Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
ORAL LESIONS OF HIV INFECTIONS: FEATURES AND THERAPY
AIDS Clinical Review 1990. Volberding P and Jacobson MA, eds. New York, Marcel Dekker, p. 81-93, 1990.. Unique Identifier : AIDSLINE ICDB/91675540 Greenspan D; Greenspan JS; Dept. of Stomatology, Univ. of California-San Francisco, San; Francisco, CA
Abstract:
The oral lesions of HIV infection are important for several reasons. First, they often represent a relatively early stage of HIV disease. Thus, their prompt and accurate diagnosis is important in staging and may be a determining factor in the initiation of preventive therapy such as prophylactic pentamidine and/or zidovudine. Early recognition and therapy may prevent significant morbidity and maintain the patient's (pt's) quality of life. Oral lesions associated with HIV infection are reviewed, including Kaposi's sarcoma (KS), other malignancies, bacterial infections (periodontal disease), viral infections (herpes simplex virus, varicella zoster virus, cytomegalovirus, human papillomavirus, Epstein-Barr virus), fungal infections (oral candidiasis), salivary gland disease, and oral ulcers. KS can occur in the oral cavity before skin lesions appear. The lesions usually are symptomless, unless infected or ulcerated, in which case there may be pain, tenderness, or bleeding. The lesions may occur anywhere in the mucosa, but the palate and gingiva are the most common locations. In a recent study of a clinical population of pts with AIDS, 40% of KS pts had oral lesions. Pts with or without oral KS lesions showed the same distribution of other lesions and of a prior history of Pneumocystis carinii pneumonia. Oral KS lesions often respond well to local therapy, such as radiation therapy, surgery, or chemotherapy. Intralesional vinblastine has been used with some success, resulting in significant regression of the oral lesions with minimal systemic side effects. External radiation therapy produced regression of lesions in 36 pts and use of the carbon dioxide laser has yielded some success. AIDS-associated lymphoma can present in the mouth as a solitary ulcer or swelling or as multiple lesions. These usually are of sudden onset, painful, and grow rapidly. Oral lymphoma can present diagnostic challenges, particularly in the absence of disseminated disease. Diagnosis is made on biopsy and, in the authors' experience, confirmation usually requires plastic embedding and lymphocyte marker studies. At this time there is no convincing evidence for an association between HIV infection and other oral malignancies such as squamous cell carcinoma. (40 Refs)
Keywords: Diagnosis, Differential Human HIV Infections/COMPLICATIONS/*DIAGNOSIS Mouth Mucosa/PATHOLOGY Mouth Neoplasms/*DIAGNOSIS Opportunistic Infections/COMPLICATIONS/*DIAGNOSIS Sarcoma, Kaposi's/*DIAGNOSIS Stomatitis/*DIAGNOSIS MONOGRAPH REVIEW 911030
M91A1126
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Important note: Information in this article was accurate in 1991. The state of the art may have changed since the publication date.
