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Oral and Maxillofacial Surgery (Expert Forum)
ORAL HAIRY LEUKOPLAKIA and ESOPHAGEAL CANDIDIASIS
Answered by
Michael H Kirsch, DDS - Oral Surgery, Maxillofacial, Wisdom Teeth, Bone Grafting, dental implants
Dr. Michael H. Kirsch
Caldwell - NJ
Questions in the Oral and Maxillofacial Surgery forum are answered by Dr. Michael H Kirsch and Dr.
Mario Tuchman. Topics covered include teeth extractions, wisdom teeth, dental implants, bone grafting, orthognathic surgery, facial bones realignment, facial trauma repair, jaw alignment, anesthesia , jaw cyst or tumor diagnosis, reconstructive jaw surgery, temporomandibular joint syndrome (TMJ) and TMJ surgery.
ORAL HAIRY LEUKOPLAKIA and ESOPHAGEAL CANDIDIASIS
by nervousnelly77, Oct 10, 2009 05:10PM
I am in the dental field and i had an possible exposure at work....about 8 days after a possible exposure...
I developed Thrush on my tongue; had a culture it was negative; but I know it has to be thrush because I had burning esophagus and lips and a white coating on the back of my tongue. And I developed angular chelitis from it. I let it go for a few months (untreated) due to anxiety. Finally I got Nystatin (2 week dose) but it did not work probably becasue I have had it so long. I have not done any other treatment ...It seems to be subsiding a bit becasue I have been taking probiotics. The white appearance is really mild, it does not bleed, I do brush it softly am/pm, But my burning esophagus still persists some days its worse than others.
Also, about 2-3 months later I developed hairy- like thickened papilla on the anterior and lateral portions of my tongue. My tongue looks/feels like a cats tongue it is very rough in texture, and when I dry it off it looks fissured and its very red and can become sore to touch. my taste buds are red and inflammed.I wake up in the morning with white rings on the anterior portion but they brush right off. My tongue just looks very red almost bluish at times. I think it is OHL. I have had all the tests: PCR-RNA and 4 HIV tests; the last one at 21 weeks (5 months and 1 week) test for HIV, HEP C, Syphillis= all NEG.
My questions are: Is there any differential diagnosis you can think of for pregnancy or stress...
1) Can pregnancy or hormones cause anything like what I am describing?
2) Can stress cause anything like what I am describing?
3) Is there a way to have thrush and OHL but not have HIV? I don't have any other diseases...I am pregnant and have been under severe emotional stress.
4) Does OHL always present like a white patch on the lateral portion of the tongue that does not wipe off or change?
5) I am convinced of HIV. The experts/doctors have told me no way/no how and to stop testing.
I developed Thrush on my tongue; had a culture it was negative; but I know it has to be thrush because I had burning esophagus and lips and a white coating on the back of my tongue. And I developed angular chelitis from it. I let it go for a few months (untreated) due to anxiety. Finally I got Nystatin (2 week dose) but it did not work probably becasue I have had it so long. I have not done any other treatment ...It seems to be subsiding a bit becasue I have been taking probiotics. The white appearance is really mild, it does not bleed, I do brush it softly am/pm, But my burning esophagus still persists some days its worse than others.
Also, about 2-3 months later I developed hairy- like thickened papilla on the anterior and lateral portions of my tongue. My tongue looks/feels like a cats tongue it is very rough in texture, and when I dry it off it looks fissured and its very red and can become sore to touch. my taste buds are red and inflammed.I wake up in the morning with white rings on the anterior portion but they brush right off. My tongue just looks very red almost bluish at times. I think it is OHL. I have had all the tests: PCR-RNA and 4 HIV tests; the last one at 21 weeks (5 months and 1 week) test for HIV, HEP C, Syphillis= all NEG.
My questions are: Is there any differential diagnosis you can think of for pregnancy or stress...
1) Can pregnancy or hormones cause anything like what I am describing?
2) Can stress cause anything like what I am describing?
3) Is there a way to have thrush and OHL but not have HIV? I don't have any other diseases...I am pregnant and have been under severe emotional stress.
4) Does OHL always present like a white patch on the lateral portion of the tongue that does not wipe off or change?
5) I am convinced of HIV. The experts/doctors have told me no way/no how and to stop testing.
Doctor's Answer
by Michael H Kirsch, DDS, Oct 10, 2009 05:50PM
, Oct 10, 2009 05:50PM
Forum rules only allow to answer one question per posting. However, I can tell that you are concerned so I will do my best.
1. Unlikely
2. Yes, cortisol level change with varying degrees of stress and my influence your condition.
3. Yes
4. No, there are no absolutes in medicine.
5. It is unlikely to have HIV in the absence of negative repeated serologic exams.
I suggest the following:
See an Oral and Maxillofacial Surgeon and have the lesion(s) biopsied and cultured as well as cytological examination. Only a biopsy can definitively diagnose an oral lesion.
See an infectious disease doctor to discuss your concerns (not a general medical doctor).
There are long lists of potential medical condition that are associated with a variety of oral lesions. The first step is to find out exactly what the lesion is and then move forward from there.
Another option would be to locate and see a dentist who specializes in Oral Medicine. They are not very common and often affiliated with a dental school. Check with your State Board of Dentistry for a list of names.
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation. This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
1. Unlikely
2. Yes, cortisol level change with varying degrees of stress and my influence your condition.
3. Yes
4. No, there are no absolutes in medicine.
5. It is unlikely to have HIV in the absence of negative repeated serologic exams.
I suggest the following:
See an Oral and Maxillofacial Surgeon and have the lesion(s) biopsied and cultured as well as cytological examination. Only a biopsy can definitively diagnose an oral lesion.
See an infectious disease doctor to discuss your concerns (not a general medical doctor).
There are long lists of potential medical condition that are associated with a variety of oral lesions. The first step is to find out exactly what the lesion is and then move forward from there.
Another option would be to locate and see a dentist who specializes in Oral Medicine. They are not very common and often affiliated with a dental school. Check with your State Board of Dentistry for a list of names.
Information contained within this reply is intended solely for general educational purposes and is not intended nor implied to be a medical diagnosis or treatment recommendation. This is not a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your own doctor for medical condition. Only your doctor can provide specific diagnoses and therapies.
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