Leukoplakia in HIV patients and risk of malignancy: A case report

Yuli Fatzia Ossa, Anandina Irmagita Soegyanto, Diah Rini Handjari, Endah Ayu Tri Wulandari

= http://dx.doi.org/10.20473/j.djmkg.v53.i3.p159-163

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Background: Oral potentially malignant disorder (OPMD) was defined by the World Health Organization (WHO) as an oral lesion which shows abnormalities with potential to become malignant. Leukoplakia is one such OPMD that may present in patients with human immunodeficiency virus (HIV), with the condition of HIV presenting a heightened risk of malignancy. Purpose: This case report aims to describe the initial finding and case management of an oral lesion that was suspected as leukoplakia in an HIV-positive patient on antiretroviral therapy (ART). Case: A 34-year-old male patient was referred to the Oral Medicine Division from an HIV clinic at Dr. Cipto Mangunkusumo General Hospital, Jakarta, with a chief complaint of dental caries. The patient was HIV and hepatitis C positive and already undergoing ART. Case Management: During the intraoral examination, we found multiple caries, poor oral hygiene and a single thin white plaque lesion on the right buccal mucosa around the second and third mandibular molar region. The white plaque was painless, irregular, clearly demarcated, could not be rubbed off and did not disappear when stretched. History of trauma in this area was non-contributory and the lesion had gone unnoticed prior to oral examination. The patient had an existing smoking habit of 25 years. As clinical examination suggested leukoplakia, a biopsy was arranged. Conclusion: Leukoplakia is defined as a potentially malignant lesion. The risk of shifting into malignancy can be higher for patients who are HIV positive. Especially in HIV-positive patients, special measures are needed to prevent shifting into malignancy, such as early detection, elimination of risk factors, performing excisional biopsy and regular intraoral examination.


HIV; leukoplakia; oral potentially malignant disorder

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Mortazavi H, Baharvand M, Mehdipour M. Oral potentially malignant disorders: an overview of more than 20 entities. J Dent Res Dent Clin Dent Prospects. 2014; 8(1): 6–14.

Speight PM, Khurram SA, Kujan O. Oral potentially malignant disorders: risk of progression to malignancy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 125(6): 612–27.

Warnakulasuriya S, Ariyawardana A. Malignant transformation of oral leukoplakia: A systematic review of observational studies. J Oral Pathol Med. 2016; 45(3): 155–66.

van der Waal I. Historical perspective and nomenclature of potentially malignant or potentially premalignant oral epithelial lesions with emphasis on leukoplakia—some suggestions for modifications. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018; 125(6): 577–81.

van der Waal I. Oral leukoplakia, the ongoing discussion on definition and terminology. Med Oral Patol Oral Cir Bucal. 2015; 20(6): e685–92.

Bobat R, Archary M. HIV infection. In: Green RJ, editor. Viral Infections in Children, Volume I. Spinger; 2017. p. 69–100.

Ditjen P2P Kementrian Kesehatan Republik Indonesia. Laporan perkembangan situasi HIV-AIDS & PIMS di Indonesia Januari-Desember 2017. Jakarta; 2018. p. 560.

Lima JS, Pinto DDS, De Sousa SOM, Corrêa L. Oral leukoplakia manifests differently in smokers and non-smokers. Braz Oral Res. 2012; 26(6): 543–9.

Villa A, Woo S Bin. Leukoplakia—A diagnostic and management algorithm. J Oral Maxillofac Surg. 2017; 75(4): 723–34.

Kayalvizhi EB, Lakshman VL, Sitra G, Yoga S, Kanmani R, Megalai N. Oral leukoplakia: A review and its update. J Med Radiol Pathol Surg. 2016; 2: 18–22.

Ribeiro AS, Salles PR, da Silva TA, Mesquita RA. A review of the nonsurgical treatment of oral leukoplakia. Int J Dent. 2010; 2010(2): 1–10.

Deliverska EG, Petkova M. Management of oral leukoplakia - Analysis of the literature. J IMAB - Annu Proceeding (Scientific Pap. 2017; 23(1): 1495–504.

Borges A, Dubrow R, Silverberg M. Factors contributing to risk for cancer among HIV-infected individuals and evidence that earlier cART will alter risk. Curr Opion HIV AIDS. 2014; 9(1): 34–40.

Farah CS, Jessri M, Currie S, Alnuaimi A, Yap T, McCullough MJ. Aetiology of oral cavity cancer. In: Kuriakose MA, editor. Contemporary Oral Oncology. Springer; 2017. p. 31–76.

Silverberg MJ, Chao C, Leyden WA, Tang B, Horberg MA, Klein D, Charles P, Jr Q, Towner WJ, Abrams DI. HIV infection and the risk of cancer with and without a known infectious cause. AIDS. 2009; 23(17): 2337–45.

Seo J, Utumi ER, Zambon CE, Pedron IG, Ceccheti MM. Use of retinoids in the treatment of oral leukoplakia: review. Rev Clín Pesq Odontol Curitiba. 2010; 6(2): 149–54.

Salati NA. Clinico-pathologic evaluation & medical treatment of oral leukoplakia. Int J Pharm Sci Invent. 2014; 3(2): 7–12.


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