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Hairy leukoplakia is a white patch on the side of the tongue with a corrugated or hairy appearance. It is caused by Epstein-Barr virus (EBV) and occurs usually in persons who are immunocompromised , especially those with human immunodeficiency virus infection/ acquired immunodeficiency syndrome (HIV/AIDS).
Leukoplakia is, therefore, the most common premalignant lesion that occurs in the mouth. [41] Leukoplakia is more common in middle-aged and elderly males. [30] The prevalence increases with increasing age. [2] In areas of the world where smokeless tobacco use is common, there is a higher prevalence. [2]
Oral hairy leukoplakia (seen in people with immunosuppression, caused by Epstein–Barr virus) Oral candidiasis can affect the tongue. Risk factors for oral candidiasis include antibiotic and corticosteroid use, and immunodeficiency (e.g. HIV), [5] or diabetes mellitus).
Hairy tongue may be confused with hairy leukoplakia, however the latter usually occurs on the sides of the tongue and is associated with an opportunistic infection with Epstein–Barr virus on a background immunocompromise (almost always human immunodeficiency virus infection but rarely other conditions which suppress the immune system).
Diagnosis is mainly clinical, based on the history and clinical appearance. The differential diagnosis includes other oral white lesions such as Leukoplakia, squamous cell carcinoma, oral candidiasis, lichen planus, white sponge nevus and contact stomatitis. [7] In contrast to pseudomembraneous candidiasis, this white patch cannot be wiped off. [7]
Abnormal findings includes marked redness, cyanosis or extreme pallor. Diseases include scrotal or fissured tongue, migratory glossitis (geographic tongue), atrophic glossitis, black hairy tongue, caviar lesions, carcinoma, macroglossia, candidiasis, aphthous ulcer and leukoplakia.
Hairy cell leukemia is an uncommon hematological malignancy characterized by an accumulation of abnormal B lymphocytes. [1] The incidence of hairy cell leukemia (HCL) is 0.28-0.30 cases per 100,000 people in Europe and the United States and the prevalence is 3 cases per 100,000 in Europe with a lower prevalence in Asia, Africa and the Middle East.
In pseudomembraneous candidiasis, the membranous slough can be wiped away to reveal an erythematous surface underneath. This is helpful in distinguishing pseudomembraneous candidiasis from other white lesions in the mouth that cannot be wiped away, such as lichen planus, oral hairy leukoplakia. Erythematous candidiasis can mimic geographic tongue.