Approach to Tongue Hyperpigmentation in General Practice: Pigmented Fungiform Papillae and Complexion-Associated Melanosis in a Young Pakistani Female

Abstract

Hyperpigmentation in exposed areas like the tongue and conjunctiva can pose diagnostic challenges in general practice, ranging from serious conditions to benign, aesthetic concerns. This case report examines a 21-year-old female with concurrent benign hyperpigmentation of the tongue and conjunctiva. A thorough evaluation ruled out extrinsic causes and systemic illnesses, leading to the diagnosis of Pigmented Fungiform Papillae (PFP) on the tongue and Complexion Associated Melanosis (CAM) in the conjunctiva. Due to the absence of concerning features, biopsy was deferred in favor of routine surveillance. An inquiry into the potential association between hyperpigmentation and conditions such as anemia and vitamin D deficiency revealed no definitive connection, as correcting these deficiencies did not resolve the hyperpigmentation. This case underscores the importance of recognizing benign hyperpigmentation to avoid unnecessary procedures and emphasizes a cost-effective, patient-centered approach.

Keywords

• pigmented fungiform papillae
• tongue hyperpigmentation
• complexion-associated conjunctival melanosis
• iron deficiency anemia
• tongue melanosis
• black tongue.