We report on the rare case of a 64-year-old European woman with a viral aca
nthoma of the oral mucosa of the clinical Heck type with unprecedented mole
cular-biological proof of HPV 24 DNA and so far undescribed malignant trans
formation with a long existence of the vegetation. After surgical therapy a
circumscribed relapse of viral acanthoma developed, which responded favour
ably to a combined antiviral and antiproliferative therapy with acitretin p
erorally and interferon, first subcutaneously, later intralesionally for 3
months.