​Dermatology - Oral Hairy Leukoplakia

​Dermatology - Oral Hairy Leukoplakia
The Epstein-Barr virus reactivates from a dormant state in individuals with severe HIV infection, leading to the development of harmless excessive growth of the mucous membranes. Occurs when the CD4+ cell count is below 300 cells per microliter.

The condition is characterized by the absence of symptoms, however patients may be worried about the social stigma associated with HIV infection.
Abnormalities
The tongue exhibits white or grayish-white plaques that are well defined and have a wrinkled texture. These plaques are commonly found on the sides and undersides of the tongue, and are frequently present on both sides. The lesions are resistant to rubbing or clearing even with sufficient anticandidal treatment.

The diagnosis is based only on clinical observations and assessments. The differential diagnosis comprises pseudomembranous candidiasis (thrush), geographic or migratory glossitis, tobacco-associated leukoplakia, mucous patch of secondary syphilis, and squamous cell carcinoma in situ.

Antiviral treatment and immunological reconstitution typically lead to the resolution of oral hairy leukoplakia.
Lesions can also be treated with a 25% concentration of podophyllin in tincture of benzoin. This solution is applied to the lesion using a cotton-tipped applicator for a duration of 5 minutes.