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Hairy leukoplakia--a histological study.

J C Southam1, D H Felix, D Wray

  • 1Department of Oral Medicine & Oral Pathology, University of Edinburgh, Scotland, UK.

Histopathology
|July 1, 1991
PubMed
Summary

Hairy leukoplakia, an oral condition in immunocompromised individuals, is linked to Epstein-Barr virus (EBV) reactivation. Histological analysis reveals characteristic epithelial changes and EBV-infected cells, aiding diagnosis.

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Area of Science:

  • Oral Pathology
  • Virology
  • Immunology

Background:

  • Hairy leukoplakia is an oral mucosal condition observed in immunosuppressed individuals.
  • It is frequently associated with Human Immunodeficiency Virus (HIV) infection, indicating reduced immune function.
  • The condition is believed to stem from the reactivation of Epstein-Barr virus (EBV).

Purpose of the Study:

  • To histologically characterize hairy leukoplakia.
  • To identify key cellular and viral markers for diagnosis.
  • To differentiate typical from atypical presentations.

Main Methods:

  • Histological examination of 20 patient cases.
  • Microscopic analysis of epithelial and subepithelial tissues.
  • Identification of EBV-infected cells and Candida hyphae.

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Main Results:

  • Typical hairy leukoplakia shows acanthotic, hyperkeratinized epithelium with EBV-infected koilocyte-like cells in the upper prickle cell layer.
  • Candida hyphae may be present in the parakeratin layer.
  • Atypical cases exhibit irregularly arranged koilocyte-like cells without hyperkeratinization.

Conclusions:

  • Histological findings are crucial for diagnosing hairy leukoplakia.
  • The presence of EBV-infected koilocyte-like cells is a hallmark of the condition.
  • Immunocytochemistry or DNA in situ hybridization can confirm EBV presence for definitive diagnosis.