White End of Hairy Leukoplakia to the Dark End of Human Immunodeficiency Virus: A Diagnostic Challenge.

As commonly accepted hairy leukoplakia may be highly associated with human immunodeficiency virus (HIV) infection and may be the first sign of the infection. Even though it is highly associated with immunosuppression, the awareness of oral hairy leukoplakia became prevalent with the advent of HIV and AIDS and it became the first suspicious sign of HIV and later the hallmark of disease process. A 36-year-old male taxi driver presented with the complaint of deposits on his teeth. Medical history revealed chronic cough, weight loss, loss of appetite, recurrent episodes of fever since 1-year, which was not investigated. Examination revealed multiple palpable cervical lymph nodes with intraoral findings such as pigmentation on buccal mucosa, erythema of palate, non-scrapable and non-tender white patch on lateral border of tongue, papillary atrophy on the dorsal surface of the tongue, and gingival inflammation (Figures 1-3). Patient was referred to higher medical center for investigation where the patient was diagnosed as HIVpositive.

De Novos Presentation of Cannon’s Disease.

White spongy nevus (WSN) is a rare hereditary disorder belonging to genodermatosis with a suggested etiology as a mutation in a gene.1 Lesions usually appear in younger age which can be seen in any part of the oral mucosa.2 WSN can affect any mucosa in body with or without oral involvement. A 12-year-old female patient came to our department for dental evaluation. A general examination of body showed no abnormalities. The intraoral examination revealed generalized white patches in the oral mucosa with the wrinkled surface (Figures 1-4). The lesion was totally asymptomatic and the patient was aware of roughness in oral mucosa which she noticed from her childhood. There were no mucosal changes anywhere in the body. There was no history of a similar lesion in family members. An incisional biopsy was done from the buccal mucosa. Fromclinical and histopathological features, we arrived at a diagnosis of WSN.

Painless Management of Speckled Leukoplakia using Cryosurgery.

Cryosurgery is a well-known and well-documented treatment modality in orofacial lesions since 1960. According to review of literature various studies has already proved the efficacy of cryosurgery in leukoplakia.2,3 Cryosurgery was done for a male patient of age 38 years who was diagnosed with speckled leukoplakia on the left buccal mucosa (Figure 1). Cryosurgery was selected because of patients fear for scalpel surgery. The Patient was treated in outpatient department using liquid nitrogen and cryogun. Liquid nitrogen was sprayed directly into lesion using cryogun till ice ball was formed in the lesion (Figure 2). There was no intra operative or post-operative pain during cryosurgery and no anesthetic agents were used during treatment. The patient was recalled after 7 days and intra oral examination revealed a healing ulcer formation in the area of treatment (Figure 3). There was no pain or any symptoms on the site of treatment. The patient was recalled after 15 days of treatment, which showed healed ulcer and areas of re-epithelization (Figure 4). Patient compliance toward the treatment was good. The patient was advised to do review after 1-month.