Nonavalent Human Papillomavirus Vaccine as a Treatment for Recalcitrant Warts in an Adult with HIV

Main Article Content

Michael Tassavor, MD
Peter Hashim, MD
Folawiyo Babalola
Mehul Bhatt, MD

Keywords

human papillomavirus, immunosuppressed, vaccine, wart, HIV, nonavalent, gardasil

Abstract

To the Editor: Cutaneous warts are seen in as many as a quarter of immunosuppressed patients. 1 Cell-mediated immunodeficiency, as seen in HIV, is correlated with increased rates of palmoplantar warts. 2 These warts often cause discomfort, and can progress to verrucous carcinoma. As they can be resistant to traditional treatments like cryotherapy, patients must resort to more aggressive and invasive measures like intralesional bleomycin. In this case report, we present an immunocompromised patient with HIV successfully treated for his palmoplantar human papilloma virus (HPV) warts using the nonavalent HPV vaccine (Gardasil 9TM, Merck Inc, Kenilworth, NJ, USA) after only marginal improvement with six treatments of bleomycin.

References

1. Wieland U, Kreuter A, Pfister H. Human papillomavirus and immunosuppression. Curr Probl Dermatol. 2014;45:154-65. doi:10.1159/000357907

2. Leto M, Santos Júnior GF, Porro AM, Tomimori J. Human papillomavirus infection: etiopathogenesis, molecular biology and clinical manifestations. An Bras Dermatol. Mar-Apr 2011;86(2):306-17. doi:10.1590/s0365-05962011000200014

3. King CM, Johnston JS, Ofili K, et al. Human papillomavirus types 2, 27, and 57 Identified in plantar verrucae from HIV-positive and HIV-negative individuals. J Am Podiatr Med Assoc. Mar 2014;104(2):141-6. doi:10.7547/0003-0538-104.2.141

4. Whitaker JM, Palefsky JM, Da Costa M, King CM, Johnston JS, Barbosa P. Human papilloma virus type 69 identified in a clinically aggressive plantar verruca from an HIV-positive patient. J Am Podiatr Med Assoc. Jan-Feb 2009;99(1):8-12. doi:10.7547/0980008

5. Ferguson SB, Gallo ES. Nonavalent human papillomavirus vaccination as a treatment for warts in an immunosuppressed adult. JAAD Case Rep. Jul 2017;3(4):367-369. doi:10.1016/j.jdcr.2017.05.007

6. Smith SP, Baxendale HE, Sterling JC. Clearance of recalcitrant warts in a patient with idiopathic immune deficiency following administration of the quadrivalent human papillomavirus vaccine. Clin Exp Dermatol. Apr 2017;42(3):306-308. doi:10.1111/ced.13038

7. Silling S, Wieland U, Werner M, Pfister H, Potthoff A, Kreuter A. Resolution of novel human papillomavirus-induced warts after HPV vaccination. Emerg Infect Dis. Jan 2014;20(1):142-5. doi:10.3201/eid2001.130999

8. Kreuter A, Waterboer T, Wieland U. Regression of cutaneous warts in a patient with WILD syndrome following recombinant quadrivalent human papillomavirus vaccination. Arch Dermatol. Oct 2010;146(10):1196-7. doi:10.1001/archdermatol.2010.290

9. Waldman A, Whiting D, Rani M, Alam M. HPV Vaccine for Treatment of Recalcitrant Cutaneous Warts in Adults: A Retrospective Cohort Study. Dermatol Surg. Dec 2019;45(12):1739-1741. doi:10.1097/dss.0000000000001867

10. Landis MN, Lookingbill DP, Sluzevich JC. Recalcitrant plantar warts treated with recombinant quadrivalent human papillomavirus vaccine. J Am Acad Dermatol. Aug 2012;67(2):e73-4. doi:10.1016/j.jaad.2011.08.022

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