👅 Oral Hairy Leukoplakia – Overview
Oral hairy leukoplakia (OHL) is a white patch or plaque that appears on the side of the tongue, often with a “hairy” or corrugated texture. It is strongly associated with immunosuppression, especially in people with HIV/AIDS.
🧬 Cause:
- Caused by Epstein-Barr Virus (EBV) infection/reactivation
- Most commonly seen in immunocompromised individuals, particularly:
- People with HIV infection
- Organ transplant recipients
- Patients on immunosuppressive therapy
🩺 Clinical Features:
- White, painless plaques on the lateral borders of the tongue
- May look shaggy, hairy, or ridged
- Cannot be scraped off
- Often bilateral (both sides of tongue)
- No associated soreness or ulceration
🔍 Diagnosis:
- Clinical appearance is often sufficient
- Confirmed by:
- Biopsy and histopathological exam
- Detection of EBV DNA via PCR or in situ hybridization
⚠️ Important Associations:
- Often an early marker of HIV infection or progression to AIDS
- Can occur in other forms of immunodeficiency
- Not considered precancerous (unlike some other leukoplakias)
💊 Treatment:
- Often not necessary unless symptomatic or cosmetically concerning
- Treat the underlying immunosuppression (e.g., antiretroviral therapy in HIV)
- Antiviral therapy (e.g., acyclovir or valacyclovir) may reduce lesions but often recurs if stopped
- Lesions may regress spontaneously with immune recovery