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Date of last update: 10/12/2017.

Forum Name: AIDS

Question: One more question

 Sunblind - Sun Dec 05, 2004 11:24 pm

Thanks so much for taking the time to address my concerns. Through my own research I had deducted that of all the oral manifestations of HIV infection, and that the only two that are similar to my own condition are OC and OHL. However, I should have been more clear because the "white coating" on my tongue is NOT present on the sides or underneath. It stops rather abruptly as it approaches the sides of my tongue, and doesn't resemble any pictures of OHL that I've seen, so I feel confident in ruling that out. My symptoms don't match any of the 4 types of OC that you've described either; the white area is not made up of plaques (it's more a coating, as you'd see from not brushing your teeth all day), no cracking or redness at the corners of my mouth, and no patchy redness on the hard palette, etc... In any case, my primary complaint is not the white coating of my tongue, it is the small white bumps on my tongue and the rough/burning sensation that has been with me throughout these past couple of months. The bumps are pinsized, not immediatly noticable, only present on the top of my tongue, and mostly towards the front. The rough/burning sensation is elusive and mild, but bothersome nonetheless. I cannot find any description of any disease that matches my symptom, and that's what is driving me crazy. I think my question is, what could be going on with me? Have you ever heard of anything that sounds like my problem, or a symptom of anything that resembles mine? In the later stages of HIV infection, when T-cell counts drop and opputunistic infections begin, wouldn't an individuals overall health decline? or could he/she have an isolated symptom like thrush and feel 100percent healthy besides? And lastly, if my symptom is not an oral cavity disease normally associated with AIDS/HIV, then could it just be a complication of the mouth trauma and infection that I suffered a couple prior to the onset of these symptoms? I'm sorry to ask so many questions, but none of the answers that I've found seem to explain what I'm going through, they only seem to make more questions. Thanks again for your help and your time, I really appreciate it more than you know.
 Dr. Anthony Solomon - Thu Dec 23, 2004 1:33 pm

Hello again,

It appears that by your own inspection and self-examination, you are confident that you do not have Oral Hairy Leukoplakia. That should be reassuring to you, because as I stated earlier, the condition appears almost exclusively in HIV disease.

In your previous note, you stated that your doctor commented that the state of your gums and tongue was not impressive. What was his diagnosis? Is your dental hygiene satisfactory? Are you a chronic smoker? Are you on any long term medication?

The descriptions you give of “small, hardly noticeable, pin-sized white bumps on your tongue and a burning sensation" are insufficient for any doctor to arrive at a diagnosis. A good history and examination are mandatory, preferably under an oral surgeon, who may decide to conduct some tests. It is unethical to attempt a diagnosis without examination. As we state on this site, the information we provide is designed to support, not replace, the relationship existing between a site visitor and his/her physician.

I note from your correspondences that you have done an extensive research on HIV disease and viewed several clinical photographs. I am of the opinion that you are very worried of the possibility that your complaints may be HIV-related. You are right to state that in later stage HIV disease when opportunistic infections develop, an individual’s health will decline to an extent that it is apparent. In your own case, you maintain that your general health is satisfactory. Since you claim you have no risk factors and you are generally in good health, would a (negative) HIV test not give you peace of mind?.

It is not unlikely that you are suffering from a benign condition termed GLOSSODYNIA. This is burning and pain of the tongue which may occur with or without an inflammation of the tongue. It is associated with diabetes, use of certain medications, tobacco, xerostomia, candidiasis and nutritional deficiencies. Once again, I am advising you to consult a doctor who specializes in diseases of the oral cavity for diagnosis and reassurance.

Thank you for coming back to our website with your problems. Merry Christmas!

Dr Anthony Solomon
Consultant Physician, Tropical & Genitourinary Medicine

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