Extensive human papillomavirus type 7-associated orofacial warts in an immunocompetent patient

Human papillomavirus (HPV) type 7 is frequently found in butchers' warts and has been demonstrated in oral and facial warts of HIV-infected patients. The reservoirs of HPV7 and the route of transmission are still unclear. Here we describe an HIV-negative, otherwise healthy patient with extensive, recurrent orofacial papillomatosis whose immune status proved to be normal and who had no history of meat handling. HPV7 L1 gene DNA that differed in 3 point mutations from the HPV7 prototype could be detected in 2 morphologically distinct, perioral lesions by different PCR protocols. In situ hybridization confirmed the presence of HPV7 DNA in the nuclei of vacuolated cells of the granular layer. Our data show that HPV7 can lead to perioral, spiky warts and brownish plaques in immunocompetent patients who had never been working as a meat or fish handler.