Black Coating on a Woman’s Tongue

After a “swig” of Kaopectate, this patient noticed tongue discoloration. Is this coincidental, or is there a clinical connection?

This image of the dorsum of the tongue of a 42-year-old African American woman shows parallel linear black coatings.

What's your suspicion?

Mucosal candidiasis
Oral leukoplakia
Black hairy tongue
Pigmented fungiform papillae
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