[CIS PIDD] [cis-pidd] recalcitrant warts in PLE s/p Fontan

[Richard Wasserman]

If he has not been vaccinated with HPV vaccine, I would administer it. I
don't fully understand it but I have heard that it can be helpful and I
have had a positive personal experience (N=1).
Richard Wasserman
Dallas

On Wed, Mar 25, 2015 at 9:17 PM, Perez, Elena Elizabeth <
e.perez13 at med.miami.edu> wrote:

>
>
> Dear colleagues,
>
> I met a 16yo male patient last week with PLE s/p Fontan (followed at
> CHOP), who does not really get sick with recurrent infections but has had a
> chronic problem with recalcitrant warts all over his hands and fingers
> (very impressive physical exam).
>
> Traditional therapies have not worked per dermatology. Local
> dermatologists are looking into using intralesional bleomycin and laser
> therapy or imiquimod. From what I read the bleomycin treatment can be
> pretty effective but painful and not without side effects (Dobson 2014 and
> Pollack 2002).
>
> I'm sure this topic has been covered before, so I apologize if too much
> "repeat"...
>
> In any case, wondering what the collective experience is in our
> immunodeficiency patients with intralesional bleomycin and laser vs.
> imiquimod, how effective, and whether any worrisome side effects have been
> noted in our populations...? or other alternatives?
>
> [He has a h/o entocort use for PLE during a clinical study and then again
> later. He has adrenal issues followed by endocrine. Latest WBC, and ALC a 2
> years ago was around 420. I don't yet have T cell function or antibody
> results].
>
> (he is due for follow up at CHOP this summer but if I can help in the
> meantime, willing to do so)...
>
> Thanks,
> Elena Perez
> Univ of Miami
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-- 
Richard L. Wasserman, MD, PhD
DallasAllergyImmunology
7777 Forest Lane, Suite B-332
Dallas, Texas 75230
Office (972) 566-7788
Fax (972) 566-8837
Cell (214) 697-7211

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