1. 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.

2. 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.

3. Benign Migratory Glossitis
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

4. Hairy Tongue White Hairy Tongue Black 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.

5. 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
Hyperplastic Candidiasis
White lesion that doesn’t 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 doesn’t respond to antifungal therapy.

6. ‘ Which is it? 1. Hairy leukoplakia 2. Benign Migratory Glossitis
3. Hairy Tongue
4. Median Rhomboid Glossitis
5. Median Rhomboid Glossitis