tretinoin and Epidermodysplasia-Verruciformis

Topics: Acitretin; Adjuvants, Immunologic; Drug Therapy, Combination; Epidermodysplasia Verruciformis; Female; Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; Humans; Imiquimod; Immunosuppression Therapy; Keratolytic Agents; Kidney Transplantation; Middle Aged; Tretinoin

Epidermodysplasia verruciformis (EV) is a rare genetic disorder characterized by widespread human papillomavirus (HPV) associated lesions and an increase susceptibility to cutaneous malignancies. A host of medications traditionally used to treat warty lesions have been used with variable results and limited success. To our knowledge, we describe the first reported case of a patient with Imiquimod resistant EV successfully treated with topical ingenol mebutate (Picato).. A patient with a 5 year history of EV failed to respond to a 6 week course of 5% imiquimod on the forehead and was subsequently treated with a 3 day course of 0.015% Picato gel which resulted in significant clinical improvement. A one month follow-up examination showed no reoccurrence of the lesions with the patient reporting continued satisfaction of the outcome.. Our case provides insight into the potential use of ingenol mebutate for EV patients unresponsive to traditional medical treatments.

Topics: Acitretin; Adult; Aminoquinolines; Antineoplastic Agents; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Diterpenes; Drug Resistance; Epidermodysplasia Verruciformis; Female; Gels; Humans; Imiquimod; Keratolytic Agents; Rare Diseases; Skin Neoplasms; Treatment Outcome; Tretinoin

Topics: Aminoquinolines; Antiretroviral Therapy, Highly Active; Biopsy; Cryosurgery; Electrocoagulation; Epidermodysplasia Verruciformis; HIV Infections; Humans; Imiquimod; Keratinocytes; Male; Tretinoin; Young Adult