Author(s) : B. Niebrügge, E.-M. De Villiers, K.-L. Gerlach, I. Franke, H. Gollnick, Department of Dermatology and Venerology, Otto-von-Guericke-University, Magdeburg, Germany..
Summary : We report on the rare case of a 64-year-old European woman with a viral acanthoma of the oral mucosa of the clinical Heck type with unprecedented molecular-biological proof of HPV 24 DNA and so far undescribed malignant transformation with a long existence of the vegetation. After surgical therapy a circumscribed relapse of viral acanthoma developed, which responded favourably to a combined antiviral and antiproliferative therapy with acitretin perorally and interferon, first subcutaneously, later intralesionally for 3 months.
Figure 1. Clinical findings: buccal oral mucosa and adjacent corner of
the mouth, right side.
Figure 2. Histology: invasively growing, differentiated squamous-cell
carcinoma in the upper submucosa.
Figure 3. Immunohistochemistry: epithelial cells of the oral mucosa membrane,
infected with virus reaction with PAN-HPV antibody partly intracytoplasmatically,
partly intranuclearly (red reaction product).
Figure 4. Demonstration of HPV DNA in tissue. Amplification by (lanes
1-3) and "nested" (lanes 5-7) polymerase chain reaction. Lane 1: Positive
control with the primers CP 65/70; Lane 2: Negative control with the primers
CP 65/70; Lane 3: Patient sample with the primers CP 65/70; Lane 4: Molecular
weight marker; Lane 5: Positive control with the primers CP 66/69; Lane
6: Negative control with the primers CP 66/69; Lane 7: Patient sample
with the primers CP 66/69; Lane 8: Molecular weight marker.
Figure 5. Findings 8 weeks after the operation with a relapse of the
viral acanthoma in the fringe area of the transplant.
Figure 6. Regression of the viral acanthoma after a 12-week intralesional
INF-alpha-injection.
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