Letter to the Editor
Regression of giant condilloma after removal of immunosuppressive treatment
Regresión de condiloma gigante tras retirada de tratamiento inmunodepresor
Juan Vicente Hernandis Villalba
, Ana Fabregues Olea, María José Gil Torregrosa
Corresponding author
Servicio de Cirugía General y del Aparato Digestivo, Hospital General Universitario de Elda, Alicante, Spain
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Serology for HBV, HCV, HIV, and syphilis was negative.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Given the failure of medical treatment and given the extent of the disease, surgical treatment was decided in several sessions, with an anatomical pathology diagnosis of genital wart positive for HPV type 6. During follow-up, graft rejection occurred, and immunosuppressive treatment was discontinued, with the remaining lesions disappearing. Subsequent HPV determination was negative.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Human papillomavirus infection can behave clinically, subclinically or latently, with the first being evident on physical examination. The latent form is proven by evidence of virus DNA on skin and mucous membranes.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Approximately 70% of infections resolve spontaneously within the first year and 90% within two years. Its elimination depends on a cellular immune response.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Factors involved in viral clearance failure include HIV immunosuppression and immunosuppressive treatments due to organ transplantation or chronic diseases.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Life-long immunosuppressive treatment in kidney transplant recipients has been described as an etiopathogenic factor in several dermatological conditions, including skin infections and skin cancer. Oh et al. reported 88 cases of skin infection of various aetiology in 178 patients undergoing renal transplantation, with viral warts being the most common (15%, n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>29).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">HPV vaccine is proving effective in preventing human papillomavirus infection.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The US <span class="elsevierStyleItalic">Advisory Committee on Immunization Practices</span> recommends the HPV vaccination at around 26 years of age in immunocompromised individuals who have not been previously vaccinated or in whom the recommended doses have not been completed.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Recently, Nailescu et al. examined the immunological response and tolerability of the HPV vaccine in 29 paediatric patients undergoing vaccination after kidney transplantation, comparing it with 36 future transplant candidates for advanced kidney disease or on dialysis, finding good tolerance to the vaccine in all three groups, but with lower seroconversion in the transplant group, recommending immunisation preferably prior to transplantation and subsequent immunosuppression, although it is also safe afterwards.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Given the course observed in our patient, with the onset of the disease under immunosuppression and its subsequent disappearance once the immunosuppression was discontinued, with a strong cause-effect relationship, we believe it is necessary to propose new and extensive studies on the need for its administration, as well as the efficacy and appropriate time to administer the vaccine to this group of patients.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hernandis Villalba JV, Fabregues Olea A, Gil Torregrosa MJ. Regresión de condiloma gigante tras retirada de tratamiento inmunodepresor. Med Clin (Barc). 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.medcli.2020.05.051">https://doi.org/10.1016/j.medcli.2020.05.051</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diseases associated with human papillomavirus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.A. Cubie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.virol.2013.06.007" "Revista" => array:7 [ "tituloSerie" => "Virology." 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