Focal epithelial hyperplasia by human papillomavirus (HPV)-32 misdiagnosed as HPV-16 and treated with combination of retinoids, imiquimod and quadrivalent HPV vaccine

Franco Gemigniani, Javier Hernández-Losa, Berta Ferrer, Vicente García-Patos

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)

Abstract

© 2015 Japanese Dermatological Association. Focal epithelial hyperplasia (FEH) or Heck's disease is a rare, benign and asymptomatic mucosal proliferation associated with human papillomavirus (HPV) infection, mainly with genotypes 13 and 32. We report a florid case of FEH in an 11-year-old Haitian girl with systemic lupus erythematosus receiving immunosuppressive therapy. Cryotherapy was previously performed on numerous occasions with no results. We decided to prescribe a non-invasive and more comfortable treatment. A combination of topical retinoid and imiquimod cream was well tolerated and led to an important improvement. The evidence of infection by HPV-16 detected by polymerase chain reaction (PCR) technique, prompted us to prescribe the quadrivalent HPV vaccine (types 6, 11,16 and 18). Subsequent PCR sequencing with generic primers GP5-GP6 and further BLAST comparative analysis confirmed that genomic viral sequence in our case truly corresponded with HPV-32. This molecular misdiagnosis can be explained by the similarity between genomic sequences of both HPV-16 and -32 genotypes. At the 1-year follow up, we observed total clinical improvement and no recurrences of the disease. Complete healing in this case may correspond to a potential action of topical retinoid, imiquimod and the cross-protection mechanism of the quadrivalent HPV vaccine.
Original languageEnglish
Pages (from-to)1172-1175
JournalJournal of Dermatology
Volume42
Issue number12
DOIs
Publication statusPublished - 1 Dec 2015

Keywords

  • focal epithelial hyperplasia
  • human papillomavirus
  • imiquimod
  • polymerase chain reaction
  • quadrivalent human papillomavirus vaccine

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