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Oral hairy leukoplakia in a patient on long-term anticonvulsant treatment with lamotrigine

Lookup NU author(s): Professor Philip Sloan, Dr Gavin Spickett, Dr Konrad Staines


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We describe a case of oral hairy leukoplakia that presented with an atypical appearance in a patient on long-term anticonvulsant treatment with an aromatic antiepileptic, lamotrigine. Recent medical history was also significant for recurrent respiratory tract infections requiring treatment with oral antibiotics. Immunologic investigations revealed inverted CD4/CD8 ratio, mild hypogammaglobulinemia, and poor specific antibody titers. Combined immune deficiency caused by long-term treatment with lamotrigine was suspected after other known factors and conditions (including retroviral infection) leading to acquired immune deficiency were excluded. Withdrawal of lamotrigine resulted in complete resolution of oral hairy leukoplakia. There was no significant improvement in immunoglobulin levels. The effect of lamotrigine and other aromatic antiepileptics on the immune system should be considered in a patient presenting with otherwise unexplained oral hairy leukoplakia. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:e17-e23)

Publication metadata

Author(s): Gordins P, Sloan P, Spickett GP, Staines KS

Publication type: Article

Publication status: Published

Journal: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology

Year: 2011

Volume: 111

Issue: 5

Pages: E17-E23

Print publication date: 22/03/2011

ISSN (print): 1079-2104

ISSN (electronic): 1528-395X

Publisher: Mosby, Inc.


DOI: 10.1016/j.tripleo.2010.12.012


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