Hairy oral leukoplakia: Difference between revisions
ClaireLewis (talk | contribs) No edit summary |
m (Rossdonaldson1 moved page Hairy Oral Leukoplakia to Hairy oral leukoplakia) |
||
| (One intermediate revision by one other user not shown) | |||
| Line 7: | Line 7: | ||
*Characterized by white plaques over the lateral sides of the tongue. | *Characterized by white plaques over the lateral sides of the tongue. | ||
*Unlike [[oropharyngeal candidiasis]], the white plaques are unable to be scraped off. | *Unlike [[oropharyngeal candidiasis]], the white plaques are unable to be scraped off. | ||
*It is asymptomatic, with most patients presenting over concern for aesthetic appearance | *Unlike other forms of leukoplakia, it is NOT a precancerous lesion | ||
*It is asymptomatic, with most patients presenting over concern for aesthetic appearance | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
Latest revision as of 18:07, 6 May 2021
Background
- 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.
Clinical Features
- 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
Differential Diagnosis
Tongue diagnoses
- Tongue laceration
- Strawberry tongue
- Black hairy tongue
- Oropharyngeal candidiasis (oral thrush)
- Hairy Oral Leukoplakia
- Tongue swelling
- Trauma
- Angioedema
- Hereditary
- Allergic (ACE)
- Idiopathic
Oral rashes and lesions
- Angioedema
- Aphthous stomatitis
- Herpes gingivostomatitis
- Herpes labialis
- Measles (Koplik's spots)
- Perioral dermatitis
- Oral thrush
- Steven Johnson syndrome
- Streptococcal pharyngitis
- Tongue diagnoses
- Vincent's angina
Evaluation
- Diagnosed clinically
- Consider HIV testing if no other etiology is determined or if risk factors are present
Management
- 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
Disposition
- Discharge unless concomitant symptoms require further work-up
See Also
References
- 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.