# Long‐Term Control of Human Papillomavirus‐Related Focal Epithelial Hyperplasia in an Human Immunodeficiency Virus‐Positive Patient Using Methylene Blue‐Mediated Photodynamic Therapy. A Case Report

## TL;DR

A HIV-positive patient with HPV-related oral lesions was successfully treated with methylene blue-based photodynamic therapy, with no recurrence after two years.

## Contribution

Demonstrates the long-term effectiveness of methylene blue-mediated photodynamic therapy for HPV-related focal epithelial hyperplasia in an HIV-positive patient.

## Key findings

- Methylene blue-mediated photodynamic therapy successfully cleared focal epithelial hyperplasia lesions in an HIV-positive patient.
- No recurrence of lesions was observed over a 24-month follow-up period.
- The treatment improved the patient's quality of life and offered a safe alternative to conventional therapies.

## Abstract

Human papillomavirus (HPV) infections are a major cause of oral lesions, and in individuals living with HIV, lesions such as focal epithelial hyperplasia (FEH) may persist or exhibit atypical features, potentially progressing to more severe conditions if untreated. Managing oral HPV lesions in immunocompromised patients is challenging, as conventional therapies may carry higher risks or show limited efficacy.

This study reports the case of a 49‐year‐old HIV‐positive male with valve disease and arthritis, requiring crutches for mobility. He presented with multiple painless oral lesions, diagnosed as FEH associated with oral HPV, and had previously undergone unsuccessful treatments. Photodynamic therapy (PDT) using methylene blue (MB) and a red laser was proposed as a treatment.

Topical MB‐mediated PDT successfully cleared the FEH lesions, with no recurrence observed over 24 months.

PDT mediated by MB is an effective and affordable approach for treating FEH associated with HPV in immunosuppressed patients, offering favorable outcomes and improved quality of life.