Case Study 2

by Alex, Dipu, Tever

A 55yr 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 the
hairy area on the tongue
three months earlier
The patient was not aware of
any changes in size, shape,
color. The patient stated there
is no pain associated with
hairy lesion on his tongue.


History
The patient admitted smoking
one pack of cigarettes for the
past 10 years. The patient
seems to be in a good states of
health. The patient health
history was reviewed and shows
no positive findings.
Examination

The patient has regular dental

exams and routine treatment.
Vital were with in normal limits,
with no enlarge lymph nodes.
The oral exam revealed a large
brown matte plaque on the
posterior dorsal tongue. The
plaque looked hair like and
could not be rubbed off by
scrapping.

Hairy leukoplakia

Occurs on the lateral border surface of

the tongue
Corrugates in an irregular white lesion
Occurs in HIV and organ transplant
plant patients

Benign Migratory
Glossitis

Genetic factors play a role. Its

exaggerated by stress
Found on the dorsal and lateral
borders of the tongue
Diffused area devoid of filiform
papillae
Looks like erythema patches,
that are surrounded by a white
or yellow perimeter
Burning discomfort is common
No treatment indicated

Hairy Tongue
White Hairy Tongue

White hairy tongue Is an increase

accumulation of keratin on the filiform
papillae, result in white hairy
appearance

Black Hairy Tongue

Black hairy tongue has the same texture

as the white hairy tongue, except the
papillae are brown to black color.
The cause of the black is due to
chromogenic bacteria
Tobacco and certain foods may also
discolor the papillae.

Median Rhomboid Glossitis

Hyperplastic Candidiasis

The cause is unclear, may be

associated with chronic fungal
infection,; candida albicans
Appears flat or slightly raised oval /
rectangle erythematous area in
midline of the dorsal surface of the
tongue
Devoid of filiform papilla; texture is
smooth

White lesion that doesnt wipe off the

mucosa
It is in response to antifungal
medication
When leukoplakia is caused by
candidiasis it disappears when treated
with antifungal medication
Biopsy is considered if the lesion
doesnt respond to antifungal therapy.


Which is it?

1. Hairy leukoplakia
2. Benign Migratory Glossitis
3. Hairy Tongue

4. Median Rhomboid Glossitis

5. Median Rhomboid Glossitis