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Severe oral ulceration in patients with HIV infection: a case series
J M Zakrzewska1, P Robinson, I G Williams
1Department of Oral Medicine, St Bartholomew's, London, UK.
Objective:
Oral ulceration occurs in an estimated 2-4% of patients with HIV infection. This retrospective observational study describes the aetiology and characteristics of 94 HIV-positive patients with either severe and/or recurrent oral ulceration presenting at a dedicated HIV dental unit over a 4-year period.
Methods:
Case records were reviewed for diagnosis investigations, CD4 count, CDC stage and treatment modality.
Results:
Of the 94 patients 50% had an AIDS diagnosis. In patients with asymptomatic HIV disease minor recurrent oral ulceration was the commonest diagnosis whilst large non-specific neutropenic ulcers were more frequently seen in patients with symptomatic disease with low CD4 counts. A variety of treatment modalities were used including thalidomide. An algorithm is presented for the management of patients with severe oral ulceration.
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