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Updated: 12/26/2021

Oral Lesions in HIV

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  • Introduction
    • Oral lesions in patients with HIV are common (30-80%) vertically corrugated, hairy white lesions on the lateral border of the tongue
      • may indicate impairment in general health and poor prognosis
      • presence suggests low CD4+ count and high viral load
      • often an early marker of infection
      • may be infectious, neoplastic, or traumatic
    • Infections
      • candidiasis
        • "oral thrush" infection from Candida yeast
        • soft white/yellow, curd-like plaques on the oral mucosa
          • can be scraped off leaving a red undersurface
        • prevalence as high as 95%
        • pre-AIDS defining lesion
      • hairy leukoplakia
        • infection of the tongue by EBV
        • asymtomatic, bilateral, vertically corrugated, or hairy white lesions on the lateral border of the tongue
      • herpes simplex virus
        • clusters of painful, small vesicles and ulcers on the palate or gingiva
    • Neoplastic
      • Kaposi's sarcoma
        • caused by HHV-8 infection
        • painless violaceous lesions, most commonly seen on hard palate or anterior gingival mucosa
      • non-Hodgkin's lymphoma
        • rapidly enlarging rubbery mass in the tonsillar fossa, palate, or gingiva
    • Other
      • apthous ulcers
        • "canker sores"
        • unknown origin, but may be viral or stress-induced
      • angular chelitis
        • red, ulcerated, and fissured lesions at the angles of the mouth
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