Oral Hairy Leukoplakia — MFDS Part 1 MCQ
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Correct answer: C — Epstein-Barr virus (EBV)
The correct answer is **A, Epstein-Barr virus (EBV)**. Oral hairy leukoplakia results from productive EBV infection and replication within oral squamous epithelium. It classically presents as an asymptomatic, non-scrapable white plaque with a corrugated or “hairy” surface, usually on the lateral border of the tongue. It is particularly associated with impaired cell-mediated immunity, including HIV infection and therapeutic immunosuppression, although it can occasionally occur without overt immunodeficiency. HPV is associated with squamous papillomas and some oropharyngeal carcinomas; HSV usually causes vesicles and ulcers; CMV may cause persistent oral ulceration in severe immunosuppression; and HHV-8 is associated with Kaposi sarcoma. These viruses do not cause oral hairy leukoplakia.
Reference: Wu Y-H, Chiang C-P. Oral hairy leukoplakia: The role of Epstein-Barr virus, the occurrence in immunocompetent patients, and the malignant transformation potential. Journal of Dental Sciences. 2025;20(3):1398–1405. https://pubmed.ncbi.nlm.nih.gov/40654445/