Multiple Vulgar Warts Caused by a High-Risk HPV 16 in an HIV Positive Immunodeficient Patient
Authors:
M. Part; D. Švecová
Authors‘ workplace:
Dermatovenerologická klinika LF UK a UNB Bratislava-Staré Mesto, prednosta prof. MUDr. Mária Šimaljaková, PhD.
Published in:
Čes-slov Derm, 90, 2015, No. 1, p. 20-24
Category:
Case interpretation
Overview
HPV infections (Human Papilloma Virus) are the most common infections of the skin and mucous membranes. Some of them can be classified as sexually transmitted infections with the highest incidence in the younger sexually active population. Fully functional immune system is able to deal with the high-risk virus infection in some cases. In immunodeficient individuals HPV infection can present with different clinical picture and torpid course. The authors present a case of 48-year-old HIV-positive patient with numerous papular lesions on his face. Histopathologic examination confirmed the diagnosis of vulgar warts. Molecular genetic method (PCR) demonstrated the presence of highly oncogenic HPV 16, which is not considered as an etiological agent in verrucae vulgares. HPV 16 may lead to dysplastic changes localized on the cervix, vagina, vulva, penis, anus and oropharynx. Due to HIV infection, the patient was treated with triple combination of antivirals (lamivudine, etravirine, darunavir), with 30/µl of CD4 T lymphocyte count initially. Antiretroviral treatment was given continuously during topical treatment of HPV infection. Topical application of imiquimod was effective in eradicating of all skin lesions within 1 month of therapy. After one-year follow up, the patient was without any cutaneous manifestations of HPV infection.
Keywords:
vulgar warts – HPV infection – HIV- immunodeficiency – imiquimod
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Labels
Dermatology & STDs Paediatric dermatology & STDsArticle was published in
Czech-Slovak Dermatology
2015 Issue 1
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