Oral hairy leukoplakia, viral infection

Oral hairy leukoplakia has a high incidence rate among men and is very common in AIDS patients. It is a viral infection, and this disease is easily confused with candidiasis and oral lichen planus. Attention should be paid to diagnosis and differentiation and symptomatic treatment.

1. Reasons

It is caused by infection with human papillomavirus, Epstein-Barr virus, or human papillomavirus combined with herpes virus, and often occurs in patients with AIDS. It has been found that 78 out of 79 patients with this disease were HIV antibody positive, so this disease is considered a clinical sign for early monitoring of AIDS patients.

2. Physiological changes

The epidermis is hyperkeratotic, with keratin protruding from the surface (often resembling hairs), parakeratosis, acanthosis, and large, light-stained, balloon-like cells with pyknotic nuclei in the upper part of the spinous layer below the parakeratosis. The dermis rarely shows inflammation.

3. Symptoms and signs

On one or both sides of the lateral edge of the tongue there are wrinkled or hairy white patches, which are slightly raised and have unclear boundaries. They range in size from a few millimeters to 3.5×3 cm. There are no subjective symptoms. The lesions may also develop to the dorsum or ventral side of the tongue. Candida can often be detected clinically, but the lesions persist after the disappearance of Candida with antifungal drugs. Therefore, the presence of Candida is considered to be secondary.

4. Diagnostic examination

The diagnosis can be made based on clinical manifestations and pathological changes, but it needs to be differentiated from diseases such as mucosal leukoplakia, candidiasis, white sponge nevus, oral lichen planus, and geographic tongue.