Toxic Epidermal Necrolysis

ESCMID - Transplant virology – Lausanne - 15

HPV in transplant Titrerecipients © by author ESCMID Online Lecture Library Olivier Gaide, MA, MD-PhD Dermatologie et Vénéréologie Human Papilloma VirusIntroduction

• Group 1: ds DNA virus • Papillomaviridae • Non-envelloped • Circular DNA of 8kb • 8 proteins © by author • 6 early = viral replication ESCMID• 2 late = structural prot. Online Lecture Library 8kb of malevolence

Disease HPV type Common warts 2, 7, 22 Plantar warts 1, 2, 4, 63 Flat warts 3, 10, 8 Anogenital warts 6, 11, 42, 44 and others Anal dysplasia (lesions) 6, 16, 18, 31, 53, 58 Highest risk: 16, 18, 31, 45 Genital cancers Other high-risk: 33, 35, 39, 51, 52, 56, 58, 59 Probably high-risk: 26, 53, 66, 68, 73, 82 Epidermodysplasia verruciformis© bymore authorthan 15 types

Focal epithelial hyperplasia (oral) 13, 32 OralESCMID papillomas Online6, 7, Lecture 11, 16, 32 Library Oropharyngeal cancer 16 Laryngeal papillomatosis 6, 11 How to prevent it

Focal epithelial hyperplasia (oral) 13, 32 OralESCMID papillomas Online6, 7, Lecture 11, 16, 32 Library Oropharyngeal cancer 16 Laryngeal papillomatosis 6, 11 Prevention, larger than it may seem

• ---- Immuno-therapy Variable

• Cryo-therapy Destruction 30%

• Laser Destruction 50%

• Condylin Immuno-therapy 70% © by author • Imiquimod Immuno-therapy 70%

•ESCMIDBleomycine OnlineChemo-therapy Lecture Library 80% When to fear it !

• Nail warts

• Old warts

• Nail warts

• Old warts

• Mismatches

• Nail warts

• Old warts

• Mismatches

• Immune suppr. • Transplant R. © by author • HIV ESCMID• LLC Online Lecture Library

Is it safe to use Imiquimod in OTR patients ?

Harder Not harder

Eminence based… Eminence based Makes sense --- Stockfleth, pc

Evidence based© by authorEvidence based HPV in HIVp studies AK co Renal Tr. ESCMID Online Lecture Library When to fear it !

• Hidden lesions

• Wrong diagnosis

• Hidden lesions

• Wrong diagnosis

• Ignorance

• Hidden lesions

• Wrong diagnosis

• Ignorance

• Hidden lesions

• Wrong diagnosis

• Ignorance

Vaccinate your kids

Vaccinate your transplant-reciptient patients

Challenge each and every wart diagnosis

Treat HPV-induced© carcinomaby author very aggressively ESCMIDConsider Online mTORi switch Lecture early (SCC Library pat.)

Thank you !