Views 2,032
Citations 0
Case Report/Case Series
December 2015

Effect of Quadrivalent Human Papillomavirus Vaccination on Oral Squamous Cell Papillomas

Author Affiliations
  • 1Department of Dermatology, University of Texas Southwestern Medical Center, Dallas
  • 2Department of Dermatology, University of Virginia Health System, Charlottesville
  • 3Department of Dermatology, University of Pennsylvania Health System, Philadelphia
  • 4Department of Pathology, Pennsylvania Hospital, Philadelphia
  • 5DDL Diagnostic Laboratory BV, Rijswijk, the Netherlands
  • 6Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
  • 7Division of Infectious Diseases, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia

Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Dermatol. 2015;151(12):1359-1363. doi:10.1001/jamadermatol.2015.2805

Importance  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.

Observations  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 and Relevance  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.