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Hairy tongue is characterized by enlongated hypertrophied filiform papillae causing a hair-like appearance involving the dorsum of the tongue. The frequency of this increases with age, with no gender predilection. It is more common in heavy smokers with poor oral hygiene, in persons following chronic or excessive antibiotic use, use of certain medications, especially antipsychotic drugs, and in HIV-positive individuals. The food debris and bacterial and fungal overgrowth plays a role in the colour of the tongue. Individuals may sometimes complain of a metallic taste. Food debris entrapped in between the papillae may result in bad breath, which improves with regular brushing of the tongue. Hairy tongue should not be confused with oral hairy leukoplakia. The diagnosis is based on the clinical appearance. No specific treatment is required for hairy tongue except for maintaining good oral hygiene.

Differential diagnosis:




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Figure 1: Hairy tongue. Note the hypertrophy of filiform papillae with superadded candidiasis. A longitudinal fissure can be seen in the mid part of the dorsum tongue.
Figure 2: Hairy tongue. Note the hypertrophy of filiform papillae of the tongue forming a thick matted layer on the dorsum of tongue.
Figure 3: Hairy tongue. Note the hypertrophy of filiform papillae of the tongue forming a thick matted layer on the dorsum of tongue.
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