Comparison of the efficacy of surgery and acyclovir therapy in oral hairy leukoplakia.

To compare the therapeutic effects of surgical excision and orally administered acyclovir therapy on symptomatic oral hairy leukoplakia, 45 homosexual men who were seropositive for human immunodeficiency virus participated in a 3-month open-label study. In the 14 patients who had surgical excision, pain resolved in four symptomatic patients and the leukoplakia did not recur in the areas of excision. New foci of leukoplakia, however, appeared in 10 patients after 3 months. Of the 16 patients who received acyclovir therapy, 12 had a clinical regression, although recurrences were noted in all patients after 3 months. Three patients had resolution of pain while taking acyclovir; in two the pain recurred after acyclovir was discontinued. No spontaneous remissions of the leukoplakia occurred in the 15 patients who refused therapy. We conclude that surgical excision is effective in patients with symptomatic oral hairy leukoplakia.