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Oral hairy leukoplakia is a corrugated ("hairy") white lesion on the sides of the tongue caused by opportunistic infection with Epstein-Barr virus on a systemic background of immunodeficiency, almost always human immunodeficiency virus (HIV) infection. [15]
The lesion is a white patch, which almost exclusively occurs on the lateral surfaces of the tongue, although rarely it may occur on the buccal mucosa, soft palate, pharynx or esophagus. [5] The lesion may grow to involve the dorsal surface of the tongue. The texture is vertically corrugated ("hairy") or thickly furrowed and shaggy in appearance.
White sponge nevus (WSN) is an extremely rare autosomal dominant [4] condition of the oral mucosa (the mucous membrane lining of the mouth). It is caused by one or more mutations in genes coding for keratin , which causes a defect in the normal process of keratinization of the mucosa.
Transient lingual papillitis (TLP) is a medical term for painful, hypertrophic, red, and white lingual papillae on the tongue. [3] TLP is also called lie bumps and fungiform papillary glossitis. This condition has four types: classic form, transient u-shaped lingual papillitis, papulokeratotic variant, and eruptive lingual papillitis. [ 4 ]
Leukoedema lesions disappear when the mucosa is stretched, which helps to differentiate it from other white lesions in the mouth. [2] The differential diagnosis is with leukoplakia , oral candidiasis , oral lichen planus , white sponge nevus , morsicatio buccarum , [ 3 ] hereditary benign intraepithelial dyskeratosis and dyskeratosis congenita.
Tongue lesions are very common. For example, in the United States one estimated point prevalence was 15.5% in adults. [10] Tongue lesions are more common in persons who wear dentures and tobacco users. [10] The most common tongue conditions are geographic tongue, followed by fissured tongue and hairy tongue. [10]
Diagnosis is mainly clinical, based on the history and clinical appearance. The differential diagnosis includes other oral white lesions such as Leukoplakia, squamous cell carcinoma, oral candidiasis, lichen planus, white sponge nevus and contact stomatitis. [7] In contrast to pseudomembraneous candidiasis, this white patch cannot be wiped off. [7]
A lesion of geographic tongue may start as a white patch before the depapillation occurs. [4] In certain cases there may be only one lesion, but this is uncommon; [ 4 ] the lesions will typically occur in multiple locations on the tongue and coalesce over time to form the typical map-like appearance.