ORAL HAIRY LEUKOPLAKIA IN IMMUNOCOMPROMISED PATIENTS

Oral hairy leukoplakia has been demonstrated in immunocompromised patients. This was first described as pathognomonic of infection with the human immunodeficiency virus (HIV); however, it has been noted since in groups that are not HIV positive, but who are chronically and severely immunosuppressed. The presence of Epstein-Barr virus (EBV) is common in these lesions although not all lesions that clinically and histologically resemble hairy leukoplakia are Epstein-Barr virus positive. The lesion serves as a marker of probable reactivation of EBV in a chronic immunosuppressed patient. In those without a specific history of another disease or medical management, HIV infection is the probable cause of immunosuppression. The condition is generally asymptomatic and usually does not require therapy. Thorough oral examination is important due to the significance of the underlying etiology that the presence of this lesion may represent.