Can a black pigmented lesion of the oral cavity : Journal of Family Medicine and Primary Care Oral pigmented lesions: a pragmatic approach to diagnosis and management Faculty Dental Journal 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? Angiokeratomas on the tongue Stock Image C056 4416 Science Photo Library What Causes Dark Spots on the Tongue? Pigmented fungiform papillae of the tongue Cosmoderma