Man’s tongue turns BLACK and ‘HAIRY’ after a stroke

Yuck! You can say that again! A man’s tongue turned black and ‘hairy’ after he was put on a pureed diet following a stroke.

IT REALLY DID HAPPEN!

The 50-year-old man developed a thick carpet of dead skin and bacteria on his tongue within two months of eating blended meals and soups.

According to a report by the Jama Dermatology the man suffered a stroke three months earlier, which paralysed his whole left side, including his face, and made it difficult to chew.

“Three months prior, he had experienced a cerebrovascular incident with dense hemiplegia, and his caregivers first noticed the black pigmentation over the dorsum of the tongue 15 days before presentation.

“He was being fed a diet of pureed food and liquids and was taking oral antiplatelets and antihypertensives,” the report stated.

“On examination, he did not have a fever and was conscious and oriented, with left-sided motor weakness. The dorsal aspect of his tongue showed a thick black coating that was yellowish toward the medial and proximal parts.”

Doctors diagnosed the man with lingua villosa nigra after taking mucus samples from his tongue.

WHAT IS A HAIRY TONGUE OR LINGUA VILLOSA NIGRA?

A hairy tongue is an unusual, harmless condition characterised by a ‘hairy’ enlargement and discolouration of the filiform papillae. The filiform papillae are tiny conical bumps found on the surface of the front two-thirds of the tongue that do not carry taste buds.

It is also known as black hairy tongue and lingua villosa nigra.

WHO GETS A HAIRY TONGUE?

Hairy tongue most often occurs in adults over 40 years of age and is rare in infants [1].

A range of medications has been linked to a hairy tongue, including penicillin, erythromycin, tetracycline, doxycycline, lansoprazole, olanzapine, bismuth [1], erlotinib [2], linezolid [3].

Other factors that may cause and/or aggravate hairy tongue include:

• Poor oral hygiene
• Smoking or chewing tobacco
• Drinking alcohol
• Cocaine
• Chlorhexidine or peroxidase-containing mouthwash
• Coloured beverages, including coffee
• Dehydration
• Hyposalivation (dry mouth)
• Radiation therapy [3].

Writing in the Jama Dermatology journal, the doctors said: ‘The patient and caregivers were given advice regarding proper cleansing measures, and the discoloration resolved after 20 days.’