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Updated February 3, 2011

Case 2: Oral Hairy Leukoplakia

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

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.

  • The following link will open in a new window.
    Figure 1. Oral Hairy Leukoplakia

    Bilateral white patchy OHL lesions located predominantly on the lateral aspect on the tongue. The lesions did not remove when scraped with a tongue blade.


    Figure 1
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    Figure 2. Oral Hairy Leukoplakia Lesion on Lateral Tongue

    In this patient, oral hairy leukoplakia was most evident on the lateral aspect on the tongue. The lesions would not have been evident without examining the lateral tongue.


    Figure 2