Management of cutaneous human papillomavirus infection in immunocompromised patients

Individuals with inherited immunodeficiencies, autoimmune disorders, organ or bone marrow transplantation and with human immunodeficiency virus are particularly susceptible to developing severe, persistent and extensive manifestations of cutaneous human papillomavirus (HPV) disease. These complex cases require a unique and often multimodal approach to management. In this chapter, we discuss several states of immune compromise with increased susceptibility to HPV disease and review the literature on available management strategies including acitretin, cidofovir, Candida antigen, cimetidine, imiquimod, isotretinoin, fluorouracil, selenium, podophyllotoxin, photodynamic therapy, mammalian target of rapamycin inhibitors and the quadrivalent HPV vaccine.