Table 3.72.

The more common oral manifestations of HIV infection

Condition*	Features	Diagnosis	Management
Candidosis	White removable lesions or red lesions, typically in the palate, but anywhere	Clinical plus investigations; smear or rinse, culture, or biopsy	Antifungals
Hairy leukoplakia	White non-removable lesions almost invariably bilaterally on the tongue	Clinical plus investigations; cytology; DNA studies or biopsy	None usually
Periodontal disease	Linear gingival erythema, necrotising gingivitis or periodontitis	Clinical	Oral hygiene, plaque removal, chlorhexidine, metronidazole
Herpesvirus ulcers	Chronic ulcers anywhere but often on tongue, hard palate or gingivae. Zoster increased by HAART	Clinical plus investigations; cytology, EM, DNA studies or biopsy	Antivirals
Aphthous-like ulcers	Recurrent ulcers anywhere but especially on mobile mucosae	Clinical plus investigations; possibly biopsy	Corticosteroids or thalidomide or granulocyte colony stimulating factor
Papillomavirus infections	Warty lesions, increased by HAART	Clinical plus investigations; DNA studies possibly biopsy	Excise or remove with heat, laser, or cryoprobe, imiquimod or podophyllin
Salivary gland disease	Xerostomia and sometimes salivary gland enlargement	Clinical plus investigations; sialometry, possibly biopsy	Salivary substitutes and/or pilocarpine or cevimeline
Kaposi's sarcoma	Purple macules leading to nodules, seen mainly in the palate	Clinical plus investigations; biopsy	Chemotherapy, usually vinblastine, or laser or radiation
Lymphomas	Lump or ulcer in fauces or gingivae	Clinical plus investigations; biopsy	Chemotherapy or radiation or both

^*HAART reduces many of these manifestations.