Recalcitrant oral squamous cell papilloma lesions in two HIV-infected patients successfully treated with topical imiquimod.
BACKGROUND
Squamous cell papilloma is a benign mucosal disease associated with human papillomavirus. Its presence in human immunodeficiency virus (HIV)-infected patients has rarely been reported. Therapeutic modalities for oral squamous cell papilloma have limited success and recurrences are frequent in HIV-infected subjects. Imiquimod, is a topical immunomodulator successfully used in some human papillomavirus-related oral lesions. However, its use for oral squamous cell papillomas in HIV-infected individuals has never been described.


METHODS
We report two male adult patients with HIV-infection, B2 and C3 stage respectively, undergoing antiretroviral therapy, with multiple recalcitrant oral squamous cell papillomas, predominantly affecting the masticatory mucosa. These lesions were successfully treated with daily topical imiquimod 5% cream for a few weeks, with only mild and well-tolerated side effects. No recurrences were observed after a follow-up period of over 20 months.


CONCLUSIONS
Our cases highlight the value of imiquimod for the non-invasive treatment of multiple persistent oral squamous cell papillomas in two HIV-infected patients.
Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, Mexico;
Lilly
L
Esquivel-Pedraza
Oral Pathology Department, Centro Dermatológico "Dr. Ladislao de la Pascua", México City, Mexico;
Laura
L
Fernández-Cuevas
Pathology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, Mexico.
Marcela
M
Saeb-Lima
Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, Mexico;
Brenda Alicia
BA
Guerrero-Ramos
Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, Mexico;
Amparo
A
Hernández-Salazar
Dermatology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", México City, Mexico;
Silvia
S
Méndez-Flores
AIDS; mucous membrane; skin tumor