title: HPV Type 6 and 18 Coinfection in a Case of Adult-Onset Laryngeal Papillomatosis: Immunization with Gardasil.
abstract: Laryngeal papillomatosis (LP) is a rare human papillomavirus (HPV) related disease that often requires multiple surgical interventions and residual impairment of voice is almost inevitable. We report the case of a patient with adult onset recurrent LP, showing moderate dysplasia and coinfection with HPV types 6 and 18. The tetravalent HPV vaccine Gardasil was prescribed off label, with the aim of triggering an immunogenic response and consequently reducing the probability of further recurrences. The patient was followed for 9 months with no sign of relapse of his LP. The postexposure use of the anti-HPV vaccine could represent a promising therapeutic agent in established LP. Unfortunately, the potential efficacy of this new therapeutic option in this situation has been suggested only by isolated case reports. Further controlled studies, with a longer follow-up and a larger sample size, are needed to assess efficacy of Gardasil in LP.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy.
authors.forename: Virginia
authors.initials: V
authors.lastname: Fancello
authors.affiliation: Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Melis
authors.affiliation: Hygiene and Preventive Medicine, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
authors.forename: Andrea Fausto
authors.initials: AF
authors.lastname: Piana
authors.affiliation: Hygiene and Preventive Medicine, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Castiglia
authors.affiliation: Hygiene and Preventive Medicine, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cossu
authors.affiliation: Hygiene and Preventive Medicine, Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sotgiu
authors.affiliation: ENT Department, P. Dettori Hospital, Tempio Pausania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Bozzo
authors.affiliation: Department of Head and Neck Surgery, Poole Hospital NHS Foundation Trust, Poole, UK.
authors.forename: Emma Victoria
authors.initials: EV
authors.lastname: King
authors.affiliation: Division of Otorhinolaryngology, Department of Surgical, Microsurgical and Medical Sciences, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Meloni