Oral Hairy Leukoplakia in Transgender
Patients as Oral Manifestation of HIV/AIDS

Ni Putu Riskayanti1, Dahlia Riyanto1, Saka Winias2

Oral Medicine Residency Program, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia

Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia


Objective: Human Immunodeficiency Virus (HIV) is a virus that will gradually destroy the immune system, which makes it difficult for the body to fight infection. The most frequent oral lesion detected in HIV patients was pseudomembranous candidiasis, periodontal disease, herpetic lesions, hairy leukoplakia, gingivitis, oral ulceration, Kaposi's sarcoma and non-Hodgkin's lymphoma. Oral hairy leukoplakia (OHL) is caused by the Epstein- Barr virus (EBV), which has a close relationship to HIV condition. Clinical manifestation of OHL is a white plaque with vertical corrugation, mostly found on posterior lateral border of the tongue. This case report describes a 29-year-old transgender patient who presented with an ulcer on the floor of the mouth and a white plaque on the lateral border of the tongue. The patient had  never been treated for HIV or hospitalised.


Methods: The treatment plan was to give the patient chlorine dioxide dental gel for the oral ulcer. A complete blood count was requested, liver and kidney functions were tested, anti HCV, HbsAg, CD4, KOH test and anti-HIV were also performed.


Results: The oral ulcer healed after four days of treatment. The result of several tests including liver and kidney function tests were re normal, CD4 count resulting 152 cells/µL (low), KOH test is negative, anti HCV and HbsAg is non-reactive, anti-HIV with imunochromatography and ELISA is reactive.


Conclusion: Oral hairy leukoplakia is an oral manifestation of HIV associated with low CD4 count.


Keywords: HIV/AIDS, oral hairy leukoplakia, transgender, CD4.