Spot Diagnosis

Lingua villosa nigra (black hairy tongue) in a 2-week-old newborn

Leonor Aires Figueiredo1, Sandra Pera2, Diogo Bacalhau3, Rui Garcia2
1Serviço de Pediatria, Departamento da Saúde da Mulher e da Criança, Hospital do Espírito Santo de Évora, Portugal, 2USF Salus, Évora, Portugal, 3Serviço de Imagiologia, Hospital do Espírito Santo de Évora, Évora, Portugal

Address for Correspondence: Leonor Aires Figueiredo, Largo do Sr. da Pobreza, 7000-811 Évora, Portugal.
Email: leonor.figueiredo12@gmail.com
Keywords : Black hairy tongue, lingua villosa nigra, newborn
Question :
A two-week-old term male was brought to a primary care appointment for a routine health assessment. Birth history was unremarkable. The patient was exclusively breastfed up to 7 days of life, when artificial formula was started due to apparent insatiability. No feeding difficulties were noted, and median weight gain was 42 g/day since birth. He was receiving supplementation with 667 UI of cholecalciferol daily and parents denied any other supplementation or off-label drugs. Physical examination was unremarkable except for a brown lesion with irregular borders located on the posterior two-thirds of the tongue dorsum (Figure 1). Parents had not noticed the presence of this lesion prior to the appointment and had no knowledge of similar cases in the family.

Figure 1. Newborn’s black hairy tongue.
<b>Figure 1.</b> Newborn’s black hairy tongue.


What is the diagnosis?
 
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