Hairy Tongue — MFDS Part 1 MCQ
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Correct answer: B — Elongated filiform papillae on the dorsal tongue, often with yellow, brown or black discolouration
Hairy tongue is characterised by impaired shedding and retention of keratin on the filiform papillae, causing them to elongate and produce hair-like projections on the dorsal tongue. Exogenous staining may make the papillae yellow, brown or black. White corrugated lateral plaques suggest oral hairy leukoplakia, not hairy tongue. Loss of filiform papillae produces smooth erythematous or depapillated areas, as seen in conditions such as geographic or atrophic glossitis. A solitary tip ulcer is more consistent with local trauma, while painful vesicles followed by ulcers suggest a viral vesiculoulcerative disorder.
Reference: BMJ Best Practice. Fissured, hairy, and geographic tongue, Definition and Summary sections. Topic updated 2023; evidence reviewed 26 July 2026. https://www.qvh.nhs.uk/wp-content/uploads/2020/09/Coated-hairy-Tongue.pdf