Oral hairy leukoplakia (OHL) is a benign, virally induced hyperplasia of the oral mucosa, most commonly of the inferolateral surface of the tongue, characterized by white, corrugated, verrucous plaques, occurring in patients with symptomatic HIV disease.
Causes of Oral Hairy Leukoplakia
Many adults have asymptomatic EBV infection of the oral mucosa. EBV is thought to emerge from latency as HIV-induced immunocompromise progresses and to cause the epidermal hyperplasia in OHL. In those patients who do not carry the diagnosis of AIDS at the time of detection of OHL, the probability of developing AIDS has been reported to be 48% by 16 months after detection and 83% by 31 months.
Symptoms of Oral Hairy Leukoplakia
Oral hairy leukoplakia does not cause any symptoms. It does not affect taste and does not cause pain or discomfort. If it becomes very heavy or noticeable, it can be treated.
More than 25% of HIV-positive people develop OHL at some point during the course of their infection. It is most common among HIV-positive men and smokers.
Diagnosis
Clinical diagnosis. Does not rub off; does not clear with adequate anticandidal therapy.
Treatment
OHL is asymptomatic, but its presence may cause anxiety in patients with the lesion. Reassurance that OHL is a benign viral infection is usually adequate to reduce patients’ concerns.
Topical Therapy Podophyllin 25% in tincture of benzoin applied to the lesion with a cottontipped applicator for 5 min is very effective in most individuals. OHL usually recurs in weeks to months.
Systemic Antiviral Drugs Concomitant use of acyclovir, valacyclovir, famciclovir, ganciclovir, foscarnet for other indications often results in regression/clearing of OHL.
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