159 159 Dental Journal (Majalah Kedokteran Gigi) 2020 September; 53(3): 159–163 Case Report Leukoplakia in HIV patients and risk of malignancy: A case report Yuli Fatzia Ossa, 1 Anandina Irmagita Soegyanto, 1 Diah Rini Handjari 2 and Endah Ayu Tri Wulandari 3 1 Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia 2 Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia 3 Division of Oral Medicine, Department of Dentistry, Dr. Cipto Mangunkusumo General Hospital / Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia ABSTRACT Background: Oral potentially malignant disorder (OPMD) was defined by the World Health Organization (WHO) as an oral lesion which shows abnormalities with potential to become malignant. Leukoplakia is one such OPMD that may present in patients with human immunodeficiency virus (HIV), with the condition of HIV presenting a heightened risk of malignancy. Purpose: This case report aims to describe the initial finding and case management of an oral lesion that was suspected as leukoplakia in an HIV-positive patient on antiretroviral therapy (ART). Case: A 34-year-old male patient was referred to the Oral Medicine Division from an HIV clinic at Dr. Cipto Mangunkusumo General Hospital, Jakarta, with a chief complaint of dental caries. The patient was HIV and hepatitis C positive and already undergoing ART. Case Management: During the intraoral examination, we found multiple caries, poor oral hygiene and a single thin white plaque lesion on the right buccal mucosa around the second and third mandibular molar region. The white plaque was painless, irregular, clearly demarcated, could not be rubbed off and did not disappear when stretched. History of trauma in this area was non-contributory and the lesion had gone unnoticed prior to oral examination. The patient had an existing smoking habit of 25 years. As clinical examination suggested leukoplakia, a biopsy was arranged. Conclusion: Leukoplakia is defined as a potentially malignant lesion. The risk of shifting into malignancy can be higher for patients who are HIV positive. Especially in HIV-positive patients, special measures are needed to prevent shifting into malignancy, such as early detection, elimination of risk factors, performing excisional biopsy and regular intraoral examination. Keywords: HIV; leukoplakia; oral potentially malignant disorder Correspondence: Yuli Fatzia Ossa, Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jl. Salemba Raya 4 Jakarta 10431, Indonesia. Email: yuliossa92@gmail.com. INTRODUCTION In conjunction with a workshop with the Centre for Oral Cancer/Precancer, the World Health Organization (WHO), in 2007, outlined the characteristics of patients who have the potential to develop malignant disorders, or what is called a potentially malignant disorder, classifying potentially malignancy disorders into subgroups as follows. The first subgroup includes precancerous lesions which are benign with morphologically altered tissue and have a greater risk becoming malignant than normal lesions. 1,2 The second group describes a precancerous condition in which a disease or patient’s oral hygiene habits do not necessarily alter the clinical appearance of local tissues, but are associated with greater than normal risk of a precancerous lesion or the development of cancer in the affected tissue. 1,3 Leukoplakia is defined as a white plaque lesion that cannot be clinically or histologically characterised by other conditions or diseases. 4 The prevalence of leukoplakia is estimated at 2% of the global population, with this condition known to occur in individuals who have a habit of smoking and drinking alcohol. 1,4 Leukoplakia can occur in all parts of the oral mucosa and is clinically divided into two types, namely homogenous lesions, which are flat, thin and a uniform white in colour, and non-homogenous lesions, Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 32a/E/KPT/2017. Open access under CC-BY-SA license. Available at http://e-journal.unair.ac.id/index.php/MKG DOI: 10.20473/j.djmkg.v53.i3.p159–163