Case of multiple Bowen diseases associated with human papillomavirus type 16 in a patient with atopic dermatitis

Treatment of Pediatric Anogenital Warts in the Era of HPV-Vaccine: A Literature Review

“…Notably, in atopic dermatitis, impaired local immune response and altered skin barrier may favor viral infection and persistence [ 16 , 17 ]. Additionally, viral infection and persistence may be favored by immunosuppression, both iatrogenic and non-iatrogenic, especially in organ transplant recipients, where cell-mediated immunity is reduced, as well as in diabetic patients or after repeated local trauma [ 16 , 17 , 18 , 78 ].…”

“…Of note, a high rate of spontaneous clearing is reported in immunocompetent children, namely, 70% in one year and 90% in two years, prompting the adoption of a wait-and-see approach in asymptomatic AW cases [ 1 , 2 , 15 ]. However, immunosuppression and atopic skin may favor viral persistence and thereby facilitate secondary infections, symptomatic disease, and even thriving HPV infections, including Buschke-Lowenstein tumors, giant tumor masses largely occupying the anogenital area, Bowen disease, and acquired epidermodysplasia verruciformis [ 14 , 15 , 16 , 17 , 18 ]. Accordingly, persistent lesions, lasting over 2 years, or symptomatic lesions, associated with pruritus, burning, bleeding, and secondary infections, are actively treated [ 19 ].…”

Invasive Squamous Cell Carcinoma and Numerous Bowen Disease Lesions of the Hand and Foot With Infection of HPV-18 and HPV-45

“…5 Multiple BD lesions are rare and sometimes associated with immunologic dysfunction, although cases of such numerous lesions of 30 or more, as in our case, have not been reported. [6][7][8] Our patient also had a history of primary macroglobulinemia and Evans syndrome, which may be associated with immunologic dysfunction. 9,10 Therefore, although the precise mechanism remains unclear, the potential immunologic dysfunction associated with these disorders might have been involved in the development of such numerous BD lesions through impaired immune response to the tumors and promotion of the rare types of oncogenic HPV infection.…”