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 Oral Melanotic Macule MEDizzy Oral pigmentation in children: a diagnostic challenge Archives of Disease in Childhood 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?