Letters to the Editor

We saw a 73-year-old man in September 2020, who was referred by his GP for multiple lumps on his tongue and lower lip of unknown duration. His past medical history was significant for ischaemic heart disease, COPD, asthma, osteopenia and chronic kidney disease. He smoked 20 cigarettes a day (50 pack-years) and did not drink alcohol regularly.

On examination there was no obvious cervical lymphadenopathy. Multiple painless pedunculated papillomatous lumps of the lower lip, anterior mandibular ridge and ventral/dorsum of the tongue were noted (Figure 1).

Excisional biopsies of these lesions and subsequent histopathological evaluation revealed multiple papillomatous lesions suggestive of a viral aetiology. Genotype testing confirmed human papilloma virus (HPV), X09/11 presence (low risk). Unfortunately, this patient attended again in October 2021 with recurrence of lesions and further excision of these lumps was undertaken. The results confirmed the earlier diagnosis with no sinister changes. He was seen again in November 2022 with further recurrence of lesions in the same sites noted earlier. The patient was referred to the infectious diseases team for further assessment and management of these morbid recurrent lesions.