Black Lesion on the Tongue ORAL MELANOSIS leading to the diagnosis of HIV infection. Despite being a weak association, any unexplained oral pigmentation in a high risk individual should make one suspect HIV associated oral melanosis and proceed Differential Diagnosis of Pigmented Lesions in the Oral Mucosa: A Clinical Based Overview and Narrative Review Pigmented fungiform papillae, or papillary tip melanosis Registered Dental Hygienists Causes of Black Spots on Tongue Living In Well Being Cancer patient's tongue turned black and hairy 'after rare antibiotics reaction' The Independent