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 Dermatologic Look Alikes: Hyperpigmented Patches on Face and Neck Dermatology Advisor Differences among Dermoscopic Findings in Riehl's Melanosis of the Cheek and Neck 05 May 03 Eng Oral hyperpigmentation Clinical Advisor