The management of numerous carcinomatous sequelae of human papilloma virus in an allogeneic stem cell transplant patient with chronic graft versus host disease

The clinical manifestations of human papilloma virus (HPV) infection are vast, ranging from common warts to squamous cell carcinomas (SCCs). Immunodeficient populations are particularly susceptible to HPV infection in part because of deficiencies of cell-mediated immunity and diminished production of neutralizing antibodies.1 In particular, recipients of allogenic stem cell transplantation (allo-SCT) exhibit an increased risk for cutaneous SCC (cSCC) development, with a 20-year posttransplant incidence of 3.4%.2 Patients that have chronic graft versus host disease (cGVHD) are even more dramatically affected, with a risk of cSCC 5 times higher than that of the general population.3