History of the present illness

This is an 84-year-old white female referred by her dentist for the evaluation of a flat bluish black lesion on the anterior ventral surface of tongue (Figure 1). The lesion was of unknown duration and was asymptomatic.

Figure 1 Clinical photograph of the lesion taken at the first visit. Note the flat, irregular, dark blue to black lesion on the anterior ventral surface of tongue. Also note the purplish-red flat or slightly raised blebs on the lateral ventral surface of tongue