Patient of 60 years old with type II diabetes since 15 years | Figure 1

josue_hdz95

Urology Resident

Patient of 60 years old with type II diabetes since 15 years ago that presents to the consult because of the appearance of black stains in the tongue since 3 years ago.

The black stain measures approximately 1.5 cm, the patient refers that sometimes she loses the taste and feels paresthesia in the tongue.

We decide to take a biopsy of the black stain to have a diagnostic (you can see the place where we took the biopsy in the last picture)

What would be your diagnosis and differentials?

Do you have any recommendation?