Oral hairy leukoplakia: observations in 95 cases and review of the literature

Abstract

Oral hairy leukoplakia; observations in 95 cases and review of the literature, J Oral Pathol Med 1989; 18; 410-415. Oral hairy leukoplakia (HL) was observed in 25.4% of 373 HIV-seropositive patients (« = 95). 87 were men of an average age of 37.1 yr, 8 were women (30,3 yr). 71.6% of the patients were male homosexuals. At initial diagnosis of HL the majority of cases was elassified as CDC IVc, (45,3%) and CDC II (22,1%), Average CD4/CD8 ratio {n = 19) was 0,24 with a range of 0,04-1,0, Thirty biopsies of HL revealed some of the histologic features thought to be characteristic. In only 20 of 30 biopsies EB-virus-specific-capsid antigen was detected. The problems of clinical and histological diagnosis of HL are discussed. Further strict criteria are necessary in order to define HL more ' distinctly. Three years after the first patients with acquired immunodeficiency syndrome (AIDS) were reported in 1981, oral hairy leukoplakia (HL) was described (1). Clinical features and epidemiologyOral hairy leukoplakia is clinically characterized as a white lesion of the lateral border of the tongue, occasionally also occurring in the buccal mucosa with slightly raised, poorly demarcated and corrugated "hairy" surface. Lesions cannot be rubbed off and are reported to be usually symptomless. Hairy leukoplakia has so far not been observed in other mucosal areas than the oral (2), During recent years a number of HL cases either as case reports or larger series have been reported from various areas of the USA, , While HL was initially observed in male homo-or bisexual men, it has now been shown to occur, though less often, in all HIV risk groups; hemophiliacs (4, 8, 21), drug abusers (6, 10, 17), blood transfusion recipients (21) and female partners of HIV-infected men (21). Recently, HL has been described in an HIV-negative patient with acute myeIoblastic leukemia (22) and an HIVnegative renal transplant patient (23), suggesting that HL is not a specific lesion associated to the HIV-infection, but may be a sign of immunosuppression in general.Prevalence rates of HL vary considerably. Four out of 23 patients with antibodies against HIV revealed HL (17.5%) (24), Among 115 HIV-seropositive patients 13% revealed HL (25). Among HIV-seronegative male homosexuals {n = 492) 1% demonstrated HL (25). Of a total of 375 homosexual men 28% had developed HL; it occurred in 23% of the AIDS cases, in 9% of the ARC cases and 47% in high risk persons (9), In a study from Berlin, 26% of ARC patients had HL (6). In Copenhagen, 32% of 69 seropositive asymptomatic patients, 36% and 46% of ARC and AIDS patients revealed HL (26), Low prevalenee rates were reported from New York (5%) and Frankfurt (4,8%) (28), None of 30 hemophiliac patients with factor VIII or IX deficiencies revealed HL (29), In contrast, 23 of 120 consecutive patients belonging to the i.v, drug abusing risk group (19%) had developed HL (17), In a study on oral manifestations of AIDS in Tanzania 35% of 58 patients had developed HL, The male; female ratio in this cohort was 1,6 ; 1,0...

Detection of the Epstein–Barr Virus (EBV) by In situ Hybridization as Definitive Diagnosis of Hairy Leukoplakia

“…The most common histopathological features observed in our study were similar to those found in other studies [20,27,30], except for the presence of hyphae of Candida sp. Candida was found in 27.7% of the specimens analyzed in this study, which is below the average of 50% found in other studies [30].…”

“…Candida was found in 27.7% of the specimens analyzed in this study, which is below the average of 50% found in other studies [30]. Since the emergence of AIDS, the diagnosis of HIV-related oral lesions has been important to the diagnosis, monitoring, and staging of the syndrome.…”

A retrospective analysis of oral hairy leukoplakia in South Australia

“…CD4+ Tlymphocyte counts also help predict the development of opportunistic infections. [22][23] Reichart et al 24 found, in a study of 95 HIV-infected patients with clinical and histological evidence of OHL, the average CD4+ Tlymphocyte count was 149 cells/µL (range 10-470 cells/µL). Glick et al 25 found, in patients with OHL, the mean CD4+ T-lymphocyte count was 143.3 cells/µL.…”

Importancia de la detección temprana de cáncer.

“…Para ciertas formas de cáncer se ha detectado agregación en la familia por factores genéticos, como se observa en el cáncer de mama. Se ha determinado también de que algunos tipos de cáncer pueden vincularse con infecciones, ejemplo, virus de Hepatitis B y hepatoma, HTLV1 y linfoma de células T, cáncer de estomago y Helicobacter pylori, entre otros (2). También se conoce ampliamente que los pacientes infectados con VIH, durante la progresión de su enfermedad desarrollan un mayor riesgo de tumores, algunos de los cuales pueden estar relacionados a enfermedades que se adquieren sexualmente, como el virus de Papiloma.…”