Circumferential cutaneous papilloma on the external auditory canal presenting as chronic otitis externa
DOI:
https://doi.org/10.34631/sporl.462Keywords:
cutaneous papilloma, external ear canal, external otitis, imiquimodAbstract
Introduction: The authors present a case of a circumferential cutaneous papilloma on the external auditory canal wrongly diagnosed and unsuccessfully treated as chronic otitis externa during fifteen years. This case is interesting for the unusual location and extension of this papilloma, as well as for the treatment used for eradicating the disease with no complication.
Material and methods: The external ear canal and tympanic membrane on both ears showed circumferential lesions suggesting cutaneous papilloma, confirmed by histology of biopsy specimen. Surgical treatment was withheld because of unacceptable morbidity and instead was treated with topical imiquimod.
Results: Complete resolution was obtained after twelve weeks of treatment, and no recurrence was observed after one year.
Conclusions: Imiquimod has been used as a topical agent with an important action over the cutaneous immune system, and is being growingly accepted as an alternative treatment for aggressive or difficult skin problems, such as the one we present.
References
Gale N, Zidar N. Squamous Cell Papilloma, Verruca Vulgaris, Condyloma Acuminatum and Focal Epithelial Hyperplasia. In Cardesa,
Slootweg (Eds.) Pathology of the Head and Neck. (pp2) Springer-Verlag Berlin Heidelberg 2006
Gibbs S, Harvey I.Topical treatments for cutaneous warts. Cochrane Database Syst Rev. 2006 Jul 19;(3)
Wang S, Yee H, Wen HY, Wang BY. Papillomas of the external ear canal: report of ten cases in Chinese patients with HPV in situ hybridization. Head Neck Pathol. 2009 Sep;3(3):207-11.
Yadav SP, Chanda R, Goyal N, Chanda S. Aural papillomatosis in a 3-year-old child. Int J Pediatr Otorhinolaryngol. 2002 Nov 11;66(2):185-7.
Syrjänen S. Human papillomavirus infections and oral tumors. Med Microbiol Immunol. 2003 Aug;192(3):123-8.
Welsh RL, Gluckman JL. Dissemination of squamous papilloma by surgical manipulation: a case report. Laryngoscope. 1984 Dec;94(12
Pt 1):1568-70.
Syrjänen S. Current concepts on human papillomavirus infections in children. APMIS. 2010 Jun;118(6-7):494-509.
Ganjian S, Ourian AJ, Shamtoub G, Wu JJ, Murase JE. Off-label indications for imiquimod. Dermatol Online J. 2009 May 15;15(5):4.
Infarmed - Prontuário Terapêutico Online consultado em 13/03/2012 no endereço: http://www.infarmed.pt/prontuario/frameprimeiracapitulos.html
