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Oral Lesions in HIV

Topic updated on 05/17/16 4:08pm

  • Oral lesions in patients with HIV are common (30-80%) White corrugated plaque on left lateral tongue border
    • 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 HSV-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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