Lupton G P, James W D, Redfield R R, Brown C, Rodman O G
Arch Dermatol. 1987 May;123(5):624-8. doi: 10.1001/archderm.123.5.624.
Oral hairy leukoplakia (HL) is a newly described lesion occurring principally on the lateral borders of the tongue in immunosuppressed homosexual men infected with human T-cell lymphotropic virus type III (HTLV-III). Clinically, HL appears as a slightly raised, poorly demarcated lesion with a corrugated or "hairy" surface. Histologically, the lesion is characterized by keratin projections on the surface (which often resemble hairs), parakeratosis, and acanthosis. In addition, large pale-staining cells with pyknotic nuclei are seen in the upper stratum malpighii, which appear similar to the koilocytes described in uterine condylomata. Candida organisms are frequently observed on the lesion surface. Little, if any, subepithelial inflammation is present. Human papillomavirus and Epstein-Barr virus have been identified in biopsy specimens from lesions of oral HL. The association of this lesion in patients with HTLV-III infection has been established. We saw a patient with HTLV-III infection and HL, in whom the immunochemical and ultrastructural findings revealed the presence of a mixed viral infection. Because oral HL may be of diagnostic value as an early indicator of HTLV-III infection, awareness of its characteristic clinical, histologic, immunochemical, and ultrastructural features is important.
口腔毛状白斑（HL）是一种新描述的病变，主要发生在感染人类嗜T淋巴细胞病毒III型（HTLV-III）的免疫抑制同性恋男性的舌侧缘。临床上，HL表现为略微隆起、边界不清的病变，表面呈波纹状或“毛状”。组织学上，该病变的特征是表面有角质突起（常类似毛发）、不全角化和棘层肥厚。此外，在马尔匹基层上层可见大的淡染细胞，核固缩，其外观与子宫尖锐湿疣中描述的凹空细胞相似。病变表面经常观察到念珠菌。几乎没有或根本没有上皮下炎症。在口腔HL病变的活检标本中已鉴定出人乳头瘤病毒和EB病毒。这种病变与HTLV-III感染患者的关联已经确立。我们见过一名患有HTLV-III感染和HL的患者，其免疫化学和超微结构检查结果显示存在混合病毒感染。由于口腔HL作为HTLV-III感染的早期指标可能具有诊断价值，了解其特征性的临床、组织学、免疫化学和超微结构特征很重要。
