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Oral warts in an African female child; a rare pathology, diagnostic and therapeutic challenges in a resource limited setting: A case report

Background: Warts are benign lesions that are dermatological manifestation of Human Papilloma viruses. They are unusual in infancy and early childhood with the lowest prevalence among children less than 6 years old, nevertheless the incidence increases as they approach school-age. The appearance of warts is determined by the type of virus and the location of the infection; ranging from common warts, palmer and planter warts to flat, filiform and genital warts. Oral warts however, are rare findings in adults and even more so in children and the diagnosis as well as management in resource poor settings is often challenging. Case presentation: We report the case of an 8 year old black African girl with no relevant past history, who presented with a 6 month history on multiple painless oral lesions. She had no soreness, no fever nor any other relevant symptom. Oral examination revealed multiple hyperkeratotic, sharply marginated, flat-topped papules covered by normal mucosa with no specific pattern of organization, lining the oral cavity excluding the soft palate. There were no signs of excoriations, swellings or other suspicious lesions on the face, hands, knees, genitalia and perianal areas. The rest of the examination was unremarkable. A diagnosis of oral warts was made and was managed by electrocauterization and subsequent mouth washing with salt and warm water. Conclusion: Oral warts are a rare pathology especially in children. HPV infection is the most like aetiology. Investigating the origin is often a daunting task as well as method of management. Spoon sharing is a possible risk factor for oral warts especially in children and electrocauterization is an effective and less costly method of management in pediatric cases. We therefore recommend thorough oral exam for all individuals at risk and electro cautery for identified cases of oral warts especially in limited resource settings.

Author(s): Roland Cheofor Ngu, John Fonyuy Tengen, Laura Tchouamou, Elvis Tajoache Amin, Alexis Awung Tazinya