Warty Oral Lesions in a Boy
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.
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.
Complete blood cell count and immunoglobulin levels normal. HIV test results negative.
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