Journal Article

Oral Hairy Leukoplakia: Clinicopathologic Features, Pathogenesis, Diagnosis, and Clinical Significance

Dimitris Triantos, Stephen R. Porter, Crispian Scully and Chong Gee Teo

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 25, issue 6, pages 1392-1396
Published in print December 1997 | ISSN: 1058-4838
Published online December 1997 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/516131
Oral Hairy Leukoplakia: Clinicopathologic Features, Pathogenesis, Diagnosis, and Clinical Significance

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Oral hairy leukoplakia (OHL) is a lesion frequently, although not exclusively, observed in patients infected by human immunodeficiency viruses (HIV). OHL is clinically characterized by bilateral, often elevated, white patches of the lateral borders and dorsum of the tongue. Histologically, there is profound acanthosis, sometimes with koilocytic changes, and a lack of a notable inflammatory infiltrate. The koilocytic changes are due to intense replication of Epstein-Barr virus (EBV), while epithelial hyperplasia and acanthosis are likely to result from the combined action of the EBV-encoded proteins, latent membrane protein-1, and antiapoptotic BHRF1. How OHL is initiated and whether it develops after EBV reactivation from latency or superinfection remain unresolved; nevertheless, definitive diagnosis requires the demonstration of EBV replicating vegetatively in histological or cytological specimens. In patients with HIV infection, the development of OHL may herald severe HIV disease and the rapid onset of AIDS, but despite its title, OHL is not regarded as premalignant and is unlikely to give rise to oral squamous cell carcinoma.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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