Successful treatment of intranasal papillomata with imiquimod cream in a human immunodeficiency virus positive patient

Abstract

To report a new, alternative treatment for nasal papillomata in human immunodeficiency virus positive patients with multiple recurrences after surgical removal. A human immunodeficiency virus positive patient presented with multiple, recurrent nasal papillomata which developed after repeated surgical removal procedures. In this patient, complete and persistent resolution of the lesions was achieved after topical treatment with imiquimod cream. Imiquimod is a class of non-nucleoside imidazoquinolinamines which promotes local cytokine release from antigen-presenting cells inducing a T-h1 dominant cell-mediated response against virus-infected cells. Topical imiquimod 5 per cent cream, applied for four to 16 weeks, may offer some benefit in the management of recurrent nasal papillomata in human immunodeficiency virus positive patients. Such treatment may be preferable to surgery or destructive therapeutic options when patients are unwilling or are poor surgical candidates, and also avoids potential surgical sequelae such as scar formation and stenosis.