10.5826/dpc.1401a24
text/xml
2160-9381
3508
en
Tripathi Akansha 
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Fox Tail Like Furry Appearance in a Case of Black Hairy Tongue 
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Image Letter
2024-01-31
2023-05-05
2024-01-31
2024-02-21
e2024024
Dermatol Pract Concept
Tripathi Akansha 
2024/01/31
10.5826/dpc.1401a24
e2024024
Department of Dermatology, Base hospital Lucknow (Uttar Pradesh), India
2160-9381
en
e2024024
Sil A, Panigrahi A. "Sea Anemone" Appearance in Dermoscopy of Black Hairy Tongue. Indian Dermatol Online J. 2021;14(4):580-581. DOI: 10.4103/idoj.IDOJ_58_21. PMID: 37521216. PMCID: PMC10373830.
Fox Tail Like Furry Appearance in a Case of Black Hairy Tongue 
https://dpcj.org/index.php/dpc/article/download/3508/2566
    Fox Tail Like Furry Appearance in a Case of Black
                       Hairy Tongue
           Parul Kamboj1, Preema Sinha1, Choudhary Sampoorna Raj1, Prashantha G B1,
                                       Akansha Tripathi1


1 Department of Dermatology, Base hospital Lucknow (Uttar Pradesh), India



Citation: Kamboj P, Sinha P, Raj CS, Prashantha GB, Tripathi A. Fox Tail Like Furry Appearance in a Case of Black Hairy Tongue.
Dermatol Pract Concept. 2024;14(1):e2024024. DOI: https://doi.org/10.5826/dpc.1401a24
Accepted: May 20, 2023; Published: January 2024
Copyright: ©2024 Kamboj et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding author: Dr Choudhary Sampoorna Raj, Department of Dermatology, Base hospital Lucknow (Uttar Pradesh), India.
Phone: (+91) 7004913218 E-mail: csr8711@gmail.com
Acknowledgement: The patient in the manuscript has given written informed consent to the publication of case details and photographs.




Case Presentation                                                        revealed no fungal hyphae, and the culture revealed no
                                                                         growth. ­Dermoscopy was performed which revealed charac-
A 22-year-old Indian male, non-smoker, a known case of                   teristic findings (described below). The patient was advised
non-Hodgkin B-cell lymphoma, subtype diffuse large B-cell                to practice regular tongue brushing and maintain proper oral
lymphoma, developed dark discoloration of the dorsum of                  hygiene, which led to regression of elongated papillae and
the tongue, with dysgeusia, metallic taste, and halitosis two            resolution of symptoms in 2 weeks.
weeks after undergoing an autologous stem cell transplant
and being started on prophylactic Tab Penicillin G and Tab
                                                                         Teaching Point
Acyclovir [1]. The discoloration was insidious in onset and
progressed over 20 days to involve the majority of the ante-             Dermoscopic     examination     revealed    yellowish‐brown
rior two thirds of the tongue. Examination of oral mucosa                and brownish‐black furry projections (elongated filiform
revealed a brownish to black-colored furry tongue predom-                ­papillae) resembling ‘Fox tail’ (green arrow), white globular
inantly involving the anterior two-thirds of the tongue an-              areas (red arrow) over a pinkish background (black arrow)
terior to the circumvallate papillae, with relative sparing              resembling rose petals. A distinct color variation was also
of the tip and lateral borders (Figure 1A). No significant               appreciated in individual filiform papillae, with the base
                                                                         ­
pigmentation was noted at any other site. The KOH mount                  being a lighter shade than the tip (blue arrow) (Figure 1B).




Image Letter | Dermatol Pract Concept. 2024;14(1):e2024024                                                                              1
Figure 1. (A) Revealed a brownish to black-colored furry tongue predominantly involving the anterior two-thirds of the tongue anterior to
the circumvallate papillae, with relative sparing of the tip and lateral borders. (B) Revealed yellowish‐brown and ­brownish‐black furry pro-
jections (elongated filiform papillae) resembling ‘Fox tail’ (green arrow), white globular areas (red arrow) over a pinkish background (black
arrow) resembling rose petals. A distinct color variation was also appreciated in individual filiform papillae, with the base being a lighter
shade than the tip (blue arrow).




References                                                               2. Sil A, Panigrahi A. “Sea Anemone” Appearance in Dermoscopy of
                                                                            Black Hairy Tongue. Indian Dermatol Online J. 2021;14(4):580-
 1. Akay BN, Sanli H, Topcuoglu P, Zincircioğlu G, Gurgan C,                581. DOI: 10.4103/idoj.IDOJ_58_21. PMID: 37521216. ­PMCID:
    Heper AO. Black hairy tongue after allogeneic stem cell transplan-       PMC10373830.
    tation: an unrecognized cutaneous presentation of graft-versus-
    host disease. Transplant Proc. 2010;42(10):4603-4607. DOI:
    10.1016/j.transproceed.2010.09.177. PMID: 21168745.




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