Warty Oral Lesions in a Boy

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Authors: 

STAMATIA ALEXIOU, MD, GARY GRIFFIN, MD, BRETT LAGGAN, DDS
JAMES J. BURNS, MD, MPH Florida State University

Dr Alexiou is a third-year pediatric resident, Dr Griffin is clinical assistant professor, Dr Laggan is an oral surgeon, and Dr Burns is clinical professor at Florida State University College of Medicine in Tallahassee and Sacred Heart Children’s Hospital in Pensacola.

Alexander K. C. Leung, MD—Series Editor: Dr Leung is clinical professor of pediatrics at the University of Calgary and pediatric consultant at the Alberta Children’s Hospital in Calgary.

HISTORY

A 10-year-old African American boy with lumps in the mouth for the past 2 years. The lesions had increased in size and number. They were generally asymptomatic but would become painful and bleed when the child accidentally bit them.

The patient was born vaginally to an HIV-negative mother who had no history of genital warts. Family history was negative for condylomas. He denied any sexual abuse; social services investigation was negative. Review of systems was negative for cough, stridor, or hoarse voice.

PHYSICAL EXAMINATION

About 30 to 40 pink, soft papulonodules of 0.2 to 0.5 cm with verrucous surface noted on the tongue, buccal, and labial mucosae. Lesions were nontender except where traumatized by biting. The child had a 2-mm wart on the hand, no other lesions. Physical examination findings otherwise normal.

LABORATORY RESULTS

Complete blood cell count and immunoglobulin levels normal. HIV test results negative.

WHAT’S YOUR DIAGNOSIS?

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