ABSTRACT
Oral hairy leukoplakia (OHL) is generally reported in patients with severe immunosuppression, except for a few cases in individuals with moderate degree of immunodeficiency. It is a white lesion that appears mainly in the lateral border of the tongue, caused by Epstein-Barr virus (EBV). The nuclear changes caused by EBV (Cowdry A inclusion, ground glass and nuclear beading), observed in cytopathology, are specific and enough for the definitive diagnosis of OHL, independent of the identification of the virus. Here we investigated the prevalence of OHL and the presence of EBV-DNA in the lateral borders of the tongue from 90 pregnant women, 90 diabetes mellitus (DM) patients, 30 healthy individuals (negative group) and 30 HIV+ with OHL (positive group). Smears were analyzed by cytopathology and polymerase chain reaction (PCR). A case of subclinical OHL and candidiasis was identificated in a DM patient by cytopathologic analysis. PCR results demonstrated EBV-DNA in 65 percent of the pregnant women, in 35 percent of DM patients, and in 20 percent of the healthy individuals. We concluded that DM patients can develop OHL with a low prevalence. Furthermore, the prevalence of the EBV in lateral border of the tongue is larger in pregnant women than in healthy individuals.
Subject(s)
Humans , Female , Pregnancy , Adult , AIDS-Related Opportunistic Infections/epidemiology , Diabetes Mellitus/virology , /genetics , Leukoplakia, Hairy/epidemiology , Pregnancy Complications, Infectious/epidemiology , AIDS-Related Opportunistic Infections/pathology , AIDS-Related Opportunistic Infections/virology , Brazil/epidemiology , Case-Control Studies , Candidiasis/epidemiology , Candidiasis/pathology , DNA, Viral/analysis , Leukoplakia, Hairy/pathology , Leukoplakia, Hairy/virology , Polymerase Chain Reaction , Prevalence , Pregnancy Complications, Infectious/pathology , Pregnancy Complications, Infectious/virology , Tongue/pathology , Tongue/virologyABSTRACT
A leucoplasia pilosa oral (OHL) é uma infecção oportunista causada pelo Vírus Epstein-Barr (EBV) encontrada em pacientes infectados pelo HIV. É uma lesão assintomática que tem um importante valor prognóstico na AIDS. Diferentemente de pacientes adultos, a OHL tem sido descrita na literatura como tendo uma prevalência muito pequena em pacientes pediátricos. Logo, o objetivo deste estudo foi investigar a prevalência da OHL em pacientes pediátricos positivos para o HIV através do uso da citopatologia. A amostra consistiu-se de 120 pacientes, que foram submetidos a exame oral e coleta de material de ambos os lados da língua. O critério diagnóstico foi baseado na identificação de alterações nucleares. A OHL clínica foi identificada em dois (1,67%) pacientes. A citopatologia revelou vinte casos (16,7%) de OHL subclínica. Nossos resultados mostram que a prevalência de OHL em pacientes pediátricos infectados pelo HIV deve ser maior que a relatada na literatura.
Subject(s)
Child , Female , Humans , Male , AIDS-Related Opportunistic Infections/epidemiology , HIV-1 , Leukoplakia, Hairy/epidemiology , AIDS-Related Opportunistic Infections/pathology , AIDS-Related Opportunistic Infections/virology , Brazil/epidemiology , Chi-Square Distribution , Cytodiagnosis , Lymphocyte Count , Leukoplakia, Hairy/pathology , Leukoplakia, Hairy/virology , Prevalence , Statistics, Nonparametric , Tongue/pathology , Viral LoadABSTRACT
La patología blanca de la mucosa oral comprende una constelación de enfermedades cuyos cuadros clínicos se asemejan mucho entre sí y se caracterizan por la presentación de una lesión de aspecto blanquesino en la cavidad bucal. Con el fin de remarcar las diferencias entre cada afección, sus diversas evoluciones y pronósticos y alertar sobre aquellas con tendencia cancerígena y pronóstico más ominoso es que se realiza este trabajo. Es también nuestro interés señalar que no debemos olvidar a la cavidad bucal en el examen dermatológico de rutina