39 White lesions: Hairy leukoplakia, lichen planus

39 White lesions: Hairy leukoplakia, lichen planus

Figure 39.1 Hairy leukoplakia.

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Figure 39.2 Lichen planus and lichenoid lesions etiology.

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Figure 39.3 Lichen planus pathogenesis.

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Figure 39.4 Lichen planus.

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Figure 39.5a Lichen planus.

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Figure 39.5b Lichen planus.

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Figure 39.6 Lichen planus.

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Figure 39.7 Lichen planus.

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Figure 39.8 Histological features of LP.

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Figure 39.9 Lichen planus management.

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Hairy leukoplakia

Definition: Bilateral white tongue lesions.

Prevalence (approximate): Uncommon.

Age mainly affected: Adult.

Gender mainly affected: M > F.

Etiopathogenesis: Epstein-Barr virus, usually in an immunocompromised patient, especially in HIV/AIDS. Cases have been reported in patients with hematological malignancies or organ transplants.

Diagnostic features

Clinical features

Oral: Vertically corrugated symptomless white lesions on the margins, dorsal or ventral surfaces of the tongue (Figure 39.1).

Extraoral: Maybe lesions of HIV/AIDS or immunodeficiency.

Differential diagnosis: Frictional keratosis, lichen planus, tobaccoassociated leukoplakia, geographic tongue.

Investigations

  • HIV serotest.
  • Biopsy/histopathology shows irregular parakeratosis and vacuolated cells with dark pyknotic nuclei (koilocytes-like) in the stratum spinosum.

Epithelial nuclei stain positively immunocytochemically and in situ hybridization for EBV capsid antigen.

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Jan 12, 2015 | Posted by in Oral and Maxillofacial Pathology | Comments Off on 39 White lesions: Hairy leukoplakia, lichen planus
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