Hairy oral leukoplakia: Difference between revisions

Revision as of 01:24, 22 October 2020

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.
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

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

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.

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
-*It is caused by the Epstein-Barr Virus (EBV)
+*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.
+*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==
-*Hairy Oral Leukoplakia is 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
@@ Line 21: / Line 21: @@
 * 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
+* High dose [[acyclovir]] can be used (4g/day), but relief is temporary and often lesions recur until immunocompromised status is reversed
 ==Disposition==
-*Hairy Oral Leukoplakia is a benign condition and patients may be discharged home unless concomitant symptoms require further work-up
+*Discharge unless concomitant symptoms require further work-up
 ==See Also==
@@ Line 33: / Line 33: @@
 *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.
+[[Category:ENT]]