HIV, AIDS, Pox, & Sars
_________ lesions remain a significant cause of morbidity & mortality in HIV-seropositive
individuals. They are often the first indicators of
systemic illness
Oral
May be the first manifestation of potential HIV infection
Most often caused by Candida ablicans, tx: Nystatin rinse, lozenges, troches or clotrimazole;
sugar content of medication w/ long term use can contribute to caries ; Fluconazole &
Itraconazole systemic antifungals
Pts. experience: asymptomatic or burning sensation, altered taste
If in esophagus: difficulty swallowing, nausea, chest pain, weight loss
Candidiasis
Candidiasis is associated with:
angular cheilitis, black hairy tongue, median rhomboid glossitis
Oral Candidiasis
angular chelitis
black hairy tongue
median rhomboid glossitis
1st described in 1984;
1st case of HIV/AIDS 1981
Bilateral white plaques on lateral border of tongue, shaggy appearance w/ vertical folds:
diagnosed by clinical appearance
Associated w/ Epstein- Barr virus (member of the herpes virus family), fails to respond to
antifungal therapy
, May also be observed in any immunocompromised individual: organ transplant, medications
designed to suppress immune system
Hairy Leukoplakia
Hairy Leukoplakia
HIV-positive: more likely to have oral HPV, more than 1 type of HPV & infected w/ high-risk
HPV
Oral warts 1-4%
20-25% Squamous cell carcinoma HPV of head & neck (oropharyngeal carcinoma)
80-90% oropharyngeal carcinoma carry HPV 16
There are over 100 types of HPV and # are associated with the oral cavity
24
Human Papilloma Lesions (Focal epithelial hyperplasia )
Kaposi's sarcoma (2nd most common AIDS- associated neoplasia)
Manifests as angiomatous malignancy of skin & mucosa
Associated with human oncovirus (human herpesvirus 8)
Early lesions: nonpainful, purple-to- red macules, focal or diffuse, may be overlooked
Kaposi Sarcoma (HHV-8)
Kaposi Sarcoma
Kaposi Sarcoma
Seen most often in immunocompromised individuals
Rapidly growing, painful masses,
ulcerated, appear on gingiva or palate
Oral lesions occur in 4% of HIV indv w/ non- Hodgkin lymphoma
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