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Mouth Diseases

Question on oral hairy leukoplakia

02/16/2009

Question:

I developed a white hard/rough patch on the left side of my tongue some time ago.

It looked a bit similar to Oral Hairy Leukoplakia. Before the patch came up, there was a slight pain on that spot.

I used my teeth to bite off a large piece of the patch (the top part of it) & it bled a bit. After about 2-3 weeks the patch dissappeared and my tongue was normal. After 2 months this patch re-appeared and i did the same and again it dissappeared in 2-3 weeks time.

It`s been 2 months now since the last time this patch appeared. My tongue has a white lines running on each side. (not thick, but like a small piece of skin) My dentist told me that this doesn`t look serious.

any help me for the following questions would be great.

Can an oral hairy leukoplakia patch dissappear within 2-3 weeks if someone removes a part of the patch like I did ?

If the patch is left alone & no antiviral treatment is given, will it dissappear ?

Can these patches be surgically removed and if so will they re-appear ?

Thanks.

Answer:

Oral hairy leukoplakia is a rather uncommon condition caused by infection of the lining of the mouth (usually the side of the tongue) by a type of herpes virus called Epstein-Barr virus.

Most people who develop hairy leukoplakia are also infected with the human immunodeficiency virus (HIV), but sometimes non-HIV patients can develop hairy leukoplakia.

The only way this diagnosis can be confirmed is by doing a biopsy and looking at the tissue with special molecular techniques that identifiy the Epstein-Barr virus. Hairy leukoplakia can look a lot like frictional hyperkeratosis (basically a callous) caused by rubbing the side of the tongue against the teeth or nibbling the side of the tongue with the teeth. Some people know that they have this habit, but others do this unconsciously.

To complicate the situation, there are also precancerous lesions called leukoplakia that may develop on the side of the tongue, and sometimes yeast infections called hyperplastic candidiasis are seen in this location.

Ideally, you should be evaluated by an oral pathologist. He or she may recommend biopsy by an oral surgeon, and examination of the tissue sample should be done by an oral pathologist.

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Response by:

Carl M Allen, DDS, MSD Carl M Allen, DDS, MSD
Professor of Oral Pathology
College of Dentistry
The Ohio State University