Nailbed HPV-related Bowen’s disease in a man living with HIV

TL;DR

A man with HIV developed HPV-related skin cancer on his finger nailbed, highlighting the risk of non-genital HPV disease in HIV patients.

Contribution

This case report adds evidence of extra-genital HPV disease in HIV patients, despite immune reconstitution.

Findings

HPV-16 was detected in a nailbed Bowen’s disease lesion in an HIV-positive man.

The patient had good virologic control and immune reconstitution.

Surgical removal and post-exposure HPV vaccination were used for treatment.

Abstract

Human papillomavirus (HPV) is a common sexually transmitted infection with wide-ranging clinical manifestations. High-risk anogenital HPV genotypes have also been reported to cause extragenital disease. We describe the case of a 69-year-old male patient living with HIV who was diagnosed with HPV-16 associated Bowen’s Disease (BD) of the right middle finger nailbed, despite good virologic control and immune reconstitution. The lesion was managed surgically with adjunctive post-exposure HPV vaccination. This case adds to the growing body of evidence of extra-genital HPV disease attributable to anogenital genotypes in people living with HIV.

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