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Black hairy tongue (BHT) is a benign, self-limiting, and usually asymptomatic condition, characterized by abnormally hypertrophied and elongated filiform papillae on the surface of the tongue. In this article, we present the case of a woman diagnosed with hebephrenic schizophrenia who developed BHT after using olanzapine to treat an acute episode of the disease. The temporal coincidence between the development of BHT and the increase in olanzapine dosage to 20 mg daily suggests a likely dose-dependent relationship, making this psychotropic drug the most probable cause of this condition.

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Black Hairy Tongue Observed During Esophagogastroduodenoscopy.

Cureus

November 2024

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, JPN.

Black hairy tongue, also known as , is a benign oral condition characterized by a dark discoloration and "hairy" appearance on the tongue's dorsal surface, resulting from elongated filiform papillae. This condition is associated with risk factors such as smoking, poor oral hygiene, and diabetes, which increase susceptibility to microbial colonization, particularly by species. Although commonly diagnosed by visual inspection, black hairy tongue is infrequently observed during endoscopic procedures.

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Tongue conditions occur in 15.5% of the US population. The most common tongue conditions are geographic tongue, fissured tongue, and black hairy tongue; these conditions do not require treatment.

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