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Abstract
Warts are common lesions. The prevalence and incidence of squamous papilloma of the nasal vestibulum are not known, and it is not certain how often human papilloma viruses are involved. Numerous medical or surgical treatment modalities have been reported in the literature with variable, sometimes unsatisfactory results. Imiquimod cream is a topically applied immunomodulator. It is used for warts and other skin tumours on different locations of the body. We report results of six patients treated with imiquimod five per cent cream for nasal squamous papilloma.
Key words: Papilloma, Squamous Cell; Nose; Disease Management
Introduction
The prevalence and incidence of squamous papilloma of the nasal vestibulum is unknown, and it is not clear how often human papilloma viruses (HPV) are involved. HPV infection is common among all races and socioeconomic groups worldwide. HPV infect active proliferating epithelia of skin and mucous membranes and produce epithelial tumours. At least 70 different types of HPV have been identified.1
Three histological types of papilloma of the nose and paranasal sinuses were defined by the WHO in 1991:2,3 (1) Everted squamous papilloma is similar to papillomas in other parts of the upper respiratory tract. This condition is also known as exophytic squamous or fungiform papilloma. (2) Inverted papilloma (TP) is characterized by epithelial cell groups within the substance of polyps. This condition is also known as Schneiderian, transitional cell or Ringertz papilloma. (3) Cylindrical cell papilloma is composed of papillae lined by columnar epithelium. This condition is also known as microcystic papillary adenoma and oncocytic Schneiderian papilloma. Papillomas have a tendency to recur after surgery, with a reported recurrence rate of 20-47 per cent.4 Cell atypia or malignancy in inverted papilloma occurs in eight to 15 per cent of cases. True malignant transformation is a rare entity if the initial lesion is benign and there is no atypia.
Recent studies suggest that HPV might be involved in the development of sinonasal squamous papillomas (HPV 6 and 11).5 Although one of the aetiological agents for squamous nasal papillomas has been established, treatment selection often...