Journal List > J Rheum Dis > v.21(2) > 1064168

J Rheum Dis. 2014 Apr;21(2):87-90. Korean.
Published online April 30, 2014.  https://doi.org/10.4078/jrd.2014.21.2.87
Copyright © 2014 by The Korean College of Rheumatology
A Case of Condyloma Acuminata in a Virgin Systemic Lupus Erythematosus Patient
Yong Jun Kim, Chang Kyoo Byon, Eun Seok Kim, Hyun Jeong Kim, Il Hwan Jeong, Won Suk An, Sang Yeob Lee, Sung Won Lee and Won Tae Chung
Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea.

Corresponding to: Won Tae Chung, Department of Internal Medicine, College of Medicine, Dong-A University, 1, Dongdaesin-dong 3ga, Seo-gu, Busan 602-715, Korea. Email: wtchung@dau.ac.kr
Received February 20, 2013; Revised June 17, 2013; Accepted June 18, 2013.

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Anogenital infection with human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. The majority of HPV infections are transient and subclinical, with subsequent clearance by the immune system. However, in some individuals, especially those with impaired immunity, HPV infection may persist and result in condyloma acuminatum, pre-cancerous cervical abnormalities, as well as cervical cancer. Because of the intrinsic immunological aberrations and immunosuppressive treatment, patients with systemic lupus erythematosus (SLE) have higher prevalence of anogenital HPV infection, and SLE itself appears to be a major risk factor for HPV infection. HPV infection is sexually transmitted via genital contact; autogenesis of condyloma acuminatum without sexual contact is rare. In this case, a 27-year old virgin female with SLE was admitted to our clinic, presenting anogenital condyloma acuminata. It report that SLE patient can have a disease of anogenital HPV infection, despite the lack of sexual contact. Therefore, we recommend that patients with SLE have regular gynecological evaluations, in addition to prophylactic HPV vaccinations.

Keywords: Systemic lupus erythematosus; Condylomata acuminata; Human papillomavirus

Figures


Figure 1
Multiple, variable sized condyloma accuminata on external genitalia and perianal area.
Click for larger image


Figure 2
Removed multiple, large, exophytic cauliflower-like masses on perianal area.
Click for larger image

References
1. Dunne EF, Unger ER, Sternberg M, McQuillan G, Swan DC, Patel SS, et al. Prevalence of HPV infection among females in the United States. JAMA 2007;297:813–819.
2. Lyrio LD, Grassi MF, Santana IU, Olavarria VG, Gomes Ado N, CostaPinto L, et al. Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus. Rheumatol Int 2013;33:335–340.
3. Forcier M, Musacchio N. An overview of human papillomavirus infection for the dermatologist: disease, diagnosis, management, and prevention. Dermatol Ther 2010;23:458–476.
4. Lee YH, Choe JY, Park SH, Park YW, Lee SS, Kang YM, et al. Prevalence of human papilloma virus infections and cervical cytological abnormalities among Korean women with systemic lupus erythematosus. J Korean Med Sci 2010;25:1431–1437.
5. Klumb EM, Pinto AC, Jesus GR, Araujo M Jr, Jascone L, Gayer CR, et al. Are women with lupus at higher risk of HPV infection. Lupus 2010;19:1485–1491.
6. Ornstein A, Hatchette T. Human papillomavirus and anogenital warts in children. CMAJ 2012;184:321.
7. Winer RL, Lee SK, Hughes JP, Adam DE, Kiviat NB, Koutsky LA. Genital human papillomavirus infection: incidence and risk factors in a cohort of female university students. Am J Epidemiol 2003;157:218–226.
8. Nicholls PK, Stanley MA. The immunology of animal papillomaviruses. Vet Immunol Immunopathol 2000;73:101–127.
9. Zandman-Goddard G, Shoenfeld Y. Infections and SLE. Autoimmunity 2005;38:473–485.
10. Garland SM, Hernandez-Avila M, Wheeler CM, Perez G, Harper DM, Leodolter S, et al. Ectocervical Disease (FUTURE) I Investigators. Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. N Engl J Med 2007;356:1928–1943.
11. Harper DM, Franco EL, Wheeler CM, Moscicki AB, Romanowski B, Roteli-Martins CM, et al. Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet 2006;367:1247–1255.
12. Paavonen J, Jenkins D, Bosch FX, Naud P, Salmerón J, Wheeler CM, et al. Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: an interim analysis of a phase III double-blind, randomised controlled trial. Lancet 2007;369:2161–2170.
13. Mok CC, Ho LY, Fong LS, To CH. Immunogenicity and safety of a quadrivalent human papillomavirus vaccine in patients with systemic lupus erythematosus: a case-control study. Ann Rheum Dis 2013;72:659–664.
14. Santana IU, Gomes Ado N, Lyrio LD, Rios Grassi MF, Santiago MB. Systemic lupus erythematosus, human papillomavirus infection, cervical pre-malignant and malignant lesions: a systematic review. Clin Rheumatol 2011;30:665–672.
15. Febronio MV, Pereira RM, Bonfa E, Takiuti AD, Pereyra EA, Silva CA. Inflammatory cervicovaginal cytology is associated with disease activity in juvenile systemic lupus erythematosus. Lupus 2007;16:430–435.