A) Hairy black tongue. (B) Linea alba. (C) Oral melanotic macule. (D) Download Scientific Diagram Causes And Treatment For Black Spots On My Tongue NatruSmile Unusual Extensive Physiologic Pigmentation of the Tongue: A Case Report Cureus 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? Black hairy tongue syndrome