Black hairy tongue is a tongue papillary hypertrophy that acquires a hairy appearance due to the keratin cluster as well as a blackish colour because of the proliferation of pigmented bacteria. It is a benign process of unknown etiology. The antibiotic use is the most commonly involved etiologic factor. Its appearance is anecdotal in pediatric age range. In this article, the case of a 2 month old breastfed baby with a black lesion on a whitish base in the tongue, firstly diagnosed with oral candidiasis, will be described. The antifungal treatment wasn't successful. The results of the bacterial and fungal cultures were negative. The patient remained asymptomatic and the lesion improved progressively. Black hairy tongue was diagnosed. Its diagnosis is clinical. It is essential to do a differential diagnosis with oral candidiasis as well as with dark pigmentation due to food or drug ingestion, congenital lingual melanotic macule and oral hairy leukoplakia. It is a self-limited case that can improve with the use of queratinolitic substances.

C.B. Fernández

C.C. Rodríguez

M.A.S. Romero

M.R.P. de Pipaón

Not everything is oral candidiasis

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