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Hairy Leukoplakia: Follow-up

Author: Olga Kozyreva, MD, Staff Physician, Hematology Oncology Department, Tufts University School of Medicine
Coauthor(s): Sarah K May, MD, Consulting Staff, Department of Hematology-Oncology, Caritas Carney Hospital, Commonwealth Hematology-Oncology PC; Samer A Bleibel, MD, Staff Physician, Department of Internal Medicine, Wayne State University, St John's Hospital and Medical Centers; Hunter H Sams, MD, Consulting Staff, Denver Dermatology Consultants, PC; Alan Boyd, MD, Associate Professor, Department of Medicine, Division of Dermatology, Vanderbilt University
Contributor Information and Disclosures

Updated: Jul 18, 2007

Follow-up

Complications

  • The complication associated with oral hairy leukoplakia is an occasional candidal superinfection, which often results in an uncomfortable glossopyrosis (burning tongue).
  • Altered taste sensation is a rare complication.
  • The presence of oral lesions has a significant impact on health-related quality of life, because oral health is associated with physical and mental health.5

Prognosis

  • The majority of patients with OHL tend to have significant immunosuppression at the time of diagnosis. OHL occurs relatively soon after HIV seroconversion, typically before AIDS. Median CD4 count when OHL is first detected is between 235 and 468 per microliter.
  • Some studies of oral hairy leukoplakia in HIV-seropositive patients have shown that the median survival after the diagnosis of OHL is around 20 months. In patients with CD4 count greater than or equal to 300 per microliter, OHL is associated with median survival time of 25 months, compared to 52 months in patients with normal counts.

Miscellaneous

Medicolegal Pitfalls

  • Failure to inform patient with OHL who does not carry a diagnosis of HIV infection that they should have a thorough workup to evaluate for HIV infection or immunosuppression
  • Failure to tell patients that immunosuppression is a risk factor for oral cancer
  • Failure to remain alert to signs and symptoms of oral cancer and premalignancy in persons who are immunocompromised
  • Failure to counsel OHL patients to discontinue the use of all forms of tobacco and to limit consumption of alcohol
  • Always instruct patient to comply with regular dental and medical care regimens.
 


More on Hairy Leukoplakia

Overview: Hairy Leukoplakia
Differential Diagnoses & Workup: Hairy Leukoplakia
Treatment & Medication: Hairy Leukoplakia
Follow-up: Hairy Leukoplakia
References
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References

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Further Reading

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Keywords

oral hairy leukoplakia, OHL, AIDS, HIV, Epstein-Barr virus, EBV, immunosuppression, immunocompromise, homosexual men, IV drug users, acute lymphocytic leukemia, ALL, heart transplant, bone marrow transplant, kidney transplant, hematological malignancy, tongue plaque, Behçet syndrome, ulcerative colitis, cigarette smoking

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Contributor Information and Disclosures

Author

Olga Kozyreva, MD, Staff Physician, Hematology Oncology Department, Tufts University School of Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Sarah K May, MD, Consulting Staff, Department of Hematology-Oncology, Caritas Carney Hospital, Commonwealth Hematology-Oncology PC
Sarah K May, MD is a member of the following medical societies: American Society of Clinical Oncology
Disclosure: Nothing to disclose.

Samer A Bleibel, MD, Staff Physician, Department of Internal Medicine, Wayne State University, St John's Hospital and Medical Centers
Samer A Bleibel, MD is a member of the following medical societies: American College of Physicians
Disclosure: Nothing to disclose.

Hunter H Sams, MD, Consulting Staff, Denver Dermatology Consultants, PC
Hunter H Sams, MD is a member of the following medical societies: American Academy of Dermatology and American Academy of Family Physicians
Disclosure: Nothing to disclose.

Alan Boyd, MD, Associate Professor, Department of Medicine, Division of Dermatology, Vanderbilt University
Alan Boyd, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and American Society of Dermatopathology
Disclosure: Nothing to disclose.

Medical Editor

Sanjiv S Agarwala, MD, Associate Professor of Medicine, Division of Hematology and Oncology, University of Pittsburgh School of Medicine; Associate Chief, University of Pittsburgh Cancer Institute
Sanjiv S Agarwala, MD is a member of the following medical societies: American Association for Cancer Research, American Society for Head and Neck Surgery, American Society of Clinical Oncology, Eastern Cooperative Oncology Group, and European Society for Medical Oncology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Jules E Harris, MD, Visiting Professor of Medicine, Division of Hematology/Medical Oncology, Department of Internal Medicine, University of Arizona College of Medicine at Tucson; Consulting Staff, Arizona Cancer Center
Jules E Harris, MD is a member of the following medical societies: American Association for Cancer Research, American Association for the Advancement of Science, American Association of Immunologists, American Federation for Clinical Research, American Society of Clinical Oncology, American Society of Hematology, Central Society for Clinical Research, Society for Biological Therapy, and Society for Leukocyte Biology
Disclosure: GlobeImmune Salary Consulting; Amplimed Consulting fee Consulting

 
 
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