一名年轻患者的高危型人乳头瘤病毒相关角膜/结膜上皮内瘤变
High-risk human papillomavirus-associated corneal/conjunctival intraepithelial neoplasia in a young patient.
作者信息
Walia Jessica Y, Harocopos George J, Hong Augustine R
机构信息
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA.
Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
出版信息
Am J Ophthalmol Case Rep. 2023 Oct 7;32:101942. doi: 10.1016/j.ajoc.2023.101942. eCollection 2023 Dec.
PURPOSE
To report a case of high-risk human papillomavirus (HPV)-associated corneal/conjunctival intraepithelial neoplasia (CIN) in a 17-year-old fair-skinned male with no other risk factors.
OBSERVATIONS
A 17-year-old Caucasian male presented with an 18-month history of left eye pain, redness, itchiness, and decreased vision. Examination revealed a leukoplakic nasal limbal/peripheral corneal lesion resistant to topical antibiotic and anti-inflammatory treatments. Excisional biopsy confirmed the diagnosis of CIN, and RNA in situ hybridization testing for high-risk HPV types 16/18 was positive. Subsequent testing of the patient for human immunodeficiency virus (HIV) returned negative.
CONCLUSIONS AND IMPORTANCE
The median age of CIN diagnosis in the United States is in the sixth decade of life and is usually associated with a history of ultraviolet (UV) light exposure. There are reports of CIN in young patients with systemic immunodeficiency, immunosuppression, xeroderma pigmentosum, atopic dermatitis, asthma, and vaping. Here we present a case of high-risk HPV-associated CIN in a young, fair-skinned patient with no other identifiable risk factors.
目的
报告一例17岁白皮肤男性高危型人乳头瘤病毒（HPV）相关的角膜/结膜上皮内瘤变（CIN），该患者无其他危险因素。
观察结果
一名17岁的白种男性出现左眼疼痛、发红、瘙痒和视力下降18个月的病史。检查发现鼻侧角膜缘/周边角膜有白斑病变，局部抗生素和抗炎治疗无效。切除活检确诊为CIN，高危型HPV 16/18型的RNA原位杂交检测呈阳性。随后对该患者进行的人类免疫缺陷病毒（HIV）检测结果为阴性。
结论及意义
在美国，CIN诊断的中位年龄为60岁，通常与紫外线（UV）暴露史有关。有报告称，患有系统性免疫缺陷、免疫抑制、着色性干皮病、特应性皮炎、哮喘和电子烟吸食的年轻患者中存在CIN。在此，我们报告一例年轻白皮肤患者的高危型HPV相关CIN，该患者无其他可识别的危险因素。
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