A 24-year-old man presented following intentional ingestion of paraquat. Oral examination revealed ulcerations covered with yellow slough on the tongue Figure 1 and multiple erosions involving the labial, buccal, and palatal mucosa Figure 2. This mucosal injury, termed as paraquat tongue, reflects direct epithelial toxicity. Although this finding is characteristic and may raise concern for significant systemic absorption, its prognostic value has not been established in large case series.Figure 1: Dorsum of the tongue showing yellowish slough and ulceration due to paraquat exposureFigure 2: Erosions on the labial, buccal, and palatal mucosa, with surrounding erythema and necrosisParaquat preferentially accumulates in the lung tissue, triggering oxidative injury and ultimately irreversible pulmonary fibrosis.1 Despite supportive and antioxidant therapy, the patient succumbed to multiorgan failure within 72 hours. In resource-limited settings, recognition of paraquat tongue may assist clinicians in suspecting significant systemic exposure and prioritizing monitoring and intervention; however, this observation requires further validation.2 Authors’ contributions We confirm that all authors have read and approved the manuscript for submission. All authors meet authorship criteria, and the manuscript represents honest work. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal his identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest. Use of artificial intelligence (AI) The preparation of this manuscript was carried out entirely by the authors without the use of artificial intelligence technologies.
Choudhary et al. (Wed,) studied this question.