Human Papillomavirus-Associated Apoptotic Oral Epithelial Dysplasia: A Case Report

Herein, we report a case of human papillomavirus-associated apoptotic oral epithelial dysplasia (HPV-AOED) in a 40-year-old HIV+ man. In an intraoral examination, we observed a white papillary nodule in the posterior mandibular ridge with 1 year of evolution. The patient had been HIV+ for about 20 years and underwent highly active antiretroviral therapy (HAART), relation CD4/CD8 = 0.7. An incisional biopsy was performed and the histological analysis showed papillary epithelial proliferation supported by fibrovascular cores. The epithelium exhibited full-thickness involvement by cells in various stages of apoptosis (from mitosoid bodies to degenerated cells with pyknotic nuclei), discohesive cells, keratinocytes with dysplasia and koilocytes. Continuous immunostaining for p16 was observed, and the final diagnosis was severe HPV-AOED. In conclusion, HIV+ patients have increased susceptibility to developing malignancies, and the presence of high-risk HPV in oral lesions is another risk factor that must be known and investigated in this group of patients.