Tongue patches

I am 20. My tongue has been bluish black in colour since birth. The pigmentation is now darkening and spreading. Is it a symptom of any disease?

It may be a case of haemangioma tongue caused by malformation of blood vessels. It is congenital in nature. In some cases, small blue or black patches are found in the tongue or oral cavity. A harmless condition, this is called “geographical tongue”. Sometimes, the blackish colour may spread to the entire tongue as well as other parts of the body due to licken planus (a disease of the epithelial layer). Haemangioma tongue causes occasional bleeding. Laser surgery, cryo surgery and infiltration of scleroing agent to the affected tissues may help.

Running nose

My daughter’s (13) nose runs throughout the year. Anti allergic drugs give temporary relief. Is there a permanent solution?

This may be due to perineal allergic rhinitis, caused by food allergy or environmental allergens like dust, pollens or mites. A permanent solution lies in identifying the allergen responsible and avoiding it. Anti allergic therapy along with systemic decongestant and nasal drops or nasal spray (cortico steroid spray with least toxic effects) may help. If this fails, immuno therapy would be needed in which a patient is injected with specific allergens responsible for the allergy. It takes about two-three years to desensitise a patient.

Dry cough

I suffer from frequent bouts of dry cough and irritation, especially during season change. Please advise.

Dry cough and irritation of throat or larynx and trachea is due to common cold, viral infection of the upper respiratory tract or allergy. Investigations like blood test, eosinophil count and chest X-ray are needed. Cough suppressive drugs, anti allergics or antibiotics help. But if the problem persists, and is associated with blood in sputum or fever in the elderly, tests to rule out any malignancy or tuberculosis of the chest are needed.

Throat pain

My son (8) has been suffering from high fever with throat pain and difficulty in swallowing. He can’t even open his mouth properly. Please advise.

Your son is probably suffering from acute follicular tonsillitis. The tonsils get enlarged and congested with patches on the surface and neck nodes. The patches may also be due to diptheria. Besides clinical examination, investigations like blood test, throat swab for culture and sensitivity to a particular organism are needed. Antibiotics, antiseptic mouthwash, anti inflammatory or anti pyretic drugs are prescribed in this disease.

Ear discharge

I frequently suffer from painless ear discharge. What is wrong?

Recurrent mucoid or blood strained discharge for long periods could be due to middle ear infection, which may lead to hearing loss. If medication doesn’t help, surgical intervention like tympanoplasty or mastoidectomy (microsurgery) is required.

Painless tumour

I have an odd-looking big, painless tumour behind my left ear. Is it cancerous? What should I do?

A painless tumour could be benign or cancerous. The first grows slowly and takes two-three years to mature. The malignant ones grow faster and become bigger in size within just three-four months. Also, they are painless in the early stage. Diagnosis depends on the history and clinical examination including investigations like routine blood, X-ray, CT scan and biopsy. Surgery is the only solution. In case of malignancy, post-surgical radiation and chemotherapy are needed.