Human papillomavirus–related genital disease in the immunocompromised host

Gormley, Rachel H.; Kovarik, Carrie L.

doi:10.1016/j.jaad.2010.12.050

Cited by 66 publications

(76 citation statements)

References 115 publications

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“…Moreover, immunocompromised patients have equivalent clearance rates with imiquimod versus immunocompetent patients and treatment with imiquimod does not appear to be influenced by patients’ CD4 counts or viral load [119,120]. …”

Section: Management Of Cutaneous Disease In the Immunocompromised mentioning

confidence: 99%

“…Cidofovir is an acyclic nucleoside analogue of deoxycytidine monophosphate, which acts by selectively inhibiting DNA polymerase and blocking viral DNA synthesis and replication, resulting in apoptosis of virally infected cells [119]. While cidofovir is not yet approved for use in the treatment of carcinoma, it has been increasingly used off-label as therapy for severe recurrent anogential warts [120].…”

Section: Management Of Cutaneous Disease In the Immunocompromised mentioning

confidence: 99%

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HPV Carcinomas in Immunocompromised Patients

Reusser

Downing

Guidry

et al. 2015

JCM

111

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Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide and can result in pre-malignancies or overt malignancies of the skin and mucosal surfaces. HPV-related illnesses are an important personal and public health problem causing physical, mental, sexual and financial detriments. Moreover, this set of malignancies severely affects the immunosuppressed population, particularly HIV-positive patients and organ-transplant recipients. There is growing incidence of HPV-associated anogenital malignancies as well as a decrease in the average age of affected patients, likely related to the rising number of high-risk individuals. Squamous cell carcinoma is the most common type of HPV-related malignancy. Current treatment options for HPV infection and subsequent disease manifestations include imiquimod, retinoids, intralesional bleomycin, and cidofovir; however, primary prevention with HPV vaccination remains the most effective strategy. This review will discuss anogenital lesions in immunocompromised patients, cutaneous warts at nongenital sites, the association of HPV with skin cancer in immunocompromised patients, warts and carcinomas in organ-transplant patients, HIV-positive patients with HPV infections, and the management of cutaneous disease in the immunocompromised patient.

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Section: Management Of Cutaneous Disease In the Immunocompromised mentioning

confidence: 99%

Section: Management Of Cutaneous Disease In the Immunocompromised mentioning

confidence: 99%

HPV Carcinomas in Immunocompromised Patients

Reusser

Downing

Guidry

et al. 2015

JCM

111

View full text Add to dashboard Cite

show abstract

“…Prevention of HPV transmission involves barrier techniques such as condoms, although uncovered areas can still spread infection [Gormley and Kovarik, 2012]. Women receiving IMT are high-risk according to the American college of Obstetricians and Gynecologists (ACOG), requiring more frequent gynaecological examination and cervical screening compared with the general population [American Congress of Obstetricians and Gynecologists, 2009].…”

Section: Human Papilloma Virus Human Papilloma Virus (Hpv) Is a Commmentioning

confidence: 99%

Prevention of infection caused by immunosuppressive drugs in gastroenterology

Orlicka

Barnes

Culver

2013

Therapeutic Advances in Chronic Disease

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Immunosuppressive therapy is frequently used to treat gastrointestinal diseases such as inflammatory bowel disease, autoimmune hepatitis, IgG4-related disease (autoimmune pancreatitis and sclerosing cholangitis) and in the post-transplantation setting. These drugs interfere with the immune system. The main safety concern with their use is the risk of infections. Certain infections can be prevented or their impact minimized. Physicians must adopt preventative strategies and should have a high degree of suspicion to recognize infections early and treat appropriately. This article reviews the risk factors for infections, the mechanism of action of immunosuppressive therapy and proposes preventive strategies.

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“…Though they are typically painless, the lesions may be accompanied by itching or discomfort if present near delicate epithelia [8]. Approximately 80-90% of patients with HPV 6 and 11 clear the viruses from their bodies within 2 years, making a consistent, decade-long presentation unlikely except in the setting of extreme immune compromise such as AIDS [9,10]. Considering the lack of opportunistic infections since the appearance of her nodules many years ago, an underlying infection with HIV is not likely, nor is the presence of persistent, low-risk HPV infection in an otherwise immunocompetent patient.…”

Section: Discussionmentioning

confidence: 99%

Multiple Oral Mucosal Hamartomas in a 34-Year Old Female

Elo

Sun

Laudenbach

et al. 2017

Head and Neck Pathol

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reported first noticing these lesions approximately 10 years prior. She also denied any history of oral surgery, facial trauma, and alcohol, tobacco, or recreational drug use. The patient's past medical history was significant for left and right mastectomy for bilateral ductal carcinoma and partial thyroidectomy for microcarcinoma. She received blood transfusions at multiple points during her surgical journey but her current medical regimen included only levothyroxine. Clinical FindingsIntraoral examination (Fig. 1) revealed generalized multiple white-pink round/oval papules on the patient's lips. She was noted to have a distinct 6 mm × 5 mm × 3 mm papillary lesion on the facial gingiva between teeth #25 and 26 with smaller lesions extending slightly inferiorly to the distal of teeth #27 and 28. Similar small patches of lesions were noted on her contralateral mandibular quadrant. Also noted was a 7 mm × 3 mm white lesion on her right buccal mucosa just superior to the occlusal plane on the distobuccal cusp of tooth #31. In addition, pink papillary growths were found on the palatal gingiva of teeth #1, 2, 3, 6, 7, 9, 10, and 11 (Fig. 2) along with a similar but white papillary lesion on the attached buccal gingiva of tooth #15 measuring 5 mm × 5 mm × 5 mm. Another 3 mm × 7 mm papillary cluster was noted on the lingual mandibular gingiva near teeth #21 and 22. White gingival tissue was noted on the crest of her #14 edentulous ridge site (Fig. 3). None of these lesions were removable with gauze. The tongue was otherwise normal, as was the floor of her mouth. Radiographic imaging of the maxillomandibular region was otherwise unremarkable.Abstract A case of Cowden syndrome (CS) is described in a 34-year-old African American female who reported a history of breast and thyroid malignancies. Clinical examination demonstrated multiple soft, white-pink papules across multiple mucosal surfaces of the oral cavity. Microscopy of the lesions revealed hyperkeratotic surface squamous epithelium with papillomatosis and acanthosis along with elongated rete processes. A genomic polymerase chain reaction direct sequencing using the patient's blood was positive for mutations of the PTEN gene typical of CS.

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Human papillomavirus–related genital disease in the immunocompromised host

Cited by 66 publications

References 115 publications

HPV Carcinomas in Immunocompromised Patients

HPV Carcinomas in Immunocompromised Patients

Prevention of infection caused by immunosuppressive drugs in gastroenterology

Multiple Oral Mucosal Hamartomas in a 34-Year Old Female

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