Tongue diagnoses

Differential Diagnosis

Black Hairy Tongue

  • Benign reactive process
  • Hyperplasia and increased pigmentation of filiform papille
  • Smoking, GERD, Abx, poor hygiene predispose
  • Treat with improved oral hygiene, gentle brushing, and a reducing pigment intake

Oral Thrush

  • Candidal infection
  • White curd-like plaques, easily removable with erythematous base
  • Usually painless
  • Risk Factors:
    • Extremes of age
    • Abx
    • Immunocompromise (AIDS, immunosuppressants)
  • Treatment
    • Nystatin oral suspension 500,000 units (swish and swallow) QID OR
    • Clotrimazole 10mg troches 5x per day OR
    • Fluconazole, 100mg PO

Tongue Swelling

  • Differential includes trauma, angioedema, other conditions listed
  • Angioedema is true emergency, suggested by face,lip, and tongue swelling
    • Hereditary,allergic (ACE), or idiopathic

See Also

Diagnoses by Body Part (Main)