ORAL HAIRY LEUKOPLAKIA IN A PEDIATRIC PATIENT UNDER CORTICOSTEROID THERAPY

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Oral hairy leukoplakia (OHL) is a condition caused by Epstein-Barr virus (EBV) infection, usually associated with immunosuppressed patients. This study aims to report a case of atypical clinical presentation of OHL involving a 9-year-old girl, without previous history of immunosuppression. During anamnesis, the person in charge reported that the patient had recently started treatment for allergic dermatitis. Clinically, there were white corrugated lesions on both lateral tongue borders. Under the OHL diagnosis hypothesis, an incisional biopsy was performed. Microscopically, underlying the keratin layer, there were keratinocytes with pale cytoplasm, perinuclear haloes, and nuclei with margination of chromatin (nuclear beading). The final diagnosis was confirmed by chromogenic in situ hybridization (CISH) for EBV detection test. The occurrence of OHL in childhood is extremely uncommon, even in pediatric patients who are positive for human immunodeficiency virus (HIV). OHL should be included in the differential diagnosis when assessing white lesions in the oral mucosa. Oral hairy leukoplakia (OHL) is a condition caused by Epstein-Barr virus (EBV) infection, usually associated with immunosuppressed patients. This study aims to report a case of atypical clinical presentation of OHL involving a 9-year-old girl, without previous history of immunosuppression. During anamnesis, the person in charge reported that the patient had recently started treatment for allergic dermatitis. Clinically, there were white corrugated lesions on both lateral tongue borders. Under the OHL diagnosis hypothesis, an incisional biopsy was performed. Microscopically, underlying the keratin layer, there were keratinocytes with pale cytoplasm, perinuclear haloes, and nuclei with margination of chromatin (nuclear beading). The final diagnosis was confirmed by chromogenic in situ hybridization (CISH) for EBV detection test. The occurrence of OHL in childhood is extremely uncommon, even in pediatric patients who are positive for human immunodeficiency virus (HIV). OHL should be included in the differential diagnosis when assessing white lesions in the oral mucosa.