title: Twenty-first-century oral hairy leukoplakia--a non-HIV-associated entity.
abstract: OBJECTIVE
  This study presents the clinicopathologic features of a series (N = 35) of patients with non-human immunodeficiency virus (HIV)-associated oral hairy leukoplakia (OHL).
  
  
  METHODS
  Patients with non-HIV-associated OHL were identified from three centers. Epstein-Barr virus infection was demonstrated by using EBV early ribonucleic acid in situ hybridization. The presence of Candida co-infection was evaluated by diastase periodic acid-Schiff staining. The clinical features were determined by review of the medical records.
  
  
  RESULTS
  Twenty-eight patients had intercurrent respiratory problems requiring long-term steroid inhaler use, four suffered from autoimmune diseases requiring immunosuppressant therapy, and four had diabetes. The majority of lesions were located on the tongue, and 24 showed evidence of Candida co-infection.
  
  
  CONCLUSIONS
  In the twenty-first century, the presence of OHL should not be regarded as pathognomic for HIV infection or significant systemic immunosuppression. Local and systemic immunosuppression, in the form of steroid inhaler use, is a risk factor for the development of OHL.
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Cellular Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK. Electronic address: a.e.chambers@ncl.ac.uk.
authors.forename: Anne Elizabeth
authors.initials: AE
authors.lastname: Chambers
authors.affiliation: Royal Infirmary of Edinburgh, Department of Pathology, Royal Infirmary Edinburgh, Scotland.
authors.forename: Brenden
authors.initials: B
authors.lastname: Conn
authors.affiliation: University Dental Hospital of Manchester, Department of Oral Medicine, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester, UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Pemberton
authors.affiliation: Newcastle University, Centre for Oral Health Research, Newcastle University, Framlington Place, Newcastle upon Tyne, UK.
authors.forename: Max
authors.initials: M
authors.lastname: Robinson
authors.affiliation: Sunderland Royal Hospital, Department of Oral and Maxillofacial Surgery, Sunderland Royal Hospital, Kayll Road, Sunderland, Tyne and Wear, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Banks
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Department of Cellular Pathology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Sloan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002180:Candidiasis, Oral / Q000150:complications; D020031:Epstein-Barr Virus Infections / Q000150:complications; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D017403:In Situ Hybridization; D017733:Leukoplakia, Hairy / Q000276:immunology* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010503:Periodic Acid-Schiff Reaction; D012307:Risk Factors; D013256:Steroids / Q000009:adverse effects; D014059:Tongue
chemical_list: D013256:Steroids