Yuli Fatzia Ossa1, Anandina Irmagita Soegyanto2, Diah Rini Handjari3, Endah Ayu Tri Wulandari4

Oral Medicine Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia

Departement of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia

Departement of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Division of Oral Medicine, Department of Dentistry, Dr. Cipto Mangunkusumo General Hospital/Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

Abstract

Introduction: Oral potentially malignant disorder (OPMD) was defined by World Health Organization (WHO) as an oral lesion which shows abnormalities and a condition that could potentially become malignant. Leukoplakia is one of OPMD that might present in patients with human immunodeficiency virus (HIV) infection, and is a condition that has a risk of malignancy.

Aims: This case report aims to describe the initial finding of an oral lesion that we suspected as leukoplakia in HIV-infected patient on antiretroviral therapy (ART) and its case management. 

Case Report: A-34-year-old male patient was referred to Oral Medicine Division from HIV clinic at Dr. Cipto Mangunkusumo General Hospital with the chief complaint of dental caries. Th patient was HIV and hepatitis C-infected and already prescribed ART. He had been diagnosed with HIV for 22 years. During intraoral examination, we found multiple caries, poor oral hygiene, and also a single thin white plaque lesion on the right buccal mucosa around the second and third mandibular molar region. The white plaque was painless, irregular, clearly demarcated, could not be rubbed off, and when stretched it did not disappear. History of trauma in this area was noncontributory and the lesion was unnoticed prior to our oral examination. The patient had a smoking habit for the past 25 years. Clinical examination suggested a leukoplakia; therefore, biopsy was planned.

Conclusion: Leukoplakia is a potential malignant lesion and the risk for developing into a malignancy can be higher in patients with HIV infection. Special precautions are needed to prevent a malignancy developing, especially in HIV-infected patient: early detection, elimination of risk factors, performing excisional biopsy and regular intraoral examination.