Pigmented fungiform papillae of the tongue

Pigmented fungiform papillae of the tongue (PFPT) is a rare benign condition, mainly seen in dark-skinned individuals.^[1] A 25-year-old female with Fitzpatrick skin type VI presented with asymptomatic pigmented lesions on the tongue since adolescence, with a similar complaint in her mother. On examination, multiple pigmented papillae were noted over the tip and lateral aspects of the tongue [Figure 1a]. Dermoscopic examination revealed ovoid hyperpigmented projections with central dichotomized vessels originating at the base resembling a rose petal and circumscribed brownish polygonal globular papillae described as a cobblestone appearance [Figure 1b], which is consistent with typical features of PFPT. The patient was counseled regarding the benign nature of the condition. Differential diagnosis to be considered in such oral pigmentation includes Peutz–Jeghers syndrome, Laugier–Hunziker syndrome, Addison’s disease, oral melanocytic nevi, oral melanoma, amalgam-containing dental fillings, and the use of certain medications.^[1]

Close

Figure 1:

(a) Multiple brownish pigmented papillae over tip and lateral aspect of dorsum of tongue and (b) dermoscopic (DermLite DL4; 3Gen; San Juan Capistrano, California, USA, noncontact polarized mode, ×10 magnification, images capture with DermLite adapter for iPhone 13) showing ovoid hyperpigmented projections with central dichotomized vessels originating at base resembling a rose petal (black arrow) and circumscribed brownish polygonal globular papillae described as cobblestone appearance (yellow arrow).

Export to PPT