Buschke-Lowenstein Tumor Resection and Topical Care

Introduction: Buschke Lowenstein tumor (BLT) is a rare variant of anogenital condylomata acuminata, related to HPV^{1, 2}. Lesion is large, vegetating, warty, exophilic^{2, 3}. Best therapeutic strategy: not established². Incidence: 0.1%^1,2. Tumor rapid growth is associated with imunity deficiencies¹.

Case Description: NGS, black, 55 years old, single, Nurse. Patient diagnosis HIV and TBL, topical treatment failled. 1^st PO tumor resection, Skin Group assessment and management. Extensive raw area, involving penis body, extending to sacral region with points of necrosis. Topical care plan: PHMB solution, EFA, hydrofiber with silver, transparent film. Exchange daily to prevent secondary infection. 3^rd PO: foul smell, necrosis, slough across lesion. Secretion culture positive for Morganella morganii. Replaced secondary coverage by hydropolymer with ibuprofen foam in scrotum due to pain and hydropolymer with silver foam accross lesion for infection control. After 5 days observed important score reduction for pain, adopting hydropolymer with silver across the lesion. 41^st PO: pain resolution, no odor, granulation in whole extent of injury, edges contraction, no secondary infection. Programmed skin graft. Respected bioethical principles postulated by Resolution 196/96, National Research Council (CC No. 96/2012).

Discussion:  Despite the possible confusion bias, can be inferred that use of PHMB solution, EFA and coverage with hydropolymer in this case, controlled secondary infection, pain, removed unviable tissue, promoted the granulation tissue increase, contraction of edges and ideal conditions for wound bed to receive skin graft.