Hairy Tongue 黑毛(黑苔)舌

Hairy tongue is a common, benign clinical condition that represents accumulation of varying amounts of keratin on the dorsum of the tongue. Normally, the rate of keratin production on the dorsal tongue equals the rate at which keratin is naturally debrided during chewing and swallowing. If a patient has reduced food intake or a primarily soft or liquid diet, then the keratin simply accumulates. It is not a sign of any underlying systemic disease in an otherwise healthy and non-debilitated patient, as was historically believed. Factors that may be associated with increased production of keratin include smoking, poor oral hygiene, use of oxidizing mouthwashes, and hot beverages.

The elongated papillae are usually yellow to brown–black, although a wide range of colors may occur due to differential exogenous staining from food, tobacco, or chromogenic bacteria. Overgrowth of the latter may occur in the setting of systemic antibiotic therapy. Some patients complain of bad breath, bad taste, or a gagging sensation when the tongue contacts the palate.

hair tongue

Hairy tongue is a benign condition requiring no treatment. Some patients desire treatment due to the unaesthetic nature of the process, or because of altered taste, bad breath, or gagging sensation. In such cases, patients should be encouraged to scrape the tongue with a tongue scraper or brush it while tooth brushing.

黑毛（黑苔）舌是一种常见的良性临床病症，舌背上大量角蛋白聚积而至。通常，背舌上角蛋白产生的速率等于在咀嚼和吞咽期间角蛋白自然清除的速率。如果患者减少食物摄入量或以液体饮食为主，那么角蛋白就会累积。这并不是健康者或非极度虚弱患者的任何潜在系统性疾病的征兆。可能增加角蛋白产量的因素包括吸烟，口腔卫生差，使用氧化漱口水和热饮。

细长的乳突通常为黄色至棕黑色，但由于食物，烟草或发色细菌的外源性染色差异，可能会出现多种颜色。系统性抗生素治疗也会导致乳突过度生长。当舌头接触上腭时，一些患者抱怨口臭，味道不好或有呕吐感。黑毛舌是一种良性疾病，无需治疗。如果患者介意舌的不美观性，或者口臭或呕吐感而需要治疗。在这种情况下，应鼓励患者用刮舌器刮舌头或刷牙时刷舌头。

Reference:

  1. Antonella Tosti, Bianca Maria Piraccini. In: Jean Bolognia Julie Schaffer Lorenzo Cerroni, editors. Dermatology: 2-Volume Set 4th Edition. Elsevier; 2017. p1208.
  2. Taybos G. Oral changes associated with tobacco use. Am J Med Sci 2003;326:179–82.
    Yuca K, Calka O, Kiroglu AF, Akdeniz N, Cankaya H. Hairy tongue: a case report. Acta Otorhinolaryngol Belg 2004;58:161–3.
  3. Tamm L, Annagur BB. Black hairy tongue associated with olanzapine treatment: a case report. Mt Sinai J Med 2006;73:891–4.
  4. Winer LH. Black hairy tongue. Arch Dermatol 1958;77:97–103.