TREATMENT OF AIDS-ASSOCIATED ORAL HAIRY LEUKOPLAKIA WITH CRYOTHERAPY

Oral hairy leukoplakia (OHL) is an epithelial lesion frequently found in association with AIDS which usually presents as raised white corrug ated areas on the lateral border of the tongue. The histological appea rance of OHL is characterized by intracellular oedema of spinous cells and superficial hyperkeratosis. DNA hybridization, immunohistochemica l and clinical studies have established infection by Epstein-Barr viru s (EBV) as an important aetiological agent in the development of this non-malignant epithelial proliferation1-4. Although OHL is usually reg arded as a sign of clinically significant cellular immunodeficiency, i t is usually asymptomatic and no treatment is required. In cases where OHL is pronounced or unsightly, systemic treatment with high-dose acy clovir, ganciclovir and zidovudine have been reported to be successful at ameliorating this condition5-7. There are also reports of efficacy with topical applications of vitamin A8 and 25% podophyllin resin9. F or severe OHL, surgical excision of the lesion has been associated wit h long-lasting remission10, although this modality of treatment has no t been met with much enthusiasm. In this case report we describe a pat ient with severe biopsy-proven OHL responding dramatically to repeated cryotherapy.