Diagnosis of Hairy Leukoplakia

Hairy Leukoplakia is the second most common HIV-associated oral mucosal lesions after Candidiasis. It is non malignant and is not pathognomic for HIV since other immunodeficiencies such as cancer chemotherapy are also associated with hairy leukoplakia. The common site for this condition is on the lateral borders of tongue in form of vertical white folds.


Diagnosis of Hairy Leukoplakia Features
Provisional Diagnosis Characteristic gross appearance with or without non responsiveness to antifungal therapy
Presumptive Diagnosis Light microscopy of histologic sections revealing hyperkeratosis, koilocytosis, acanthosis, and absence of inflammatory cell infiltrate
OR
Light microscopy of cytologic operations demonstrating nuclear beading and chromatin margination
Definitive Diagnosis Insitu Hybridisation of histologic or cytologic specimen revealing positive staining for EBV DNA
OR
Electron microscopy of histologic or cytologic specimen showing herpes-like particles
OR
Epstein-Barr Virus was demonstrated with polymerase chain reaction technique.

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