Recurrent Tongue Hyperpigmentation in Hidradenitis Suppurativa

The authors present the case of a non-smoker, 40-year-old woman, with hidradenitis suppurativa (IHS4 9). When she presented for deroofing surgery she complained of an asymptomatic dark pigmentation of her tongue. She recalled three similar self-limited episodes, that coincided with doxycycline cycles, but denied a similar reaction when she took minocycline. A diagnosis of hairy black tongue induced by doxycycline was made and the patient was reassured (Figure 1).