Successful treatment of bowenoid papulosis in a 9-year-old girl with vertically acquired human immunodeficiency virus.
A 9-year-old black girl with vertically acquired human immunodeficiency virus (HIV) and no history of condyloma acuminata presented with a 4-year history of enlarging and spreading dark brown flat papules in the perineum. Some of the lesions were confluent and extended from the clitoris to the labia majora and posteriorly to the buttocks and perianal region. A biopsy of one of the lesions showed bowenoid features. Our patient had a normal Pap smear, but vaginal and cervical biopsy specimens revealed human papillomavirus type 16. Therapy with topical imiquimod cream every other day was started, but little improvement was noted after 2 months. Application of 25% podophyllin every 4 to 8 weeks was added, and improvement was noted within 1 month. After 1 year of treatment, the patient had complete resolution of all lesions, and she has had no further appearance of lesions. Our case emphasizes the need for increased awareness of the potential for development of bowenoid papulosis in HIV-positive children as well as the successful treatment of our patient with topical therapy alone.
Godfrey
James C
JC
Department of Pediatrics, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, Virginia 23507-1971, USA. jcgodfrey@mindspring.com
Vaughan
Mary C
MC
Williams
Judith V
JV
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000635:transmission; D000328:Adult; D000634:Aminoquinolines / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use*; D001913:Bowen's Disease / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D002648:Child; D005260:Female; D006801:Humans; D000077271:Imiquimod; D018445:Infectious Disease Transmission, Vertical; D008431:Maternal-Fetal Exchange; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000635:transmission; D010502:Perineum; D011033:Podophyllin / Q000008:administration & dosage / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000821:virology; D012074:Remission Induction; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000821:virology; D014412:Tumor Virus Infections / Q000150:complications* / Q000635:transmission; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000209:etiology / Q000821:virology
D000634:Aminoquinolines; D000972:Antineoplastic Agents, Phytogenic; D011033:Podophyllin; D000077271:Imiquimod