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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.

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Phentermine has also been associated with rare reports of pulmonary hypertension and valvular heart disease with long-term use

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In fact, free radical damage is now associated with all of the common diseases of aging