Antibiotic Reaction Left Woman With ‘Black Hairy Tongue’

A recent case report describes a rare instance of lingua villosa nigra, sometimes known as the black hairy tongue.

In a strange incident, doctors have found a rare case in which the tongue of a woman turned black and hairy after she suffered a bizarre reaction to antibiotics.

According to the British Medical Journal Case Reports, the woman had been living with rectal cancer and started treatment 14 months ago in Japan. To lessen the adverse effects of her chemotherapy, the woman, who was in her 60s, had been taking minocycline, which is used to treat everything from acne to pneumonia.

The doctors said in the report that the woman continued to receive minocycline 100 mg/day to prevent panitumumab-induced skin lesions. The patient was diagnosed with drug-induced hyperpigmentation and a black, hairy tongue (BHT)

The Metro reported that doctors found that the woman’s face had turned grey. They were stunned once more when the patient opened her mouth, revealing a ‘painful’ carpet of black and brown ‘hair-like’ tastebuds.

Doctors said that the grey patches on her face were characteristic of minocycline-induced skin damage because minocycline turns black when oxidised and can lead to skin discoloration. So they changed her medication plan to something else.

The doctors stated that “six weeks later, her facial pigmentation and BHT markedly improved,” although they did not state exactly when this occurred.

“In this instance, the disease progression indicated that it was a side effect of minocycline.”

In their report, the doctor mentioned a few important learning points from this case of a rare medical condition. Which are:

1. If the patient develops skin hyperpigmentation, check the medications taken.
2. Minocycline can cause skin hyperpigmentation as well as a black, hairy tongue.
3. Discontinuation of the causative agent may improve skin hyperpigmentation and a black, hairy tongue.

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