Hairy Oral Leukoplakia
- It is caused by the Epstein-Barr virus (EBV)
- Most commonly seen in immunocompromised individuals, and has a high specificity for individuals with HIV/AIDs.
- The white plaque appearance is due to hyperkeratosis and epithelial hyperplasia.
- Characterized by white plaques over the lateral sides of the tongue.
- Unlike oropharyngeal candidiasis, the white plaques are unable to be scraped off.
- Unlike other forms of leukoplakia, it is NOT a precancerous lesion
- It is asymptomatic, with most patients presenting over concern for aesthetic appearance
- Tongue laceration
- Strawberry tongue
- Black hairy tongue
- Oropharyngeal candidiasis (oral thrush)
- Hairy Oral Leukoplakia
- Tongue swelling
- Allergic (ACE)
- Aphthous stomatitis
- Herpes gingivostomatitis
- Herpes labialis
- Measles (Koplik's spots)
- Perioral dermatitis
- Oral thrush
- Steven Johnson syndrome
- Streptococcal pharyngitis
- Tongue diagnoses
- Vincent's angina
- Diagnosed clinically
- Consider HIV testing if no other etiology is determined or if risk factors are present
- The condition is benign and does not require treatment but many patients have concerns about the aesthetic appearance.
- Foundation of treatment is aimed at workup and management of the often underlying concomitant immunocompromised disease process.
- High dose acyclovir can be used (4g/day), but relief is temporary and often lesions recur until immunocompromised status is reversed
- Discharge unless concomitant symptoms require further work-up
- Chapple, IL; Hamburger, J (August 2000). "The significance of oral health in HIV disease". Sexually Transmitted Infections. 76 (4): 236–43. doi:10.1136/sti.76.4.236. PMC 1744197. PMID 11026876
- Cherry-Peppers, G; Daniels, CO; Meeks, V; Sanders, CF; Reznik, D (February 2003). "Oral manifestations in the era of HAART". Journal of the National Medical Association. 95 (2 Suppl 2): 21S–32S. PMC 2568277. PMID 12656429.