Iwamuro Masaya, Tanaka Takehiro, Otsuka Motoyuki
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, JPN.
Department of Pathology, Okayama University Hospital, Okayama, JPN.
Cureus. 2024 Nov 23;16(11):e74331. doi: 10.7759/cureus.74331. eCollection 2024 Nov.
Black hairy tongue, also known as , is a benign oral condition characterized by a dark discoloration and "hairy" appearance on the tongue's dorsal surface, resulting from elongated filiform papillae. This condition is associated with risk factors such as smoking, poor oral hygiene, and diabetes, which increase susceptibility to microbial colonization, particularly by species. Although commonly diagnosed by visual inspection, black hairy tongue is infrequently observed during endoscopic procedures. We report a case of a 69-year-old Japanese man with poorly controlled type 2 diabetes (hemoglobin A1c of 9.7%) and a significant smoking history of 49 pack-years. During a routine esophagogastroduodenoscopy, a dark lesion was detected on the dorsal surface of the tongue. Detailed imaging and biopsy revealed elongated papillae with fungal hyphae, confirming a diagnosis of candidiasis. This case underscores the value of esophagogastroduodenoscopy and histopathological examination in diagnosing black hairy tongue and distinguishing it from other pigmented lesions. Recognizing black hairy tongue as a potential finding during endoscopy may aid in prompt diagnosis, especially in patients with predisposing factors like smoking and diabetes.
黑毛舌，也称为 ，是一种良性口腔疾病，其特征是舌背表面出现深色变色和“毛状”外观，这是由丝状乳头伸长所致。这种情况与吸烟、口腔卫生不良和糖尿病等危险因素有关，这些因素会增加微生物定植的易感性，尤其是 物种。虽然黑毛舌通常通过目视检查诊断，但在内镜检查过程中很少观察到。我们报告一例69岁日本男性病例，其2型糖尿病控制不佳（糖化血红蛋白为9.7%），有49包年的大量吸烟史。在常规食管胃十二指肠镜检查期间，在舌背表面检测到一个深色病变。详细的影像学检查和活检显示乳头伸长并伴有真菌菌丝，确诊为念珠菌病。该病例强调了食管胃十二指肠镜检查和组织病理学检查在诊断黑毛舌并将其与其他色素沉着病变区分开来方面的价值。在内镜检查期间将黑毛舌识别为潜在发现可能有助于及时诊断，特别是对于有吸烟和糖尿病等易感因素的患者。
