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Case 2: Oral Hairy Leukoplakia

Authors: David H. Spach, MD
Mark M. Schubert, DDS, MSD

Case last updated: October 6, 2008

A 35-year-old HIV-infected man with a CD4 count of 100 cells/mm3 visits the clinic for a routine appointment. On examination, white papular lesions are observed bilaterally on the lateral aspect of his tongue (Figure 1 and Figure 2). These white lesions are presumptively diagnosed as oral hairy leukoplakia.

Which of the following statements is TRUE regarding oral hairy leukoplakia?

A It occurs in approximately 5% of persons infected with hepatitis C virus (who are not co-infected with HIV).
B It is caused by infection with human herpes virus type 8 (HHV-8).
C It is caused by infection with Epstein-Barr virus.
D Approximately 15% of lesions develop into premalignant lesions that require surgical removal.
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    Figure 1 - Oral Hairy Leukoplakia Figure 1
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    Figure 2 - Oral Hairy Leukoplakia Lesion on Lateral Tongue Figure 2