Received May 21, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HPV9 | HPV (GARDASIL 9) | MERCK & CO. INC. | 1 | — | — |
Gardasil 9 used as treatment for eyelid and facial cutaneous warts; This literature marketed report was received from the authors as stated above and refers to A 9-year-old immunocompetent boy with history of asthma, obesity, nonalcoholic fatty liver disease, and sleep apnea, on daily albuterol, cetirizine, and fluticasone. On an unknown date, reported as "for the previous year", the family had noted growths in the skin of the patient's face, including both eyelids. The family reported that the lesions were getting progressively larger, leading to significant discomfort and disfigurement for the patient, resulting in social withdrawal and low self-esteem. The family also stated they tried treating the lesions with over-the-counter topical ointments (moisturizers and steroids), which had been unsuccessful. On an unspecified date, the patient presented at the medical institution with eyelid lesions. On examination, the patient's visual acuity was 20/25 In the right eye and 20/30 in the left eye. There were multiple flesh-colored, hyperkeratotic papules with irregular, "cauliflower-like" surface of various sizes on the upper and lower eyelids of both eyes, forehead, and nasal bridge as well as on the index finger of the right hand. All lesions were clinically suggestive of cutaneous viral warts. The patient's conjunctiva was not involved, and the remainder of the ocular examination was unremarkable. Given the location and multiplicity of lesions, HPV vaccination was recommended. Therefore, on an unknown date, 5 days after visit, the patient received the first and single dose of with Human Papillomavirus 9-valent Vaccine, Recombinant (GARDASIL®9) (route, anatomical location lot # and expiration date were not reported) for cutaneous viral warts (Off label use). All lesions completely resolved 2 weeks after this single dose of vaccine. On the 2-month follow-up visit, the patient did not have any new complaints. Visual acuity was stable at 20/25 in both eyes, and no recurrence was observed. Although spontaneous resolution of cutaneous warts may occur, the temporal association between the vaccination and the resolution of the lesions was striking, suggesting a possible causal relationship. It has been demonstrated that younger individuals generate higher titers of HPV-specific B and T cells following vaccination, which likely results in a stronger immune response capable of clearing HPV-related cutaneous lesions.
Asthma; Nonalcoholic fatty liver disease; Obesity; Sleep apnea
albuterol; cetirizine; fluticasone