Oral Hairy Leukoplakia

Last updated February 24, 2015
Case Authors: 
David H. Spach, MD's picture
David H. Spach, MD
Professor of Medicine
Division of Infectious Diseases
Clinical Director, Frontier AIDS Education and Training Center
University of Washington School of Medicine
Mark Schubert, DDS, MSD
Professor, Department of Oral Medicine
University of Washington School of Dentistry
Director, Oral Medicine, Seattle Cancer Care Alliance
Learning Objectives: 
  1. Identify the viral agent that has been most strongly associated with oral hairy leukoplakia.
  2. Understand the general approach to the management of oral hairy leukoplakia.

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  1. Husak R, Garbe C, Orfanos CE. Oral hairy leukoplakia in 71 HIV-seropositive patients: clinical symptoms, relation to immunologic status, and prognostic significance. J Am Acad Dermatol. 1996;35:928-34.
  2. Patton LL, McKaig R, Strauss R, Rogers D, Eron JJ Jr. Changing prevalence of oral manifestations of human immuno-deficiency virus in the era of protease inhibitor therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;89:299-304.
  3. Greenwood I, Zakrzewska JM, Robinson PG. Changes in the prevalence of HIV-associated mucosal disease at a dedicated clinic over 7 years. Oral Dis. 2002;8:90-4.
  4. Katz MH, Greenspan D, Westenhouse J, et al. Progression to AIDS in HIV-infected homosexual and bisexual men with hairy leukoplakia and oral candidiasis. AIDS. 1992;6:95-100.
  5. Mabruk MJ, Antonio M, Flint SR, et al. A simple and rapid technique for the detection of Epstein-Barr virus DNA in HIV-associated oral hairy leukoplakia biopsies. J Oral Pathol Med. 2000;29:118-22.
  6. Hille JJ, Webster-Cyriaque J, Palefski JM, Raab-Traub N. Mechanisms of expression of HHV8, EBV and HPV in selected HIV-associated oral lesions. Oral Dis. 2002;8 Suppl 2:161-8.
  7. Kabani S, Greenspan D, deSouza Y, Greenspan JS, Cataldo E. Oral hairy leukoplakia with extensive oral mucosal involvement. Report of two cases. Oral Surg Oral Med Oral Pathol. 1989;67:411-5.
  8. Dias EP, Rocha ML, Silva JúniorA, et al. Oral hairy leukoplakia. Histopathologic and cytopathologic features of a subclinical phase. Am J Clin Pathol. 2000;114:395-401.
  9. Triantos D, Porter SR, Scully C, Teo CG. Oral hairy leukoplakia: clinicopathologic features, pathogenesis, diagnosis, and clinical significance. Clin Infect Dis. 1997;25:1392-6.
  10. Resnick L, Herbst JS, Ablashi DV, Atherton S, Frank B, Rosen L, Horwitz SN. Regression of oral hairy leukoplakia after orally administered acyclovir therapy. JAMA. 1988;259:384-8.
  11. Pastore L, De Benedittis M, Petruzzi M, Fiore JR, Serpico R. Efficacy of famciclovir in the treatment of oral hairy leukoplakia. Br J Dermatol. 2006;154:378-9.
  12. Walling DM, Flaitz CM, Nichols CM. Epstein-Barr virus replication in oral hairy leukoplakia: response, persistence, and resistance to treatment with valacyclovir. J Infect Dis. 2003 Sep 3;188:883-90.
  13. Gowdey G, Lee RK, Carpenter WM. Treatment of HIV-related hairy leukoplakia with podophyllum resin 25% solution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:64-7.
  14. Lozada-Nur F, Costa C. Retrospective findings of the clinical benefits of podophyllum resin 25% sol on hairy leukoplakia. Clinical results in nine patients. Oral Surg Oral Med Oral Pathol. 1992;73:555-8.
  15. Bhandarkar SS, MacKelfresh J, Fried L, Arbiser JL. Targeted therapy of oral hairy leukoplakia with gentian violet. J Am Acad Dermatol. 2008;58:711-2.
  16. Moura MD, Guimarães TR, Fonseca LM, de Almeida Pordeus I, Mesquita RA. A random clinical trial study to assess the efficiency of topical applications of podophyllin resin (25%) versus podophyllin resin (25%) together with acyclovir cream (5%) in the treatment of oral hairy leukoplakia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;103:64-71.
  17. Moura MD, Haddad JP, Senna MI, Ferreira e Ferreira E, Mesquita RA. A new topical treatment protocol for oral hairy leukoplakia. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:611-7.