causes of black pigmentation on tongue

Medically Reviewed By Colgate Global Scientific Communications. Protesters lined the hallways before entering the galleries of the House and Senate chambers, chanting and shouting. It is not intended to be a substitute for professional advice, diagnosis or treatment. It's caused by proliferation of malignant melanocytes within the connective tissues. The management of these depend on the severity and can be removed by surgical, radiation or drug therapy i.e. Studies have demonstrated 5year survival rates of 1540%.43,44 Involvement of the palate is predictive of the worst prognosis compared to other intraoral sites.49 Regional lymphatic metastases are frequently identified and contribute to the poor survival rate.50 Less than 10% of patients with distant metastases survive after 5 years.44 The 10year survival rate is 0%.51. Source: Based on Muller S. Melaninassociated pigmented lesions of the oral mucosa: presentation, differential diagnosis, and treatment. YYYY Colgate-Palmolive Company. Figure 510 Cutaneous macular melanoma fulfilling the ABCDE criteria. Figure 512 (A) Malignant melanoma exhibiting macular involvement of the anterior hard palate. Clinically presentation of melanotic macules are typically a brown, black, blue or grey area that is well circumscribed, lesions are usually less than 10mm in diameter but can be larger in some cases. Although lesions may present over a wide age range, the majority occur between the third and fourth decades of life. The skin lesions themselves do not cause symptoms. However, lasers allow for controlled cutting with a limited depth of necrosis. A pale and smooth tongue can be caused by iron deficiency anemia Iron Deficiency Anemia Iron deficiency anemia results from low or depleted stores of iron, which is needed to produce red blood cells. Some medications can cause generalized patchy hyperpigmentation of the tongue and oral mucosa. The cause may be a reaction to certain drugs read more (an itchy skin disease that can also affect the mouth), Leukoplakia Precancerous changes in the mouth (a flat white spot that develops as a result of prolonged irritation), Rubbing against a sharp tooth edge or broken filling. Melanin is then transferred to keratinocytes in melanosomes. Brought to you by Merck & Co, Inc., Rahway, NJ, USA (known as MSD outside the US and Canada)dedicated to using leading-edge science to save and improve lives around the world. Studies have demonstrated 5year survival rates of 1540%. 1,5 Several authors have suggested that black discolorations result from the growth of pigment-producing organisms in the oral cavity. Mouthwashes that contain peroxide or chlorhexidine can cause black tongue. Source: Courtesy of Dr. John Fantasia, North ShoreLIJ Health System, LIJMC, New Hyde Park, NY, USA. Steph Coelho is a freelance health writer, web producer, and editor based in Montreal. In summary, melanin pigmentation may be physiologic or pathologic, and may clinically present with focal, multifocal, or diffuse patterns.

Most patients report a rapid onset, with acute trauma or a history of chronic irritation preceding the development of the lesion. They are more often found in females than males[6] and the typical age at presentation is 40 years although they can appear at any age. Usually, there are no symptoms and no treatment is needed. To illustrate: familial atypical multiple mole and melanoma syndrome is characterized by the formation of histologically atypical nevi,21 blue nevus may be associated with the Carney complex,22 markedly increased numbers of common nevi are characteristic in patients with Turners syndrome23 and Noonans syndrome,24 and congenital nevi are typical of neurocutaneous melanosis.25 Thus, these findings also bring into question whether nevi are true benign neoplasms or hamartomatous or developmental in nature, as they have been historically characterized. Viral oncolytic therapies (using a modified herpes simplex virus1) are now also available. Healthy oral soft tissue presents a typical pink to red hue that reflects the degree of keratinization, quantity and activity of melanocytes, vascularization, and type of submucosal tissue of distinct topographic areas. If this is the case for you, then dont worry. The hyperpigmented spots are due to the melanin deposition in the tips of the fungiform papillae and appear around 20 to 30 years of age.4,6. The 5year survival rate of patients with metastatic melanoma is less than 15%.33. Clinically characterized by a rapidly growing macular brown lesion that appears suddenly. By Steph Coelho Studies have shown the diode laser is a safe method and is the preferred laser when no other short pulse lasers are available. For example, perform a biopsy to rule out cancer. Minimum temperature needed for cell damage is cell specific, and melanocytes are very sensitive to low temperatures at 4C to 7C where cell death can occur. The specific hue, duration, location, number, distribution, size, and shape of the pigmented lesion(s) may be of diagnostic importance. Pepto-Bismol (bismuth subsalicylate) can temporarily turn your tongue black because it contains bismuth. [3], Black hairy tongue is a harmless condition which causes blackening pigmentation on the dorsum of the tongue. In contrast, oral melanocytic nevi are rare solitary lesions that are more common in females.6. Although the lesion may develop at any age, it generally tends to present in adulthood.

In geographic tongue, some areas of the tongue are red and smooth (like ulcers), often surrounded by a white border. [8], The autosomal dominant disorder PeutzJeghers syndrome is characterized by 'intestinal hamartomatous polyps in association with mucocutaneous melanocytic macules'. Causes of black tongue include the following: Diagnosing and treating a black, hairy tongue begins with a visit to your dental professional so they can determine the state of your oral health. The patterns of pigmentation are very similar to those with Addison's. Source: Courtesy of Dr. Syphilis read more, Thrush Noncancerous mouth growths (a Candida infection), Lichen planus Lichen Planus Lichen planus, a recurring itchy disease, starts as a rash of small, separate, red or purple bumps that then combine and become rough, scaly patches. Some medications can cause generalized patchy hyperpigmentation of the tongue and oral mucosa. Memory usage: 66604.0KB. The blue nevus is described as such because the melanocytes that reside deep in the connective tissue and the overlying fibrous connective tissue often conceal the brown color of melanin, resulting in a blue tint.
Brown pigmented macule with circumscribed borders on the left lower vermilion border. Once the microscopic diagnosis is obtained, no further treatment is necessary. Superficial necrosis is observed over the next few days and a whitish slough could be separated from the underlying tissue leaving a clean pink ulcer bed.
Over time, the clustered melanocytes are thought to proliferate down into the connective tissue, often in the form of variably sized nests of relatively small, rounded cells. There were multiple small, dark macules on her tongue and hyperpigmentation on her lip mucosa and the dorsal surfaces of the distal and proximal interphalangeal joints on both hands (Figure 1 and Figure 2). A black spot that isnt going away may indicate something more serious; see your dentist right away. Scraping or brushing the tongue is usually the first suggestion for treating black tongue. For cases of iatrogenic Kaposi sarcoma any immunosuppressive medication should be stopped or reduced if able. According to Mayo Clinic, when your papillae grow longer instead of shedding, a black tongue can appear. Their presence in the skin is thought to protect against the damaging effects of actinic irradiation. Melanocytic nevi include a diverse group of clinically and/or microscopically distinct lesions.18 Unlike ephelides and melanotic macules, which result from an increase in melanin pigment synthesis, nevi arise as a consequence of melanocytic growth and proliferation.11 In the oral cavity, the intramucosal nevus is most frequently observed, followed by the common blue nevus.19 Compound nevi are less common, and the junctional nevus and combined nevus (a nevus composed of two different cell types) are infrequently identified. Sometimes. If you have discoloration on your tongue, make an appointment with your doctor. If it has been identified, the underlying source of the irritation should be eliminated in order to minimize recurrence. Black spots on the tongue can be a sign of cancer. Whereas native melanocytes tend to have a dendritic morphology, most nevic cells tend to be round, ovoid, or spindle shaped.20 Additional differences include the tendency for nevus cells to closely approximate one another, if not aggregate in clusters, and their ability to migrate into and/or within the submucosal tissues. It highlights the three stages: stage I is a primary tumor; stage II is a metastatic tumor which has spread to regional lymph nodes and; stage III is a metastatic tumor which has spread to distant sites. 6,7 BHT is not difficult to diagnose. WebDark Spots on the Tongue. [1] Management of such lesions is typically by close clinical monitoring, photographs and measuring tools. A dark brown to black tongue is most commonly attributed to bacteria from poor oral hygiene habits. The enzymes contained within the bacteria act on saliva to produce the black or brown pigment which causes the condition known as black hairy tongue (figure 2). Likewise, if the tongue discoloration is related to something you frequently eat or drink, dietary changeslike cutting out or limiting your intake of alcohol, coffee, or teacan also help. [20] Smoking results in an increase of melanin deposit in the oral mucosa [18] through physical thermal damage and chemical interaction between melanin and nicotine compounds,[19] but this is not the only risk factor towards the pigmentation, it is also associated with other aetiology factors. [citation needed], In older patients, the main consequence of the syndrome is cancer. These junctional nevi are usually small (<5 mm), macular, and tan to brown in color. Use OR to account for alternate terms

However, tongue cancer is more likely to show up as a lesion or scab that does not heal. [10] Most common oral sites include: buccal mucosa, lips, gums, hard palate or tongue. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Although there is a recognized cutaneous melanoacanthoma,16 it is clear that the similarities with oral melanoacanthoma lie solely in the nomenclature. [23] Other presentation of oral nevi includes: Blue nevus, junctional nevus and compound nevus. The first, dermoscopy (also known as epiluminescence microscopy), uses a handheld surface microscope, incident light, and oil immersion. Fungal Infection. Table 54 Etiology of multifocal, diffuse, or generalized mucocutaneous melanosis. She specializes in covering general wellness and chronic illness. For Addison's, the specific treatment option would be to treat with glucocorticoids and mineralocorticoids. Human Immunodeficiency Virus (HIV) Infection, multisystem inflammatory syndrome in children (MIS-C), ENDUR-ACIN, ENDUR-AMIDE, Niacor, Niaspan, NiaVasc, Nicomide-T, Slo-Niacin. Figure 51 Focal pigmented lesions. These papillae begin to trap food remnants and bacteria, Source: Reproduced from Tapia JL, Quezada D, Gaitan L, et al. If untreated, it can cause read more . Oral melanoacanthoma is an innocuous melanocytic lesion that may spontaneously resolve, with or without surgical intervention.14 Although the term melanoacanthoma may imply a neoplastic process, the oral lesion is actually reactive in nature.

This phenomenon most likely represents both melanotic and amelanotic areas.44,47, Additional signs and symptoms that may be associated with oral melanoma are nonspecific and similar to those observed with other malignancies. Treating a black or coated tongue. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. On physical examination, her systolic blood pressure was 100 mm Hg, and she was mildly tachycardic. Webcauses of black pigmentation on tongue; Menu. If you see your dentist about black tongue, they might suggest that you stop using mouthwashes that contain peroxide. Most common oral sites include the hard palate and gums. Let's go over what a black tongue is, causes, and how to treat it. [26], Many different diseases can cause melanin pigmented lesions in the mouth through, Melanin is an endogenous pigment synthesized by melanocytes that are located in the basal layer of epithelium. You'll notice these tiny bumps on the top and sides of your tongue. Courtesy of Dr. Rocio Fernandez, National Autonomous University of Mexico, Mexico City, Mexico. Within a week, the gingiva returns to normal and is fully healed in next few weeks minus the pigmentation. The melanocytes ( pigment cells) are located at the base of the epidermis and produce the protein melanin. Melanotic macules are the most common oral lesion of melanocytic origin. However, mortality rates are higher in black and Hispanic people. She also reported darkening of her skin, tongue, and lips over the previous two weeks. The answer is E: primary adrenal insufficiency (Addison disease). and "what does a black tongue mean?" tooth extraction or endodontic surgery, which has caused the material to become inadvertently dislodged from a restoration in an adjacent tooth. [2], An initial biopsy of the lesion may be carried out first to determine correct diagnosis. Oral melanosis can present as black, gray, blue or brown lesions depending on the site and amount of melanin deposition in tissues. In some cases they can literally be small black specks across the tongue. Figure 55 Melanotic macule exhibiting increased melanin pigmentation within the basal cell layer and melanin incontinence (hematoxylin and eosin, 400). Hairy tongue may develop when food debris is trapped in the papillae when people do not clean their mouth adequately.