Oral Mucosal Melanosis IntechOpen Causes And Treatment For Black Spots On My Tongue NatruSmile Full article: Melanosis of the Tongue Pigmented lesions of the oral mucosa and perioral tissues: a flow chart for the diagnosis and some recommendations for the management ScienceDirect 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?