Pathology · single question
CASE 11 — Patient presents with black discoloration of the dorsal tongue. What is the most likely diagnosis?
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Correct answer: C. Black hairy tongue (lingua villosa nigra)
- A. Oral melanoma is dark and irregular but the 'hairy' clinical appearance with elongated papillae is pathognomonic for black hairy tongue.
- B. Leukoplakia is a WHITE lesion — not black.
- C. Black hairy tongue presents with dramatic black/brown discoloration and elongated filiform papillae resembling hair on the dorsal tongue. Caused by overgrowth of chromogenic bacteria/fungi following antibiotic use, coffee/tobacco use, or poor oral hygiene.
- D. Candidiasis appears white (pseudomembranous) or red (erythematous) — not black.