Perianal Bowen’s disease in HIV patient which was refractory to 5% imiquimod treatment = Perianal Bowen’s disease in HIV patient which was refractory to 5% imiquimod treatment

다국어 초록 (Multilingual Abstract)

Perianal bowen’s disease is squamous cell carcinoma(SCC) in situ occurring in the perianal skin. It is not only having the potential to progress SCC, but also difficult to treat. The incidence of perianal bowen’s disease is increasing among the HIV infected man. In previous studies, topical 5% imiquimod cream, a topical immune response modifier that stimulates the production of interferon alfa and other cytokines, is an effective alternative treatment option for patients and body sites that are unsuitable for surgery. A 57-year-old man, who infected with HIV, presented with a 3~4 months history of persistent black pigmented plaques based on background erythema in the perianal region and coccyx area, histologically consistent with bowen’s disease. The lesions treated with 5% imiquimod cream three times a week for 3months, but unresponsive. In recent study, topical imiquimod has been successfully used in the treatment of anogenital neoplasia, but may be less efficacious in HIV positive individuals with low CD4 counts. The patient’s WBC counts 5,910/uL and CD4 counts 790/uL(nl: 410 - 1540/uL) where within normal range. The patient was referred to general surgery department for excision operation. After the wide excision, margin involvement was reported. The patient has followed up closely. This case highlights the difficulties faced in the treatment of perianal bowen’s disease in HIV infected patients.