Coincident Detection of Human Papillomavirus (HPV) in the Oral and Genital Regions in a Young Adult Male with Oral Lichen Planus: A Case Report

Oral lichen planus (OLP) is an atypical presentation in young males, and its co-occurrence with human papillomavirus (HPV) raises clinical concerns regarding malignant transformation. This case report describes a 27-year-old sexually active male with OLP and potentially persistent, synchronous oral and multigenotypic genital HPV co-infections. A 27-year-old male presented for follow-up 19 months after surgical excision of an oral papilloma with lichenoid features and histopathologically confirmed OLP. Molecular detection and genotyping were performed using oral and genital swabs via CFX96 real-time PCR. Results revealed potentially persistent oral co-infection with high-risk HPV 31 and low-risk HPV 44. Genital screening detected these same oral genotypes alongside four additional strains, consisting of high-risk HPV 18, 35, and 73 (classified per IARC standards), and low-risk HPV 81, with clinically evident condylomata acuminata. The long-term detection of high-risk HPV 31 in the oral swab in the presence of OLP highlights a hypothetical “dual-hit” oncogenic framework, where inflammation-induced oxidative stress may synergize with viral E6 and E7 oncoproteins to disrupt cell cycle regulation and elevate malignant transformation risks, though this remains entirely speculative in the absence of mechanistic biomarkers. Synchronous oral and anogenital HPV co-infections in young patients with OLP warrant a comprehensive multidisciplinary diagnostic protocol and cautious oncologic surveillance recommendations to prevent malignant progression and further transmission.