An adolescent girl presented with scattered hyperpigmented spots on her tongue (Figure). They had appeared a few months prior and were asymptomatic. Physical examination results revealed multiple hyperpigmented papillae and patches on the dorsal and lateral aspects of her tongue. She also had a faint hyperpigmented macule on her lower mucosal lip. No abnormalities of the buccal mucosa were noted. The rest of her physical examination was unremarkable. She was otherwise healthy. No other family members were known to be affected. A clinical diagnosis of pigmented fungiform papillae of the tongue, also referred to as hyperpigmented fungiform papillae of the tongue, was made. The patient and her family were counseled on the benign nature of the condition, and no treatment was pursued.