[Oral hairy leukoplakia. Epithelial hyperplasia in immunodeficient persons related to Epstein-Barr virus]

Oral hairy leukoplakia appears as white vertical stripes on the lateral borders of the tongue and occurs almost exclusively in HIV infected patients. The clinical appearance of hairiness is a result of emergence of floss of the parakeratinized epithelial surface. The etiologic agent seems to be Epstein-Barr virus, which may be diagnosed by in situ hybridization on tissue sections. Illustrations are shown from the case of a 30 year-old man. Approximately 25-30% of HIV positive patients have been reported to be affected by oral hairy leukoplakia. Although not causing any pain or discomfort the lesion is of clinical importance, since it may be the first sign of the development of AIDS. Moreover, for some patients who do not know their HIV infection status it may be the first sign of infection, and should alert the physician to the need to HIV test the patient.