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OHL vs Leukoplakia — MFDS Part 1 MCQ

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EasyOral PathologyOHL vs LeukoplakiaMFDS Part 1

An immunosuppressed adult has an asymptomatic, non-scrapable, corrugated white plaque along the lateral border of the tongue. Which feature most strongly distinguishes oral hairy leukoplakia from conventional oral leukoplakia?

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Correct answer: E — Association with productive Epstein–Barr virus infection of the oral epithelium

The corrugated, non-scrapable lateral tongue plaque in an immunosuppressed patient is characteristic of oral hairy leukoplakia. Its defining aetiological association is productive Epstein–Barr virus infection of the oral epithelium. Conventional oral leukoplakia is instead classified as an oral potentially malignant disorder, so B describes the comparator rather than oral hairy leukoplakia. Bilateral buccal lacy striae suggest reticular oral lichen planus. Candida causes oral candidosis rather than oral hairy leukoplakia. Oral hairy leukoplakia is usually asymptomatic, making pain an uncharacteristic feature. Although strongly associated with immunosuppression, it can occasionally occur in apparently immunocompetent patients.

Reference: Wu Y-H and 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/