View source for Hairy oral leukoplakia

==Background==
*It is caused by the [[Epstein-Barr virus]] (EBV)
*Most commonly seen in immunocompromised individuals, and has a high specificity for individuals with [[HIV]]/AIDs. 
*The white plaque appearance is due to hyperkeratosis and epithelial hyperplasia. 

==Clinical Features==
*Characterized by white plaques over the lateral sides of the tongue.
*Unlike [[oropharyngeal candidiasis]], the white plaques are unable to be scraped off. 
*It is asymptomatic, with most patients presenting over concern for aesthetic appearance  

==Differential Diagnosis==
{{Tongue DDX}}

{{DDX oral rashes and lesions}}

==Evaluation==
*Diagnosed clinically
*Consider [[HIV]] testing if no other etiology is determined or if risk factors are present

==Management==
* The condition is benign and does not require treatment but many patients have concerns about the aesthetic appearance. 
* Foundation of treatment is aimed at workup and management of the often underlying concomitant immunocompromised disease process.  
* High dose [[acyclovir]] can be used (4g/day), but relief is temporary and often lesions recur until immunocompromised status is reversed

==Disposition==
*Discharge unless concomitant symptoms require further work-up

==See Also==
*[[Tongue diagnoses]]
*[[Candidiasis]]

==References== 
*Chapple, IL; Hamburger, J (August 2000). "The significance of oral health in HIV disease". Sexually Transmitted Infections. 76 (4): 236–43. doi:10.1136/sti.76.4.236. PMC 1744197. PMID 11026876
*Cherry-Peppers, G; Daniels, CO; Meeks, V; Sanders, CF; Reznik, D (February 2003). "Oral manifestations in the era of HAART". Journal of the National Medical Association. 95 (2 Suppl 2): 21S–32S. PMC 2568277. PMID 12656429.
[[Category:ENT]]