What Is Hairy Leukoplakia?

Hairy leukoplakia refers to a hairy white plaque-like lesion that occurs at the lateral edge of the tongue. It is a common oral mucosal lesion in AIDS patients, also known as oral hairy leukoplakia and oral lingual warts. It is common among homosexuals, heterosexuals, drug users, people with hemophilia, people who receive blood transfusions and use of blood products, and HIV-infected sexual partners. High incidence between 20 and 50 years old. Hairy leukoplakia is an early clinical symptom with relatively high AIDS specificity, and the patient has no conscious symptoms or mild burning pain.

Basic Information

English name

hairyleukoplakia

Visiting department

Stomatology

Multiple groups

Homosexuality, heterosexuality, drug users, people with hemophilia, receiving blood transfusions, using blood products, HIV-infected sexual partners, etc.

Common locations

Lingual margin

Common causes

EB virus infection, human papillomavirus infection, EB virus, human papilloma virus mixed infection, human papilloma virus and herpes virus infection

Causes of hairy white spot

Hairy leukoplakia is caused by EB virus infection, human papilloma virus infection, mixed infection of EB virus and human papilloma virus, or human papilloma virus with herpesvirus infection. The disease often occurs in the lateral margin of the tongue. Due to the physiological deficiency of Langerhans cells in this area, the resistance of antibodies in this area is reduced, and it is easy to be attacked by the above viruses. The low CD4 + cell function is that the virus easily proliferates and spreads, causing excessive proliferation of the epithelium. Therefore, the horny protrusions and hairy white spots of the tongue can be seen clinically.

Hairy white spots clinical manifestations

Hairy leukoplakia is an early clinical symptom with quite high AIDS specificity, and 20% of AIDS patients may be accompanied by hairy leukoplakia. Hairy leukoplakia is common on the lateral edge of the tongue, followed by the abdomen, back of the tongue, bottom of the mouth, cheeks, palate and other parts. The skin lesions are bleaching white spots, slightly raised, the boundaries are not clear, the surface is wrinkled, hairy or fibrous, and sometimes large plaques are adhered to the side of the tongue, which cannot be wiped off, which can accompany the tongue. No conscious symptoms or mild burning pain.

Hairy leukoplakia

Laboratory inspection

The serum HIV antibody test was positive; the absolute count of peripheral CD4 + cells was significantly reduced, and the ratio of CD4 + / CD8 + cells was low; PAS stains or cultures were taken from the lesions, and Candida albicans was positive.

2. Histopathological examination

The epidermal stratum corneum has hairy protrusions, hyperkeratosis and incomplete keratosis, spinous layer hypertrophy and balloon-like degeneration, cell volume increase, nuclear condensation, pale cytoplasm staining, and even formation of vacuole cells. There are infiltrating inflammatory cells under the epidermis, mainly lymphocytes, a small number of neutrophils and plasma cells. Immunohistochemistry and electron microscopy confirmed the presence of the virus.

Hairy white spot diagnosis

The lesion on the lingual side is a white plaque with a hairy appearance. The plaque is not easily wiped off, and antifungal treatment is ineffective. Based on the histological characteristics of the disease, a diagnosis can generally be made.

Differential diagnosis of hairy leukoplakia

The disease needs to be distinguished from white candidiasis and leukoplakia of the mucosa.

Hairy leukoplakia treatment

1. Pay attention to nutrition, work and rest, maintain adequate sleep and good mood help to regulate the patient's immune function and slow or prevent the progress of the disease.

2. When combined with Candida infection, apply anti-Candida drugs locally or systemically.

3. Local application of 0.1% retinoic acid solution can temporarily eliminate the lesion, but cannot prevent recurrence.

4. If HIV positive, according to the principles of treatment of AIDS, the effective application of effective antiviral drugs.