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What Does A Black Spot On Tongue Indicate?

Posted on Mon, 17 Feb 2014

Question: This morning I noticed a black spot on the left side of my tongue, (top and side)...about mid-way. I am sick with a sore throat. What made me notice this is, I began to vomit up soup I had. As I was vomiting, I started to feel a pulling or what would almost feel like a lump in this area of my tongue. I checked it out and found no lump, but a darkening or black spot about an inch long and 1/2 inch wide. The area is not sore nor sensitive to the touch. My throat is swollen but this I believe is part of the sore throat I have. I was at my PCP's office yesterday and this spot was not there. She would have noticed it because she examined my throat. My PCP prescribed Zithromax as a precaution because I complained of a heaviness starting in my chest with some slight congestion. It almost looks like a black and blue mark. The vomiting did not make my throat feel any better, but I do not think the black mark came from this. Your advice appreciated. I am thinking of returning to my PCP this morning. I found this service in my search on Web MD inquiring about this. Thank you.

Answered by Dr. Dipti Singh (1 hour later)

Brief Answer: Can be a normal melanin pigmentation Detailed Answer: Hello, Thank you for consulting with XXXXXXX This is Dr. Dipti Singh here to answer your query. As you are mentioning that you have noticed some black spot on your tongue, there can be two possibilities for this 1-First it can be a normal melanin pigmentation of tongue as there are no symptoms like soreness or sensitivity 2-Second possibility is there can be any kind of allergy from the medication which have been prescribed to you. Better once you should visit your doctor again and get it confirmed and if needed get the medications changed. Hope this will help you. Regards, Dr Dipti Singh

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dipti Singh (19 minutes later)

Hi...thank you for your response. I have been checking it and it appears to be lessening in color and a more purplish tint to it and clearing up to a small degree. I have taken the generic form of Zithromax Z-P in the past with no reaction, but that does not mean it could not happen. If this is not a reaction to medication what will cause melanin pigmentation to develop like this? My tongue has never had this pigmentation happen before. Is there anything I can do to prevent this from happening again? It looks like a black and blue mark on the tongue. what would cause this to occur like this. Your response is appreciated. Thank you. XXXXXXX Fialo

Answered by Dr. Dipti Singh (35 hours later)

Brief Answer: Can be a lichenoid reaction or aphthous ulcer Detailed Answer: Hello,XXXX As you are mentioning that it is now lessening in size and changing its color then it cannot be a normal pigmentation. In this circumstance, I would think of three possibilities: 1. Allergic reaction of the medication -if it is a normal allergic reaction then it will heal on its own as you will stop taking the medication. 2. Lichenoid reaction 3. It can also be an aphthous ulcer or a lesion of Pemphigus. A close examination of the spot by an oral medicine specialist will be helpful to narrow down the possibilities. The doctor may order for specific tests such as biopsy if required. I would urge to consult the specialist and confirm the condition before trying any remedies. Thank you Regards Dr. Dipti Singh

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Above answer was peer-reviewed by : Dr. Prasad