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Hyperpigmentation is exclusively found in the papillae and usually has onset in childhood and is not progressive.2 The differential diagnosis includes Addison disease, Peutz-Jeghers syndrome, black hairy tongue, melanotic macule and melanocytic naevus.1 Paediatricians and paediatric dermatologists must be aware of this condition, as it can be diagnosed based on the clinical picture, avoiding the use of invasive tests.

Alternatively, they must respond with an explanation, with supporting materials, if they do not believe they have violated regulations.Potential Consequences: Failure to address the violations may result in legal action, including product seizure or an injunction

This is linked to many other comorbidities, he adds, including: Heart attack Stroke Chronic kidney disease (CKD) Non-alcoholic fatty liver disease (NAFLD) Sleep apnea (ongoing research) Fibrosis (ongoing research) The research is impressive