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Hairy leukoplakia is one of the most common oral manifestations of HIV/AIDS, along with oral candidiasis. [7] It is the most common HIV/AIDS related condition caused by EBV, although EBV associated lymphomas may also occur. [5] OHL mainly occurs in adult males, less commonly in adult females and rarely in children. [8]
Oral hairy leukoplakia is a corrugated ("hairy") white lesion on the sides of the tongue caused by opportunistic infection with Epstein-Barr virus on a systemic background of immunodeficiency, almost always human immunodeficiency virus (HIV) infection. [15]
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).
Oral manifestations of systematic disease are signs and symptoms of disease occurring elsewhere in the body detected in the oral cavity and oral secretions. High blood sugar can be detected by sampling saliva. [1] Saliva sampling may be a non-invasive way to detect changes in the gut microbiome and changes in systemic disease.
HIV-SGD is more prevalent in HIV positive children than HIV positive adults, [4] at about 19% and 1% respectively. [1] Unlike other oral manifestations of HIV/AIDS such as Kaposi sarcoma, oral hairy leukoplakia and oral candidiasis, which decreased following the introduction of highly active antiretroviral therapy (HAART), HIV-SGD has increased.
Oral candidiasis; Oral hairy leukoplakia; Pulmonary tuberculosis (TB) diagnosed in last two years; Severe presumed bacterial infections (e.g. pneumonia, empyema, meningitis, bacteraemia, pyomyositis, bone or joint infection) Acute necrotizing ulcerative stomatitis, gingivitis or periodontitis
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]