Condyloma acuminatum by human papilloma virus infection in childhood-systemic lupus erythematosus patients.

INTRODUCTION: Infections are frequent in childhood-systemic lupus erythematosus (C-SLE) patients, including human papillomavirus (HPV). HPV infection may cause genital and anal warts named condyloma acuminatum (CA). To our knowledge, none case was reported and the prevalence of CA in C-SLE population was not performed. CASE REPORTS: From January 1983 to May 2012, 5,682 patients were followed at the Pediatric Rheumatology Unit from of our University Hospital and 289 (5%) of them met the American College of Rheumatology classification criteria for C- SLE. Four (1.4%) of our female patients had CA. The median age at diagnosis was 13 years. Three of them were sexually active and all of them had active disease and had high risk HPV anogenital warts. Pap smears showed low-grade squamous intraepithelial lesion, guided biopsies identified chronic cervicitis, vulvar, vaginal, anal and/or cervix intraepithelial neoplasia. All of them were under corticosteroids and immunosuppressive drugs. The visible genital warts lesions were eradicated. DISCUSSION: Our patients requires rigorous gynecologic follow-up due to the severe anogenital dysplasia. HPV vaccine should be indicated in all C-SLE prior to sexual activity.