Haleigh Turley

Jorden Prewitt
Marissa Martin
General and Oral Pathology
October 7th, 2017
Case Study

A 55-year-old male visited a dental office for a routine check-up and

prophylaxis. Oral examination revealed a brown hairy plaque on the dorsal tongue.

The patient first noticed this approximately three months ago. The patient was not

aware of any changes of this region within the time period. There is no pain or

discomfort and the patient smokes a pack of cigarettes per day for the last 10 years.

The patient is not on any medications and vitals were all within normal limits. The

extra-oral exam had no notable findings and the intra-oral exam revealed a large

brown, matted plaque on the posterior dorsal tongue.

The patient is diagnosed with hairy tongue because the patient has an

increased accumulation of keratin on the filiform papillae that result in a “hairy”

appearance. Normally this lesion is white but is stained by tobacco use and appears

brown or blackish. This lesion occurs on the posterior dorsal surface of the tongue.

The patient does not have hairy leukoplakia because this lesion commonly

occurs on the lateral borders of the tongue. An irregular, corrugated white lesion

characterizes this lesion. This lesion has also been linked to Epstein-Barr virus,

which can be identified in the epithelial cells. Hairy leukoplakia was first identified

in patients with HIV and most commonly occurs in these patients.

The patient does not have benign migratory glossitis. The clinical appearance

involves the anterior two-thirds of the dorsal and lateral boarders of the tongue.

Diffuse areas of devoid filiform papillae surrounded by a white or yellow perimeter

Haleigh Turley
Jorden Prewitt
Marissa Martin
General and Oral Pathology
October 7th, 2017
can be observed. This condition is most likely stress induced and has also been

linked to patients with psoriasis.

The patient does not have median rhomboid glossitis because this condition

appears as a flat or slightly raised oval or rectangular erythematous area in the

midline of the dorsal surface of the tongue. It is devoid of filiform papillae; which

means the texture is smooth. The cause of this condition is unknown.

The patient does not have hyperplastic candidiasis presents as a white lesion

that does not wipe off the mucosa and is located on the entire dorsal surface and

lateral boarders of the tongue. This condition can be treated with antifungal

medications.
Haleigh Turley
Jorden Prewitt
Marissa Martin
General and Oral Pathology
October 7th, 2017
Resources

Ibsen, O. A., & Phelan, J. A. (2014). Oral pathology for the dental hygienist (7th ed.). St.
Louis, MO: Elsevier Saunders.