A 9 year old boy presented for evaluation of dark spots on the tongue. The family first noted these spots 5 months prior and reported that they remained stable. Can you make a diagnosis? Indian patient (mid 70s) with chief concern tongue is turning black. Swipe for more photos. These post inflammatory changes are more common in folks with more melanin in their skin. The underlying COM Jan. 2008 Diagnosis UW School of Dentistry Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management ScienceDirect