CLINICAL CASE A 37-year-old male presents for evaluation an
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Varada Ghadge
CLINICAL CASE

A 37-year-old male presents for evaluation and management of long-standing 'ulcers' on the tongue.

On examination -
Thin-appearing adult male
Recent diagnosis of HIV infection
Not yet initiated anti-retroviral medications
Elevated viral load and reduced CD4 lymphocyte count (240)
Presents with thick, adherent, white hyperkeratotic corrugated plaques (without underlying erythema or edema) on the bilateral tongue
No evidence of oral candidiasis on exam - potassium hydroxide preparation is negative

Diagnosis- Oral hairy leukoplakia

Treatment -
Patient initiated on topical tretinoin cream twice daily to affected areas
Patient referred to HIV primary care for evaluation and consideration for start of anti-retroviral regimen
Follow up in 4 weeks

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