A 10-year-old East Indian girl presented with several discrete, asymptomatic areas of hyperpigmentation on her tongue (Figure 1). The hyperpigmented areas had appeared several years ago and had been enlarging slowly. The patient was distraught over their appearance and con-cerned that they might spread to involve the remainder of her oral mucosa. Physical examination revealed multiple, sharply bordered, hyperpigmented patches on the dorsal and lateral aspects of the tongue. Closer inspection demonstrated that the pigmentation was limited to the tips of the papillae. No abnormalities of the buccal mucosa or lips were observed. The results of the rest of the patient's physi-cal examination were unremarkable. Her family history was significant for similar findings of long standing in her mother; no other family members were known to be affected. The patient was otherwise healthy. A biopsy specimen was obtained (Figure 2 and Figure 3).
Werchniak AE, Storm CA, Dinulos JGH. Hyperpigmented Patches on the Tongue of a Young Girl—Quiz Case. Arch Dermatol. 2004;140(10):1275-1280. doi:10.1001/archderm.140.10.1275-g