Leukoplakia In Patients Research Articles

Proliferative verrucous leukoplakia/multifocal leukoplakia in patients with and without oral submucous fibrosis.

Oral submucous fibrosis (OSF) and proliferative verrucous leukoplakia (PVL) are established as oral potentially malignant disorders. Dual pathology of the two conditions is not commonly encountered in clinical practice. This study aims to present a case series of multifocal leukoplakia in patients with and without OSF to outline the clinical behavior and challenges in the management of this high-risk group in clinical practice. We retrospectively analyzed cases of six Indian patients (four with OSF) managed over a period of 5.5 to 13 years at the Government Dental College, Nagpur. Patient data consisting of age, gender, medical history, habits, clinical findings, and biopsy reports were recorded at the initial visit. During follow-up visits, the clinicopathological data were reassessed. When surgical intervention failed to arrest the disease or when surgery was contraindicated metronomic therapy with Folitrax 15 mg once a week and Celecoxib 100mg twice daily was initiated. All patients developed PVL after the initial pathology diagnosis of OSF or oral leukoplakia. Initial lesions were either homogenous or non-homogenous leukoplakia. All patients developed multiple recurrences, regional or systemic metastasis. Despite thorough interventions, the patients died of, or with the disease. The occurrence of two or more oral potentially malignant disorders poses challenges in patient management and possibly presents a higher risk of malignant transformation. More clinical trials are necessary to assess the benefits of metronomic therapy for patients diagnosed with aggressive PVL concurrently found with OSF.

Analysis of Oral Leukoplakia and Tobacco-Related Habits in Population of Chengalpattu District- An Institution-Based Retrospective Study.

ObjectiveThe study aimed to evaluate the prevalence of oral leukoplakia and to assess the risk of developing oral leukoplakia in patients with tobacco-related habits among the populations of Chengalpattu district, Tamil Nadu, India. Materials and MethodsIncidence and prevalence of oral leukoplakia differ among different populations in India due to cultural and demographic diversities. The results obtained from this study can be used as a reference in future research and policy-making for tobacco control. Data for this study were manually ascertained from the Department of Oral Pathology and Microbiology, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Potheri, Chengalpet district, Tamil Nadu, India. The medical records of the patients diagnosed with the abnormalities and diseases of the oral mucosa, especially the white lesions of the oral cavity, between January 2011- March 2021 (10 years). The basic inclusion criteria for this study were to include the histopathology reports of the white lesions with no malignant changes during clinical diagnosis. The data was analyzed based on age, gender, tobacco-related habits, and histopathological diagnosis. The exclusion criteria for the study were the cases reported as carcinoma, patients associated with syndromes, biopsies outside the mentioned period, and those patients with incomplete clinical or histopathological details.ResultsAmong 141 white lesions, about 85 cases [60.2%] were confirmed as oral leukoplakia, of which the study population had 55 (64.7%) males and 30 (35.3%) females. The age group which was commonly seen was 41-60 years. About 80% of the population with oral leukoplakia had the habit of tobacco consumption. The use of tobacco products was seen more commonly in the male population than the female, and consumption of tobacco and alcohol was seen in 6% of the population. In our study, we found the study population had the habit of using smokeless tobacco rather than smoking cigarettes and bidis. About 20% of the population diagnosed with leukoplakia did not have any habits. The most commonly affected site was buccal mucosa (67%), followed by the tongue (12%).ConclusionOur study shows a statistical association between oral leukoplakia and tobacco product consumption among the population of Chengalpattu district. The oral health care providers must take utmost care and vigilance to diagnose the lesion at its earliest stage and give appropriate treatment modalities and effective tobacco interventions.

Prevalence of Leukoplakia among Patients Visiting a Private Dental Hospital- An Institutional Study

Background: The oral ‌mucous‌ ‌membrane‌ ‌is‌ ‌an‌ ‌integral‌ ‌part‌ ‌of‌ ‌the‌ ‌oral‌ ‌cavity‌ and oral‌ ‌premalignancy‌ plays an ‌intermediate‌ ‌stage. Oral‌ ‌leukoplakia‌ ‌otherwise‌ ‌called‌ ‌smoker’s‌ ‌keratosis‌ ‌is‌ ‌a‌ ‌potential‌ ‌premalignant‌ ‌disorder‌ and if not diagnosed early has a risk of causing oral morbidity and cancer. It ‌is‌ ‌a‌ ‌non-scrapable‌ ‌white‌ ‌patch‌ ‌or‌ ‌plaque‌ ‌which‌ ‌might‌ ‌be‌ ‌homogeneous‌ ‌or‌ ‌nonhomogeneous‌ ‌and‌ ‌is‌ ‌strongly‌ ‌associated‌ ‌with‌ ‌smoking, tobacco, alcohol‌ ‌consumption,‌‌ chronic‌ ‌irritation,‌‌ infections‌, and‌ ‌ultraviolet‌ ‌exposure‌. The etiology is idiopathic. The main aim of the study was to assess the prevalence of leukoplakia in patients reporting to a university dental hospital.
 Methodology: The present study was a retrospective observational study wherein 239 leukoplakia cases were reported to a private dental hospital located in Chennai from June 2020 to April 2021. Data was collected from DIAS and was tabulated in Excel. Data analysis was done in SPSS software Version 20.0. Descriptive statistics and the relation between variables were determined using the chi-square test where done. p<0.05 was considered statistically significant.
 Results: The results of this study reveal that oral premalignant leukoplakia has a strong male predilection (95.4%) and the age group of 50-60 years (29.71%) was the most commonly affected when compared to the other age groups. This study further results that homogenous type (75.5%) of oral leukoplakia was commonly prevalent in the right buccal mucosa (29.29%) followed by the left buccal mucosa (23.43%) of the oral cavity associated with the history of excess smoking (38.08%). Pearson chi-square test shows p-value is 0.00, (p-value < 0.05).Hence, it is statistically significant. When association was done between the site of the lesion in the oral cavity by the number of participants, 28.03% of the male participants were presented with the lesion on the right buccal mucosa. Pearson chi-square test shows p-value is 0.99, (p-value > 0.05). Hence, it is statistically not significant.
 Conclusion: The results of this study reveal that oral premalignant leukoplakia has a strong male predilection and the age group of 50-60 years was most commonly affected when compared to the other age groups.This study further results that homogenous type of oral leukoplakia was commonly prevalent in the right buccal mucosa followed by the left buccal mucosa of the oral cavity associated with the history of excess smoking.

Risk assessment of malignant transformation of oral leukoplakia in patients with previous oral squamous cell carcinoma

The aim of this study was to identify the risk factors associated with developing oral squamous cell carcinoma (OSCC) from surgically excised oral leukoplakia (OL) in patients with previous oral cavity cancer. Clinicopathological data of 84 patients who were treated for OL between July 2002 and July 2020 and who had previously received treatment for OSCC were reviewed retrospectively. The follow-up time ranged from 0.69 to 17.99 years (mean 6.78 ± 4.25 years). The overall cumulative malignant transformation rate was 25% and the annual transformation rate was 5.73%. Kaplan–Meier survival analysis and the log-rank test showed that Candida infection (P = 0.010) was a risk factor associated with malignant transformation. In the multivariate Cox regression analysis, tongue and floor of the mouth as the location of the leukoplakia (P = 0.039), multifocal lesions of OL (P = 0.047), and Candida infection (P = 0.018) were the three independent prognostic factors related to the development of OSCC from the treated OL. A cautious approach to OL of the tongue with Candida infection or multifocal disease in this group of patients would be appropriate.

Oral Hairy Leukoplakia in Patients with No Evidence of Immunosuppression

Oral Hairy Leukoplakia in Patients with No Evidence of Immunosuppression

A cytological study of leukoplakia in oral cavity at Patliputra Medical College and Hospital, Dhanbad

Objectives: To assess the role of cytology in leukoplakia and its etiology in patients attending outpatient department at Patliputra Medical College and Hospital (PMCH), Dhanbad, Jharkhand, India. Materials and Methods: The diagnosis of leukoplakia was based on clinical examination and cytological smear. Results: The total number of patients affected by leukoplakia in this time duration was 268. Of these, 238 (86%) were male, whereas 30 were female (14%). Greatest proportion of patients with leukoplakia had a habit of consuming khaini and tobacco in other forms. Mild form of leukoplakia was commonly seen. Conclusion: This study reveals that the incidence rate of leukoplakia in patients visiting PMCH, Dhanbad, was 1%. Males were more affected than females. Use of cytology in mass screening programs helped in identifying leukoplakias with parakeratotic patterns and leading to those cases, which need careful long-term follow-up.

Clinical Application of the IllumiScan Fluorescence Visualization Device in Detecting Oral Mucosal Lesions.

Objective: Fluorescence visualization devices are screening devices that can be used to examine lesions of the oral mucosa non-invasively. We observed oral squamous cell carcinoma (OSCC) and leukoplakia using the IllumiScan (Shofu, Kyoto, Japan) fluorescence visualization device and examined its usefulness and characteristics.Methods: We investigated 31 OSCC and nine leukoplakia in patients who were examined using the IllumiScan and treated in our department from January 2017 to February 2018. Images taken with the IllumiScan were analyzed using image analysis software. We also examined the lesions using narrowband imaging (NBI). Additionally, the IllumiScan and NBI images and the non-stained areas of iodine staining method (IOM) were visually evaluated.Results: The average luminance of OSCC in the keratinized mucosa was significantly lower than that of OSCC in non-keratinized mucosa. The average luminance of OSCC was significantly lower than that of leukoplakia. Even in keratinized mucosa where IOM is impossible to use, the OSCC lesion exhibited fluorescence visualization loss.Conclusion: The application of the fluorescence visualization device to the oral mucosa may be useful for distinguishing between cancer and normal areas and can be used to detect OSCC in the keratinized mucosa. The use of the IllumiScan in combination with other conventional screening methods may lead to a better diagnosis.

Oral leukoplakia, a precancerous lesion of squamous cell carcinoma, in patients with long-term pegylated liposomal doxorubicin treatment.

Pegylated liposomal doxorubicin (PLD) has a good safety profile, but long-term use has been associated with development of squamous cell carcinoma of the tongue and oral cavity (SCCTO) in some patients. The study objective was to estimate the prevalence of oral leukoplakia, a known precursor of SCCTO, in patients with ovarian cancer and long-term PLD use.After approval of the institutional review board, medical record of 114 patients who were treated with PLD at our institution between January 2010 and December 2016 were retrospectively reviewed. All those patients have been referred for routine monitoring of oral mucositis every time before administration by a dentist. The patient characteristics included in the evaluation were age, smoking and drinking habits, the PLD dose and schedule, and presence or absence of oral leukoplakia and SCCTO at each oral examination. The relationships of the incidence of oral leukoplakia and patient characteristics were analyzed.The median total PLD dose was 160 (range 40–1550) mg/m2. Oral leukoplakia was seen in 6 (5.3%) patients. The median PLD dose, at the time of oral leukoplakia diagnosis, was 685 (range 400–800) mg/m2. SCCTO was not found. Univariate analysis revealed that age, Brinkman index, and habitual drinking were not considered as risk factors for oral leukoplakia, and only total PLD dose (OR, 1.470; 95% CI, 1.19–1.91; P < .001) remained as a significant independent risk factor for oral leukoplakia. The ROC curve analysis indicated that the optimal cutoff value of the total PLD dose to predict development of oral leukoplakia was 400 mg/m2. The sensitivity was 100% and the specificity was 88.8%. No patient discontinued PLD because of oral leukoplakia or SCCTO.The 2 most important clinical observations were the occurrence of oral leukoplakia in patients with long-term PLD use and that the development of oral leukoplakia was related to a total cumulative dose ≥400 mg/m2. Routine oral surveillance is recommended, particularly when the cumulative total dose exceeds 400 mg/m2.

Oral Hairy Leukoplakia in Patient with Human Immunodeficiency Virus Infection

Oral hairy leukoplakia occurs on the lateral surface of the tongue that clinically as an asymptomatic white lesion. It is mainly found in patient with human immunodeficiency virus infection. However, it rarely outbreak immunosuppressed patients after organ transplantation, or the patients taking steroids or immunosuppressants. It is the result of proliferating Epstein-Barr virus in the oral epithelium. Most of human immunodeficiency virus infected patients with oral hairy leukoplakia are highly contagious and possible to progress acquired immunodeficiency syndrome. Therefore, the early diagnosis of oral hairy leukoplakia is very important. Taking a thorough history and human immunodeficiency virus screening test is highly recommended in case oral hairy leukoplakia is detected. In this case, a 29-year-old man presented with whitish lesion on lateral border of tongue is diagnosed as oral hairy leukoplakia and human immunodeficiency virus infection.

Oral leukoplakia in patients with Fanconi anaemia without hematopoietic stem cell transplantation.

Fanconi anaemia is a genetic disease characterized by congenital abnormalities, progressive bone marrow failure, and a higher predisposition of oral squamous cell carcinoma. The purpose of this study was to evaluate the prevalence of oral mucosa lesions in patients with Fanconi anaemia without hematopoietic stem cell transplantation (HSCT). Patients with Fanconi anaemia who had not undergone HSCT was cross-sectional evaluated for the presence of oral lesions. The sample was composed of 78 male and 60 female patients, with a median age of 9 years. Of the 138 patients, approximately 45% manifested at least one oral mucosa abnormality: 35 patients (25%) presented with traumatic injuries, and 16 (12%) exhibited leukoplakia. The following lesions were observed in low prevalence: aphthous ulcers, atrophic tongue, petechiae and hematomas, gingival hyperplasia, mucoceles, herpes, hyperpigmentation, haemangioma, non-neoplastic proliferative lesions, neutropenic ulcers, papilloma, and candidiasis. There was a high prevalence of oral leukoplakias in patients with Fanconi anaemia who had not undergone HSCT. It highlights the need of regular oral screenings in this cohort of concern for head and neck malignancies and suggests that oral leukoplakias should be further investigated as part of the syndrome phenotype.

Prevalence of Leukoplakia in Patients Visiting Dental College in Rural Area of Jaipur, Rajasthan

Objectives : The study was conducted to assess the prevalence of leukoplakia among patients of age 15 years and above visiting Dental College in rural area of Jaipur, Rajasthan. Material&Method : A cross-sectional study was conducted to access the prevalence of leukoplakia among 6800 out patients at NIMS Dental College, Jaipur, Rajasthan. Subjects were interviewed using a structured proforma. The clinical diagnosis of leukoplakia was made when patient showed documented clinical features of leukoplakia. The statistical analysis was done with SPSS software version 11.5. Results : The prevalence of leukoplakia in the study population was 145 (2.13%). Majority of subjects were males 130 (89.65%). The prevalence of leukoplakia was highest in 45-54 years of age group 71 (1.04%). Conclusion : Prevalence of leukoplakia was 2.13% and was high amongst older age group. Gender comparison showed higher male dominance and majority of subjects were bidi smokers.

Randomized controlled trial to evaluate the efficacy of oral lycopene in combination with vitamin E and selenium in the treatment of oral leukoplakia

Aims and Objectives: A randomized controlled study was carried out to evaluate the efficacy of lycopene in combination with vitamin E and selenium in the treatment of oral leukoplakia in patients visiting the Government Dental College and Hospital, Mumbai. Materials and Methods: Forty-one patients of leukoplakia were randomly categorized (irrespective of size and severity of the lesions) in two groups: Group A and B. Group A consisting of 21 patients were administered combination of lycopene (3 mg), vitamin E (200 I.U.) and selenium (100 mcg) twice daily and group B consisting of 20 patients were given placebo capsules once daily for a period of 3 months. Post-treatment follow-up period was 3-4 months. The product used in the study was LYC-O-MATO soft gels, manufactured by Mano pharmaceuticals, Chennai, India. The treatment outcome was evaluated both clinically and histologically and the results were statistically evaluated using Student's unpaired 't' test. Results: The results showed that the patients receiving lycopene in combination with vitamin E and selenium have statistically significant improvements both clinically and histologically as compared to those receiving placebo and with no side effects. Conclusion: The study results proved the efficacy and safety of lycopene along with selenium and vitamin E in the management of oral leukoplakia.

Abstract 168A: More effective therapy of cancer by the combination of anticancer drugs with green tea catechins.

Abstract Our initial work that (-)-epigallocatechin gallate (EGCG) inhibited tumor promotion on mouse skin, allowed us to develop green tea as cancer preventive in 1987. We and other research groups have further demonstrated that EGCG and green tea extract prevented carcinogenesis in a wide-range of target organs in rodents. In addition, we found that (-)-epicatechin (EC), an inactive catechin synergistically enhances the cancer preventive effects with EGCG, EGC, and ECG, specifically induction of apoptosis, inhibitions of cell growth and TNF-α released from the cells treated with okadaic acid a tumor promoter. The 10-year prospective cohort study of Drs, K. Nakachi and K. Imai in Saitama Prefecture revealed that drinking 10 Japanese-size cups (120 ml/cup) of green tea per day delayed cancer onset in humans by 7.3 years among females and by 3.2 years among males. In 2008, in collaboration with Dr. H. Moriwaki's group, we reported that 10 Japanese-size cups (120 ml/cup) of green tea extract, supplemented with green tea tablets, daily prevented 50% recurrence of colorectal adenomas in patients after polypectomy. In addition, clinical prevention trials of other investigators with green tea demonstrated the prevention of prostate cancer in Italy and high-risk oral premalignant leukoplakia in patients in the US. Cancer patients who consumed green tea and take anticancer drugs would have double prevention. Our in vivo experiments first showed that the combination of sulindac with green tea extract prevented formation of intestinal tumors in Min mice more strongly than sulindac alone or green tea extract alone, and the combination of celecoxib and green tea extract similarly prevented tumor incidence of NNK-induced lung tumors in A/J mice. The enhanced efficacy of the combination of anticancer drugs with EGCG and green tea extract is now well accepted. Recently, numerous research groups reported that the combination of various anticancer drugs with EGCG synergistically inhibited tumor growth in xenograft mouse models implanted using human cancer cell lines of the lung, breast, prostate, liver and stomach. The results of their 11 experiments are briefly summarized. We think the induction of growth arrest and DNA damage-inducible 153 (GADD153, CHOP) gene expression is important for the mechanism of the combination. Since GADD153 protein is a transcription factor and binds to promoter of death receptor (DR) 5, the combination activates both the EGCG-anticancer drug combination apoptosis pathway and the TRAIL-apoptotic pathway. The combination will greatly expand cancer treatments and will result in good prognosis for patients in tertiary cancer prevention. Citation Format: Hirota Fujiki, Tatsuro Watanabe, Atsushi Takahashi, Masami Suganuma. More effective therapy of cancer by the combination of anticancer drugs with green tea catechins. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 168A. doi:10.1158/1538-7445.AM2013-168A

Current practice and feasibility in microlaryngeal surgery: microsurgical pressing excision technique

Since the introduction of endolaryngeal microsurgery, several basic microsurgical techniques have been described for the removal of benign vocal fold lesions. These techniques include conventional incision or dissection, bimanual retraction and cutting, microflap technique and the CO2 laser. Until recently, only a few microsurgical methods have emerged as new choices for the treatment of benign vocal fold lesions. This article introduces an innovative method that can precisely remove benign sessile vocal fold lesions with epithelial keratosis or hyperplasia without jeopardizing the intermediate or deep layer of the lamina propria. Instead of using conventional vertically opening microinstruments, this microsurgical pressing excision technique (MPET) utilized two pairs of custom-made horizontally left-opening or right-opening, curved microscissors/curved cupped microforceps to remove right or left vocal fold lesions accordingly. Using one instrument at a time, the lesion was subsequently removed with the microscissors and microforceps in a press-evert-cut manner. Among a total of 553 cases, the treatment results were satisfactory, with 520 (94%) patients retaining a satisfactory/normal (G0) voice 2 months postoperatively. More importantly, no patient's voice was worse postoperatively. This technique has several advantages: utilizing one instrument at a time can maximize exposure of the narrow endoscopic view, adjusting the pressing force makes precise excision easy in a well controlled horizontal plane. The MPET is particularly useful for removing sessile vocal nodules (especially those with epithelial keratosis), epithelial hyperplasia and leukoplakia in patients with difficult endolaryngeal exposure. This could be a well tolerated and precise microsurgical technique.

Oral Erythroplakia and Speckled Leukoplakia: retrospective analysis of 13 cases

SummaryErythroplakia and speckled leukoplakia are oral precancerous lesions that have a high potential for malignant transformation.AimA retrospective analysis was conducted to investigate the clinicopathologic features of 13 cases of oral erythroplakia and speckled leukoplakia in patients who were seen at a center specialized in stomatology and Histopathological diagnosis of oral diseases.Materials and MethodsAll cases diagnosed with erythroplakia and speckled leukoplakia between 1978 and 2006 were retrieved from the service archives.ResultsThe lesions exhibited a predilection for males with a female-to-male ratio of 1:3.3. Mean age was 57 years old and soft palate was the site affected in 77% of the cases. Pain symptoms were reported by 61.5% of the patients and association with risk factors such as smoking and excessive alcohol intake was seen in 100% and in 46% of the cases, respectively. The lesions showed epithelial dysplasia, where more than 50% were diagnosed as in situ or invasive carcinoma.ConclusionsDespite low prevalence, oral homogeneous erythroplakia and speckled leukoplakia show Histopathological alterations vary from epithelial dysplasia to invasive carcinoma. These lesions must be included among those oral lesions with the highest potential for malignant tranformation.

Presence of leukoplakia at previous cancer site predicts tumor recurrence

Clinical evaluation of malignant risk of oral leukoplakia is based mainly on the clinical appearance (homogeneous vs. nonhomogeneous), size, and site of the lesion(s). However, these clinical risk predictors have been mainly derived from studies of primary oral leukoplakia. Their value in assessing cancer risk of leukoplakia at previous cancer sites is not clear. Understanding the clinical risk factors of leukoplakia in patients with a history of oral cancer is very important, because up to a third of oral cancer patients will develop a second oral malignancy (SOM), including tumor recurrence and second primary tumors, despite vigorous follow-up.

Epstein–Barr Virus Infection

The Epstein–Barr virus (EBV) was discovered 36 years ago by electron microscopy of cells cultured from Burkitt's lymphoma tissue by Epstein, Achong, and Barr.1 Four years later, in 1968, EBV was shown to be the etiologic agent of heterophile-positive infectious mononucleosis.2 EBV DNA was detected in tissues from patients with nasopharyngeal carcinoma in 1970.3 In the 1980s, EBV was found to be associated with non-Hodgkin's lymphoma and oral hairy leukoplakia in patients with the acquired immunodeficiency syndrome (AIDS).4,5 Since then, EBV DNA has been found in tissues from other cancers, including T-cell lymphomas and Hodgkin's disease.6,7 EBV is . . .

Concomitant leukoplakia in patients with oral squamous cell carcinoma.

There is an ongoing debate on the prevalence of premalignant lesions, in particular leukoplakia, at the time of diagnosis of an oral squamous cell carcinoma (OSCC). The aim of the present study was to determine the presence of concomitant leukoplakia in 100 patients with OSCC, and to evaluate possible differences in clinical and histopathological parameters of the OSCC between those with or without concomitant leukoplakia. One hundred consecutive patients, 61 men and 39 women, with a histologically proven OSCC were screened on the presence of leukoplakia. Four groups were distinguished: (I) leukoplakia adjacent to the OSCC, (II) combination of leukoplakia adjacent to the OSCC, and leukoplakia at another oral site, (III) leukoplakia present at another oral site, but not adjacent to the OSCC, and (IV) no leukoplakia present. In 47 (47%) patients with OSCC the presence of concomitant leukoplakia was observed. Thirty-six (36%) patients had a leukoplakia adjacent to the OSCC (groups I and II), of which eight (8%) patients (group II) also had a leukoplakia present at another oral site. Eleven (11%) patients (group III) had no leukoplakia adjacent to the OSCC, but a leukoplakia present at another oral site. Fifty-three (53%) patients (group IV) with OSCC had no concomitant leukoplakia present. No differences were noted between men and women, nor was there any preference for an oral subsite with regard to the carcinoma. There were no statistically significant differences in clinical and histopathological presentation of OSCC's between those with or without concomitant leukoplakia. Almost 50% of oral squamous cell carcinomas are presumably associated with or preceded by leukoplakia. Early detection and active management of patients with oral leukoplakia may prevent the true development of a number of oral squamous cell carcinomas.

Oral hairy leukoplakia in a patient with multiple myeloma

The first case of oral hairy leukoplakia in an HIV-negative patient with multiple myeloma is reported. The patient is a 56-year old man who has had monoclonal gammopathy of undetermined significance since 1986 and has been treated for a symptomatic multiple myeloma since 1993. The clinical and histopathologic findings are typical for oral hairy leukoplakia, and Epstein-Barr virus was demonstrated with polymerase chain reaction technique. Although a relatively large number of cases of oral hairy leukoplakia has been reported in HIV-negative patients, both immunocompromised and immunocompetent, only a few of these patients have had a malignant hematologic disease.