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Hairy tongue, geographic tongue, scrotal tongue and systemic connections: clinical images and an overview

Author(s): Cinzia Casu, Maria Giulia Nosotti, Antonia Sinesi, Giovanna Mosaico

Black Hairy Tongue (BHT) is a benign condition, caused by a defect of keratin desquamation over lingual papillae and its discoloration is caused by the presence of porphyrin-producing chromogenic bacteria or yeast. Geographic Tongue (GT) is characterized by a central erythematous zone consisting of atrophy of the filiform papillae, whereas the white zone shows regenerating filiform papillae along with keratin. Scrotal Tongue (ST) is a common condition, predominantly asymptomatic. Clinically, it is characterized by fissures with a depth of up to 6 mm that extend along the dorsal and/or lateral sides of the tongue. These benign entities are connected with systemic disease (psoriasis, diabetes, hypertension and GT; tumors, radiant therapies and BHT; fungal infections and Merkesson-Rosenthal syndrome and ST). Although an association between elevated IgE and migrant glossitis has been documented, associations between the three lingual conditions and the presence of allergy are unclear. We would like to present a case in which the 3 conditions were present in the same tongue of a female patient with allergic rhinitis and calcium deficiency.


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