Oral hairy leukoplakia: The role of Epstein-Barr virus, the occurrence in immunocompetent patients, and the malignant transformation potential.

Oral hairy leukoplakia (OHL) was first reported by Greenspan et al., in 1984 and it was observed in a group of male homosexuals in the San Francisco. These lesions are predominantly found on the lateral borders of the tongue and show a corrugated or "hairy" surface. The Epstein-Barr virus (EBV) was then detected in these OHL lesions and proved to be involved in the development of the OHL. Besides, the OHL is also seen in people with immunosuppressive states. In this study, we focused on three different aspects of the OHL: (1) the necessity of presence of the EBV in the OHL lesions; (2) the OHL lesions in immunocompetent patients; (3) the potential of malignant transformation in the OHL lesions. In addition to clinical presentations, histopathological examination of the biopsy specimens with the confirmation of the presence of the EBV in the lesions can make the diagnosis more reliable. Moreover, when the OHL occurs in those who are relatively healthy, a thorough survey to find out the possibly insidious diseases or contributing factors is essential. Furthermore, although the evidence to prove the potential of malignant transformation in the OHL lesions is limited, it still need further investigations.