Leucoplasia pilosa oral possivelmente associada ao uso de corticosteroides em paciente HIV negativo: relato de caso

Abstract

The oral hairy leukoplakia (OHL) presents as a white patch, non-scrapable, usually located in the border sides of the tongue. The lesion can present clinical findings such as a patch, corrugated or hairy, not removable. The etiology of the lesion is directly associated to the Epstein-Barr virus (EBV), and its occurrence is an indicator of individual's systemic impairment. Its developement is multifatorial, observed in autoimmune diseases, transplanted patients, people living with HIV (PLHIV), syndromes, and drug therapy, especially on patients taking immunosuppressive drugs and steroids in a long term. This study aims to describe a clinical case report of a patient with OHL associated to long-term use of topic corticosteroids. Patient is a white 19-year-old male, complaining of a white lesion, in the left border side of the tongue, initially reporting burning and stinging episodes in leasion’s early stages, denying any pain symptoms. Subsequently, the patent underwent exfoliative cytology, followed by specific molecular tests for EBV and HPV, and also a serology test for HIV. The probable cause associated with corticosteroids drug therapy was observed together with the EBV’S identification measured by the test, that showed positive results for both PCR and serology tests, closing the outcome of OHL.After the lesion’s remission, the patient remained in follow up. As conclusions, it was observed that OHL should not be thought as a pathognomonic lesion for HIV infection, due to the multiple possible causes of lesion’s emergence, such as long-term steroid therapy. Added to that, it must be emphasized that in these cases, reducing the exposure or even suspending the drug therapy might lead to the lesion remission, like it was observed in the present study.