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Dr. Hegland
Dr. Hegland, Dentist
Category: Dental
Satisfied Customers: 148
Experience:  Dentist at Dental Care on Demand
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I have some raised, colored, furry like growths on the top

Customer Question

I have some raised, white colored, furry like growths on the top of my my tongue, towards the middle. This is the third time I have noticed these gross appear. I have basically got them once a year for three years and they last about two weeks or so. With each time, the growth area seems to get a little larger. I can send you a picture if you'd like as well. I'm not sure what this condition is or how worried I should be. I asked my dentist a few days ago, he told me he thought it was a benign condition and he told me it was varrukas leukoplakia, also known as hairy tongue. However, when I look up these conditions online, they seem to be two separate conditions, and I am just not sure what I have. And, the for the hairy tongue pictures I see online all seem to look black and cover a large portion of the tongue, while my patches look white in color. How do I get rid of this? And is it serious? And what is it that I might have?
Submitted: 10 months ago.
Category: Dental
Expert:  Dr. Hegland replied 10 months ago.

If you can send me a picture or two I'll take a look at it for you. Dr. Hegland.

Customer: replied 10 months ago.
Attached are four pictures. The first two were taken four days ago. The last two were taken five minutes ago. You can see that the growths are starting to appear a lot flatter now. I first noticed this condition three years ago, and it started with one tiny raised growth that almost looked like a hair like projection. It went away after about two weeks. I year later it came back in the same spot and got a little bigger. This time it is even bigger than ever before. The dentist who saw it two days ago told me it's almost as if it's a little wart. And I'm also concerned whether or not this is contagious. Is this something that can be passed on through kissing or something like that? How long will this last and will it go away? The images I see a furry ton online seem to cover nearly they entire surface of someone's tongue. I definitely don't want it to lead to something like that. I am just hoping to find some answers as to what this is, whether or not it's serious, and what I can do about it. Thank you. I also want to try and rule out hairy leukoplakia. Based on pictures online hairy leukoplakia is usually on the sides of the tongue, I'm just not sure what this is.
Expert:  Dr. Hegland replied 10 months ago.

One picture came through, I'll wait for the other ones.

Customer: replied 10 months ago.
Do I need to resend them?
Expert:  Dr. Hegland replied 10 months ago.

You might want to I can only look at one image at this point and I'm not sure if it was the 4 days ago or 5 minutes ago one.

Customer: replied 10 months ago.
This is from four days ago, I will send them separately.
Customer: replied 10 months ago.
This is also from four days ago:
Customer: replied 10 months ago.
This is from five minutes ago
Customer: replied 10 months ago.
This is also from five minutes ago
Customer: replied 10 months ago.
This is another one from four days ago
Expert:  Dr. Hegland replied 10 months ago.

Alright, well I looked at your pictures they did all come through when you sent separately. From looking at the lesion, yes the general classification is leukoplakia. However, I would believe that the most likely condition is that this is an irritation based lesion. I say that because you've had it more than once in approximately the same area of the tongue. The irritant could be a variety of things, so that is difficult to determine unless you start tracking this yourself when they occur. As far as the verrucous leukoplakia you are referring to a proliferative form that does need to be monitor because it can turn precancerous from HPV 16/18. So to answer your contagious question, well as you may have heard HPV is pretty prevalent and can be acquired from contact with individuals that carry the virus. If it were my mouth, I would ask my dentist to have the area biopsied. It's super easy to numb tongue and take a segment of that leukoplakia and have the histology run so that you can sleep at night knowing it's origin. You've also noticed that when it recurs it is slightly larger each time, and with that awareness I would elect to biopsy for confirmation. Lesions like this are 95% of the time innocent, but if its easy to check it out for sure I'd ask your dentist for further work up on it. Does that answer your question?

Customer: replied 10 months ago.
this is not hairy tongue? And when you say it's leukoplakia, even though I am not a smoker, that could still be the diagnosis? Also, would "hairy leukoplakia" be the diagnosis? Even though it's not on the side of my tongue? Or what type of leukoplakia? Are you saying that this leukoplakia is caused by HPV? So I should not kiss anyone while I have this on my tongue? It could spread to them by kissing? And it seems you are saying that 5% of the time something like this could be cancerous? Based on what I read online leukoplakia mainly affects smokers, and hairy leukoplakia mainly affects HIV-positive individuals. I know I definitely had an HIV test after the first tongue symptom ever appeared, and it was negative. In fact I probably have had 2 HIV tests since 2013 when I first noticed the first spot on my tongue , and so far they have all been negative.
Expert:  Dr. Hegland replied 10 months ago.

Ok so you have had HIV test, but HPV is different. I'll refer you to CDC in regards ***** ***** http://www.cdc.gov/hpv/ Leukoplakia is more common with smokers, but there are various other factors that can cause leukoplakia. However, a complete diagnosis on the type of leukoplakia can only be given with a biopsy. As you have already researched that hairy leukoplakia often does occur on the side of the tongue. Wart looking (verrucous) leukoplakias, can be caused by HPV. So as far as spreading your tongue lesion, no that will not happen. However, if you do have HPV that can be transmitted. That's something to talk to your physician about testing for (blood test). The 5% I'm referring to is when the verrucous is proliferative form- that is PRE cancerous and needs to be monitored for changes. So again, have it biopsied.

Customer: replied 10 months ago.
I do know that about 3 days before this latest recurrence of these symptoms, I performed oral sex on a new partner. So perhaps that was an irritant? I also seem to recall that the first time this symptom ever occurred back in 2013, I also performed oral sex on a new partner as well. In fact, one of my previous partners, in 2014, told me she had tested positive for HPV, but that it was in complete remission. Thus, I thought it would be safe. I will go to my doctor to follow up with this, but in your opinion, is this something I should be overly worried about, or only slightly worried about?
Customer: replied 10 months ago.
proliferative verrucas leukoplakia" is entirely different from "verrucas leukoplakia"?
Customer: replied 10 months ago.
Also, does kissing spread HPV? Or just sexual intercourse? And oral sex? Where would sharing a toothbrush with someone spread this or sharing a glass to drink out of?
Expert:  Dr. Hegland replied 10 months ago.

Well now that you taking note of occurrence that as well would make me recommend that you have HPV test with your med doctor. Only a few forms of HPV are problematic, but if you've had partners that have it (even in remission) might want to find out. Yes, proliferative is a potentially cancerous form of verrucous leukoplakia (like a subtype). From CDC website-

"You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.

Anyone who is sexually active can get HPV, even if you have had sex with only one person. You also can develop symptoms years after you have sex with someone who is infected making it hard to know when you first became infected." Hopefully that makes sense to you now.

Customer: replied 10 months ago.
Thank you for all of your help. I really appreciate it.
Expert:  Dr. Hegland replied 10 months ago.

No problem at all, if you need any other assistance please let me know and if you can rate your experience it is helpful for quality assurance protocol. Have good evening. Dr Hegland

Customer: replied 10 months ago.
By the way, when I do searches online I cannot find "verrucas leukoplakia" by itself without it being "proliferative verrucas leukoplakia" I've tried many different sites and I don't see them distinguish the two at all. Do you happen to have a link or something you can refer me to where I can look at verrucas leukoplakia and distinguish it somehow from the proliferative type?
Expert:  Dr. Hegland replied 10 months ago.

Proliferative Verrucous Leukoplakia is a definitive diagnosis whereas verrucous (wart-like) leukoplakia is essentially a differential diagnosis (description). When you are told you have a verrucous leukoplakia its not a diagnosis its a objective finding, whereas the proliferative is definitive and identified histologically. It's complicated to explain unless you've been clinically trained in taking exam notes and making diagnosis. So I don't have a site for you to look that up at, it's more clinical lingo is all.

Expert:  Dr. Hegland replied 10 months ago.

Did that clarification answer your question? If so have good evening.

Customer: replied 10 months ago.
Thank you so much. I really appreciate your help!
Expert:  Dr. Hegland replied 10 months ago.

No problem, if you can conclude our question session by rating now that is all. Good evening

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