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Clinical Observation
October 22, 2001

Treatment of a Bowenoid Papulosis of the Penis With Local Applications of Cidofovir in a Patient With Acquired Immunodeficiency Syndrome

Author Affiliations

From the Rega Institute for Medical Research, Katholieke Universiteit Leuven, Leuven, Belgium (Drs Snoeck and De Clercq); and the Departments of Internal Medicine (Drs Van Laethem and Clumeck) and Dermatology (Dr De Maubeuge), Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium.

Arch Intern Med. 2001;161(19):2382-2384. doi:10.1001/archinte.161.19.2382

We report a case of bowenoid papulosis in a patient with acquired immunodeficiency syndrome that was successfully treated with local applications of cidofovir in Beeler base. This treatment should be confirmed as a valuable nonagressive therapy for such potentially invasive viral-induced cell proliferation.

A 38-year-old homosexual man with a 10-year history of human immunodeficiency virus and an 8-month history of acquired immunodeficiency syndrome presented with a fibrotic lesion of the penis in June 1996. His medical history revealed that he had been diagnosed as having herpes zoster in 1992. He was also known to be positive for hepatitis B antigen. In 1995, he was treated for clinical Pneumocystis carinii pneumonia. In October 1995, treatment with zidovudine and zalcitabine was initiated (CD4 cell count, 22/µL), followed by zidovudine and lamivudine (CD4 cell count, 49/µL) in April 1996 and by zidovudine, lamivudine, and stavudine (CD4 cell count, 17/µL) in June 1996 (Figure 1). At that time, he presented with a fibrotic lesion of the penis and was treated with acyclovir (800 mg 5 times per day) for possible herpes simplex and with ceftriaxone sodium (4 g/d) for possible syphilis. Serologic tests for Treponema pallidum hemagglutination, the results of which were previously negative, revealed a titer of 1:80.