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Bowenoid papulosis is a highly characteristic condition of the anogenital region which is histologically similar to bowenoid carcinoma in situ. Some evidence suggests a viral origin on the basis of infection with high-risk oncogenic genotypes of human papilloma viruses (HPV 16/18 and others) and an association with cervical carcinoma. Malignant transformation is rare in bowenoid papulosis. The condition usually shows a good response to immuno-modulatory treatment. In the following we present our first case of successful treatment with imiquimod, a topical immune response modifier which is successfully used in the USA for local treatment of condylomata acuminata. Imiquimod creme (Aldara) proved to be a safe, efficious and practical patient-applied therapeutic option for the treatment of bowenoid papulosis. In view of the oncogenic potential of high-risk HPV infections, irrespective of the treatment used, all patients with bowenoid papulosis and their sexual partners must be included in long-term follow-up and regularly examined for malignant transformation.

The monomorphic clinical aspect of destructive mid-face lesions is characterised by inflammation, induration and granulomatous transformation. This feature can be caused by various infections, toxical noxa, Wegener's Granulomatosis and different neoplasms. The case of a 19 year old patient with EBV associated nasal type T-cell lymphoma located at the hard palate is presented. The diagnostic approach and difficulties in diagnosing this entity assessing by using multiple biopsies, serological and molecularbiological detection of EBV association and immunohistochemistry for atypic T-cells are elucidated. In the presented case the treatment with chemotherapy and irradiation following a well-defined therapy concept leaded to a three year recurrence-free survival so far. The comparison of the key-histological findings and the major differential diagnoses is mandatory to establish the final diagnosis of lymphoma. This is the basement for treating this disease with combined chemotherapy and irradiation for optimizing survival.

We report on the case of a 51-year-old female patient who had been suffering from multiple itching nodules for 3 years. Some of these lesions were classified clinically and histologically as keratoacanthomas (KA), whereas the multiple smaller nodules were found on histological examination to be either early stage KA or lesions of prurigo simplex subacuta. In two KA, HPV subtype 2 was identified by in situ hybridization. Treatment with etretinate resulted in remission of the fully developed KA and reduced the occurrence of new ones. The outbreak of multiple KA in our patient resembled a rare subtype described by Witten and Zak. Postclinical follow-up for 28 months to date has revealed that the KA arise from the subacute prurigo lesions. This mode of prurigo-dependent KA development has not previously been reported.

We present an HIV-infected patient with lymphadenopathy syndrome in whom an unusually aggressive case of Hodgkin's disease developed. Examination of tissue excised from the lymphoma and of epithelial cells scraped from the tongue of the patient revealed Epstein-Barr virus (EBV). The relationship between an enhanced replication of EBV in the epithelium of the tongue and the elevated frequency of Hodgkin's lymphomas containing EBV-DNA among HIV-infected patients is discussed.

46 patients suffering from various malignancies (17 non Hodgkin lymphomas, 12 Hodgkin's diseases, 11 acute leukaemias, 4 myelomas, 2 carcinomas), 6 patients with haematological disorders such as ITP, SAA, myeloproliferative disease, LAS and 3 patients without preexisting disease were treated with acyclovir for herpes virus infection diagnosed by clinical means. All but 7 patients had been given intensive treatment with various cytostatic agents and/or irradiation. Most patients were treated with 1500 mg acyclovir daily for 5 to 13 days. Dosage was adjusted according to renal function and clinical response in the remaining 10 cases. 11 patients received intravenous immunoglobulins in addition. Side effects were negligible (local irritation, minimal rise in serum creatinine levels in 5 patients). All patients responded to treatment; 6 patients complained of severe neuralgia lasting for more than one month; 5 patients relapsed.