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All are true regarding oral hairy leukoplakia except: (Repeat)

A
It is premalignant
B
Associated with EBV infection
C
Seen in HIV infected patients
D
Hyperkeratosis on HPE
High-Yield Explanation
Ans: A (It is premalignant) Ref: Robbin's' Pathology Basis of disease, 8th ed Explanation: Leukoplakia is premalignant. not OHL. ORAL HAIRY LEUKOPLAKIA (OHL) Hairy leukoplakia is a distinctive oral lesion that is usually seen in immunocompromised patients. Approximately S0% of patients with hairy leukoplakia are infected with the human immunodeficiency virus (HIV). 20% of lesions are seen in patients who are immunocompromised for other reasons, such as cancer therapy or transplant immune-suppression. Hairy leukoplakia takes the form of white, confluent patches of fluffy ("hairy"), hyperkeratotic thickenings, almost always situated on the lateral border of the tongue. Unlike thrush, the lesion cannot be scraped off. The distinctive microscopic appearance consists of hyperparakeratosis and acanthosis with "balloon cells" in the upper spinous layer. There is no dysplasia (It is not premalignant). Sometimes there is koilocytosis of the superficial, nucleated epidermal cells, suggesting human papillomavirus (HPV) infection, and HPY transcripts have occasionally been found within the cells. However, EBV is present in most cells and is now accepted as the cause of the condition. Sometimes there is superimposed candidal infection on the surface of the lesions, adding to the "hairiness." In HIV-positive individuals, with hairy leukoplakia, symptoms of AIDS follow in 2 to 3 years.

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