezolid withheld, Tongue brushing | Resolution |
Yamagishi Y., 2017 [15] | 5 | Paresis of left limb | Reflux esophagitis, DM, Malignant brain tumor | Radiotherapy, Corticosteroids, MTX | C. albicans (2 cases) | Tongue brushing | Improvement |
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Tsioutis, C.; Symvoulidis, P.; Haralambous, M.S.; Lambrianides, S.; Zavridis, P.; Papakostas, P.; Agouridis, A.P. Black Hairy Tongue Syndrome: Case Report and Review of the Literature. BioMed 2025, 5, 22. https://doi.org/10.3390/biomed5040022
Tsioutis C, Symvoulidis P, Haralambous MS, Lambrianides S, Zavridis P, Papakostas P, Agouridis AP. Black Hairy Tongue Syndrome: Case Report and Review of the Literature. BioMed. 2025; 5(4):22. https://doi.org/10.3390/biomed5040022
Chicago/Turabian StyleTsioutis, Constantinos, Panagiotis Symvoulidis, Marilena Solonos Haralambous, Sakis Lambrianides, Periklis Zavridis, Paris Papakostas, and Aris P. Agouridis. 2025. "Black Hairy Tongue Syndrome: Case Report and Review of the Literature" BioMed 5, no. 4: 22. https://doi.org/10.3390/biomed5040022
APA StyleTsioutis, C., Symvoulidis, P., Haralambous, M. S., Lambrianides, S., Zavridis, P., Papakostas, P., & Agouridis, A. P. (2025). Black Hairy Tongue Syndrome: Case Report and Review of the Literature. BioMed, 5(4), 22. https://doi.org/10.3390/biomed5040022