{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T19:37:25Z","timestamp":1787341045465,"version":"build-2736575974"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head and Neck Pathol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Fingolimod, an immunomodulatory agent used in the treatment of multiple sclerosis, has been associated with an increased risk of human papillomavirus (HPV)-related mucocutaneous lesions due to its immunosuppressive effects. We report the first documented case of oral mucosal HPV-related epithelial proliferation in a patient undergoing long-term fingolimod therapy. A 36-year-old male presented with multiple mildly papillomatous gingival lesions, during ongoing fingolimod (Gilenya\n                    <jats:sup>\u00ae<\/jats:sup>\n                    ) therapy for eight years. Histopathologic examination revealed parakeratinized stratified squamous epithelium with acanthosis, papillary projections supported by fibrovascular cores, and koilocytosis. HPV DNA testing demonstrated the presence of low-risk HPV types 6\/11. The clinical presentation, histopathologic features, and supporting laboratory findings, in the context of long-term immunomodulatory therapy, were consistent with an HPV-related epithelial proliferation potentially associated with fingolimod use. This case expands the anatomic spectrum of HPV-associated epithelial proliferations as a potential adverse effect of fingolimod therapy in patients with multiple sclerosis, broadening clinical awareness beyond the reported cutaneous and anogenital presentations.\n                  <\/jats:p>","DOI":"10.1007\/s12105-025-01881-0","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:38:13Z","timestamp":1767875893000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Oral HPV-Related Epithelial Proliferation during Fingolimod Therapy: First Case Report and Review of the Literature"],"prefix":"10.1007","volume":"20","author":[{"given":"Kittiphoj","family":"Tikkhanarak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Saepoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Handoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Lanzel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherry","family":"Timmons","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Frost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hellstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"1881_CR1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.26858","author":"MP McGinley","year":"2021","unstructured":"McGinley MP, Goldschmidt CH, Rae-Grant AD (2021) Diagnosis and treatment of multiple sclerosis: a review. JAMA. https:\/\/doi.org\/10.1001\/jama.2020.26858. 325:765\u2009\u2013\u200979","journal-title":"JAMA"},{"key":"1881_CR2","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1007\/s11910-017-0800-8","volume":"17","author":"E Grebenciucova","year":"2017","unstructured":"Grebenciucova E, Pruitt A (2017) Infections in patients receiving multiple sclerosis disease-modifying therapies. Curr Neurol Neurosci Rep 17:88. https:\/\/doi.org\/10.1007\/s11910-017-0800-8","journal-title":"Curr Neurol Neurosci Rep"},{"key":"1881_CR3","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.msard.2018.04.018","volume":"23","author":"MD Benedetti","year":"2018","unstructured":"Benedetti MD, Marangi A, Bozzetti S, Gobbin F, Turatti M, Pea M, Gajofatto A, Mocella S (2018) HPV-related papillary squamous cell carcinoma of the tonsil during treatment with Fingolimod. 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Mult Scler Relat Disord 36:101437. https:\/\/doi.org\/10.1016\/j.msard.2019.101437","journal-title":"Mult Scler Relat Disord"},{"key":"1881_CR6","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1177\/1352458518807088","volume":"25","author":"J Triplett","year":"2019","unstructured":"Triplett J, Kermode AG, Corbett A, Reddel SW (2019) Warts and all: Fingolimod and unusual HPV-associated lesions. Mult Scler 25:1547\u20131550. https:\/\/doi.org\/10.1177\/1352458518807088","journal-title":"Mult Scler"},{"key":"1881_CR7","doi-asserted-by":"publisher","first-page":"e83652","DOI":"10.7759\/cureus.83652","volume":"17","author":"G Mamardashvili","year":"2025","unstructured":"Mamardashvili G, Botchorishvili N, Kobaidze G, Janelidze M (2025) Development of seborrheic keratosis and human papillomavirus (HPV) infection following four months of Fingolimod treatment in a patient with multiple sclerosis: a report of a rare case. 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J.H. serves as a paid consultant for RiboX Therapeutics, Princeton, NJ (circular RNA research firm).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Consent for publication was obtained for every individual person\u2019s data included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"For this type of study informed consent is not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"8"}}