ABSTRACT
This chapter presents the case study of a 51-year-old patient. A 51-year-old patient under the care of the haematologists is referred to the dermatology clinic with a 6-year history of multiple papules and nodules on her fingers. She has received several courses of chlorambucil, fludarabine and cyclophosphamide to which she partially responded and is being considered for alemtuzumab biological therapy in the future. She has multiple hyperkeratotic flesh-coloured papules and nodules, mainly over the dorsi of her fingers and hands. The lesions are warty in nature and firm on palpation. This woman has been suffering from multiple viral warts on her hands for many years. The warts result from an infection with human papilloma virus (HPV) in the cutaneous keratinocytes. HPV infections are common in the general population but are more frequently found in patients who are immunosuppressed, when warts are often multiple. Chronic lymphocytic leukaemia causes down-regulation of immune surveillance and an increased susceptibility to all manner of infections.
