Effect of Quadrivalent Human Papillomavirus Vaccination on Oral Squamous Cell Papillomas.
OBJECTIVE
Cutaneous verruca vulgaris lesions (warts) and oral squamous cell papillomas are common lesions caused by human papillomavirus (HPV). Multiple reports have described cases of wart resolution following quadrivalent HPV vaccination. We report the case of a patient with chronic oral papillomas with resolution after quadrivalent HPV vaccination and perform a review of the literature.


METHODS
An immunocompetent man in his 60s presented with chronic verrucous papules on the lips, tongue, and buccal mucosa refractory to multiple excisions. Biopsy showed squamous cell papilloma, and DNA sequencing revealed HPV-32. He received the quadrivalent HPV vaccine resulting in clearance of all lesions after 3 months. We found 8 reported cases of disseminated, recurrent warts with resolution after quadrivalent HPV vaccination. Improvement was seen within 4 weeks of vaccination, and resolution after 3 to 8 months.


CONCLUSIONS
We report the case of recurrent oral papillomas caused by HPV-32 with complete resolution after quadrivalent HPV vaccination and reviewed reports of resolution of recalcitrant and disseminated warts after vaccination. Production of cross-protective immunoglobulins and cytotoxic T cells is a possible mechanism. There remains a critical need for randomized clinical trials to assess efficacy of quadrivalent HPV vaccination for treatment of oral squamous papillomas and cutaneous verruca vulgaris.
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas.
Nika
N
Cyrus
Department of Dermatology, University of Virginia Health System, Charlottesville.
Adam B
AB
Blechman
Department of Dermatology, University of Pennsylvania Health System, Philadelphia.
Matthew
M
Leboeuf
Department of Pathology, Pennsylvania Hospital, Philadelphia.
Elizaveta A
EA
Belyaeva
DDL Diagnostic Laboratory BV, Rijswijk, the Netherlands.
Maurits N C
MN
de Koning
DDL Diagnostic Laboratory BV, Rijswijk, the Netherlands6Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
Koen D
KD
Quint
Division of Infectious Diseases, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia.
John J
JJ
Stern