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Updated: Aug 23, 2025

Objectification of Tongue Diagnosis in Traditional Medicine, Data Analysis, and Study Application
Published on: April 14, 2023
Black tongue in children: a possible drug hypersensitivity reaction?
Giulia Liccioli1, Francesca Mori1, Manuela Capone2
1Unit of Allergy, Department of Pediatrics, Meyer Children's Hospital, Florence, Italy.
Abstract:
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.
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