SPECIAL ARTICLE   

Minerva Pediatrics 2023 April;75(2):296-8

DOI: 10.23736/S2724-5276.22.07044-6

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Black tongue in children: a possible drug hypersensitivity reaction?

Giulia LICCIOLI ¹, Francesca MORI ¹, Manuela CAPONE ², Mattia GIOVANNINI ^{1, 3} ✉, Lucrezia SARTI ¹, Simona BARNI ¹, Paola PARRONCHI ²

¹ Unit of Allergy, Department of Pediatrics, Meyer Children’s Hospital, Florence, Italy; ² Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy; ³ Department of Health Sciences, University of Florence, Florence, Italy

Black tongue (BT) is a benign, self-limiting black discoloration of the lingual mucosa due to different factors. Only a few pediatric cases of BT related to drug intake are described. We report a child with BT developed after amoxicillin/clavulanic acid intake and also made a review of the pediatric cases of black tongue reported in literature after drugs. The child underwent allergy work-up with in-vivo and in-vitro tests, showing a positive lymphocyte transformation test (LTT) for amoxicillin and amoxicillin/clavulanic acid. For the first time, BT was proved to be a hypersensitivity reaction to drugs, suggesting a possible role of a T-cell mediated mechanism. Even if already reported as a mild side effect, according to our results, allergy investigations are essential to make a confident diagnosis and to give further indications to patients about the discontinuation of the culprit drug.

KEY WORDS: Black hairy tongue; Hypersensitivity; Pediatrics