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Family Medicine  (Expert Forum)
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Is this something bad? Oral Thrush, Hairy tongue...
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD Boston - MA
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
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MedHelp Member's Question

Is this something bad? Oral Thrush, Hairy tongue...

by Deedesign, Nov 22, 2004 12:00AM
Hello, I have a question & concern about oral thrush, hairy tongue... When I research this over the net I get freaked out about HIV & AIDS. I want to see what you think. Well I have had some weird like pain on my tongue which prompted me to keep looking at it. I think it may be a cold soar on my tongue but nothing has "popped" out yet & I just feel some pain when I rub my teeth over a certain area... Now I see what it looks like as this white coating that gets more prominent when it goes back toward the back end of my tongue. When I rub my teeth over it nothing comes off contrary to what I read. I think I have had this for a very long time but thought nothing of it. The when I kept looking at this it worried me & I can scrape off some stuff towards the back end of my tongue where its most visible, looks like cottage cheese kind of. I am not sure if this is hairy tongue or thrush? I have nothing anywhere else? I am scared & think maybe its something bad but I know I am worrying about it & I know stress cannot help. I took a photo of this, hope you can see it. The link is:



http://pg.photos.yahoo.com/ph/dcjano68/album?.dir=/8a02&.src=ph&.tok=phqrQGCB1NLnDHcb



Again, I think I have had this for the longest but a recent battle with Jock Itch has made me freaked about lots of things. I see others with similar tongue types so I am not sure. What do you think? I have what it appears to be hair on the top surface & I guess I have always had it.



Do you think this is thrush? Do you think its just white hairy tongue? Does it look serious? Is this normal for a tongue? (appearance) I have had uprotected sex many years ago but everything recently has been protected. I am a straight male, non smoker and do not take any drugs. I have been very fatigues but I think its from stressing over this. Thank you Dr.



Thank you!

D
Doctor's Answer

by Kevin Pho, MD, Nov 24, 2004 12:00AM
Tough to say with just the photo - closer examination is necessary.  You're right in that the possibilies would include hairy oral leukoplakia (which is a manifestation of Epstein Barr virus) or thrush.  



One way to help would be to take a quick swab of the lesion to see if fungus grows out.  If there is concern that it is hairy oral leukoplakia, then an HIV test should be considered.



Your PCP should be able to do these tests.  If there continues to be confusion, a referral to an oral surgeon can be considered for possible biopsy.



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

Medical Weblog:

kevinmd_b
Member Comments (8)

by Deedesign, Nov 22, 2004 12:00AM
I just saw my son's tongue & he also has the same exact look, & he tells me that there are larger pappila (spelled wrong) in the back of the tongue. He said that they covered this in his health's class & its very normal... Is that right Dr.?

by Deedesign, Nov 24, 2004 12:00AM
To: To the Dr.
Dr., does it look like the hairy oral leukoplakia?? Based on the photo I had submitted, does this appear to be a normal looking tongue? I looked at others & their tongues do resemble mine.I heard that the hairy oral leukoplakia is most pronounced on the sides of the tongue, correct?

by yoshi, Nov 26, 2004 12:00AM
best is to go see a doctor and have him look at  your tongue,not pictures of the tongue.

by Deedesign, Nov 27, 2004 12:00AM
Just showed the Dr. & he said that its very normal, so that that...

by emar, Dec 05, 2004 12:00AM
deedesign, I'm glad to find this site. Thanks for the pictures of your tongue, because my tongue looks just like yours, except it's worse: it has BLISTERS toward the back of the tongue.  My mouth also has strange sensations (not pain).  There's also a small white lesion/ulcer under my tongue in the middle (what do you call that, the thin membrance that divides the tongue underneath.  I DON'T THINK IT'S NORMAL.  If you have any new development or test result I will really appreciate if you let me know.  To the doctor(s) here: could you please provide some info as to what the gorup of BLISTERS on the tongue, together with white or yellowish hairy coating (like deedesign's), could indicate?? Thank you so much!

by emar, Dec 06, 2004 12:00AM
deedesign: thanks for asking the question. I'm very interested because I have the same, actually worse than your tongue, thicker and more coatings, with fissures (you seem to also have fissures on your tongue?).  I also have blisters toward the back of my tongue (one possibility of the blisters is normal anatomy, but not sure, as they are really large).  If you get any test result I'll appreciate if you post here.  I may also have tests in the near future.  I saw some web site show picture of "hairy leukoplakia" just like this, except it's more severe; it's not sides but on the entire tongue.  Some other sites however show differently.  It's confusing and worrying.

by Deedesign, Dec 07, 2004 12:00AM
To: Emar
Emar,



I did research on this & its actually very normal to have things like this on your tongue, the surface, the sides, the over-all look. The ulcer under your tongue sounds like a canker sore and that should be gone within 2 weeks. How long have you had these blister types?  How long have youhad this "coating"? I bet for some time now.



As the tongue surface goes back towards your throat, it will have more pronounced build up. Like a lunatic I had looked in many people's tongues & they all look different but normal in this area. Most of us have more build up that gets more pronounced towards the back. The more you think about these things & focus on your mouth & tongue , the more you will feel that sensation!! I am telling you its 75% mental!



By the way, the blisters may not be blisters, just fissures that does not have the "hairy" coat over them, so I would not worry to much on that.



A "hairy" coat is normal and indicates nothing. In regards to hairy oral leukoplakia, its a rare condition & seen only in HIV positive patients. Its almost always on the lateral sides of the tongue.



Oh, the fissures will become more prominent as you get older in age. Sounds like you have a normal tongue and the only thing I see you have is the canker sore. Do not worry so much! You will be fine!



by Deedesign, Dec 07, 2004 12:00AM
To: Emar
If you want, explain this & post a comment in the Dermatology forum, Dr. Rockoff is best to answer your question, if you do post, let me know. If you want, email me at: ***@****



by gemini26f, Mar 21, 2008 04:17PM
A related discussion, seem to be  something above the tongue was started.
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