Oral hairy leukoplakia in a HIV‐negative asthmatic patient on systemic steroids

Abstract

During an acute exacerbation of asthma, a HIV‐negative patient with a normal CD4 count presented with candidiasis and hairy leukoplakia which receded with treatment by systemic antifungals.

Prevalence of oral hairy leukoplakia and epithelial infection by Epstein-Barr virus in pregnant women and diabetes mellitus patients: cytopathologic and molecular study

“…The development of OHL and candidiasis in patients with severe immunodeficiency, as in HIV seropositive, organ-transplanted subjects and in individuals presenting malignant neoplasias, is already well documented in the literature (Blomgren & Bäck 1996, Ammatuna et al 2001, Casiglia & Woo 2002. Conversely, a relevant fact is that OHL findings in HIV seronegative patients, with low or moderate immunosuppression, or even in clinically healthy individuals are scarce (Eisenberg et al 1992, Felix et al 1992, Lozada-Nur et al 1994, Schiodt et al 1995, Zakrzewska et al 1995. Considering the importance of candidiasis and OHL as markers and EBV association to several malignant neoplasias, it is pertinent to identify the frequency of EBV infection and candidiasis not only in healthy individuals, but also in those showing different degrees of immunosuppression.…”

“…However, according to the literature (Table I) there are cases of OHL in patients with moderate or minor immunosuppression (self-immune diseases) and also in immunocompetent individuals (Eisenberg et al 1992, Felix et al 1992, Lozada-Nur et al 1994, Schiodt et al 1995, Zakrzewska et al 1995. Besides molecular methods to detect the presence of EBV in OHL suspect lesions, the diagnosis might be done through the identification of nuclear alterations that represent the cytopathic effect of EBV on keratinocytes: Cowdry A inclusion, ground glass and nuclear beading.…”

Oral hairy leukoplakia in a patient with acute lymphocytic leukemia

“…From the up-to-date literature data, it is clear that OHL is related to immunosuppression (Itin et al, 1988;Syrjanen et al, 1989;King et al, 1994) but immunosuppression is not the only or even the main biological factor for its pathogenesis. EBV is presumably the cause, although one reported case, in which the EBV DNA was demonstrated by in situ hybridization, receded after treatment with systemic antifungals (Zakrzewska et al, 1995). The OHL-like patterns of several lesions in which the EBV DNA cannot be demonstrated intra-epithelially (Epstein et al, 1993;Brehmer-Andersson et al, 1994;Ogutcen Toller, 1996), have posed certain arguments on the significance and the specificity of OHL.…”

“…Oral hairy leukoplakia (OHL) which was first described in 1984 (Greenspan et al, 1984) has been considered as a valuable early diagnostic and prognostic indicator for HIV infection in adults. (Greenspan and Greenspan, 1992;Lifson et al, 1994;Ravina et al, 1996) Since 1984 there have been many reports of OHL in HIV-infected patients and an increasing number of cases of OHL have been published in the literature in HIV-negative immunocompromised patients (Itin et al, 1988;Syrjanen et al, 1989;Schmidt-Westhausen et al, 1990;Epstein et al, 1993;Fluckiger et al, 1994;King et al, 1994;Schiodt et al, 1995;Zakrzewska et al, 1995;Blomgren and Back, 1996). A few cases of OHL have also been reported in HIV-negative immunocompetent subjects (Eisenberg et al, 1992;Felix et al, 1992;Lozada et al, 1994).…”

Twenty-first-century oral hairy leukoplakia—a non–HIV-associated entity

“…18 However, OHL has also been described in apparently immunocompetent individuals. 19,20 Long-term inhaled, 21,22 topical, 23 and systemic 17 steroid use has been identified as a risk factor in the development of OHL. Hypogammaglobulinemia secondary to long-term anticonvulsant treatment using lamotrigine has also been associated with OHL.…”