Oral hairy leukoplakia is a common, benign disorder of the oral cavity of patients with HIV that has been associated with Epstein Barr Virus infection. OHL is a feature of immunosuppression in general and is not limited to HIV infected patients. It is found in 7.5-25% of HIV infected patients and in up to 36% of patients with AIDS [JAAD 1996;35;928].
White, verrucous, corrugated plaques on the sides of the tongue in an HIV-positive patient are characteristic. Occasionally, the dorsa of the tongue, buccal mucosa and/or palate may be involved. Lesions on the pharynx and esophagus have been described. Occasionally patients with other types of immunosuppresion may be affected (e.g. renal transplant patients). The term pseudo hairy leukoplakia is used for patients with clinically similar lesions who are HIV negative, immunocompetent and where no EBV is found.
No treatment is needed. Improving the immune status of the patient may improve the lesions. Weekly topical 25% podophyllin combined with 5% acyclovir cream was very effective in one study [Oral surg oral med oral path oral radio endo 2007:103;64]. oral acyclovir and topical tretinoin have been been used. A single application of 25% podophyllin was quite effective as was foscarnet.
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