Hairy Leukoplakia

Comments:
Hairy Leukoplakia (HL) is infection of the oral epithelium caused by Epstein-Barr virus (EBV). It is the most common EBV-related lesion in HIV+ patients, usually in those with severe immunosuppression and advanced disease. It is considered an AIDS-defining lesion. It has also been reported in organ transplant recipients and sometimes in apparently immunocompetent individuals. It does not confer increased risk for dysplasia or squamous cell carcinoma, unlike true leukoplakia.

Most cases (>70%) appear bilaterally along the lateral border of the tongue as a white mucosal plaque with a shaggy or corrugated surface that does not rub off. Early cases show white vertical keratin streaks and fissures perpendicular to the long axis of the tongue. Less often it covers the entire dorsal and lateral surfaces of the tongue and even the entire buccal mucosa, soft palate, pharynx or esophagus.

Image credit: Sol Silverman, Jr., DDS; CDC/PHIL.