At present about 100 types of human papilloma viruses have been identified. Clinical manifestations of infection by human papilloma virus are skin and mucosa papillas within the oral cavity, airways, sex organs and urinary system.

Traumas of the epidermis, facilitating virus penetrating into the generative cells in the basal layer can be a factor initiating the infection. Incubation time varies from 3 to 8 months. An asymptomatic carrier state is also possible.

HPV duplicates its genetic material in the cell nucleus. Infection stimulates the growth of abnormal cellular forms. Changes do not affect the concern no cornifying stratified squamous epithelium of the respiratory and digestive system or skin cornifying stratified squamous epithelium. Human papilloma virus is the aetiological factor in both condylomas and papillomas, but skin lesions have a different morphological structure. Expansive proliferation with slight stromal infiltration of characteristic for papillomas. Conversely, condylomas mainly grow into skin layers and create interpapillary icicles.

All epithelial layers may be found in the histological structure of the papilla, but the majority of cells are abnormal.

In the upper layers there are dyskeratotic cells with a small nucleus and packed chromatin. Simultaneously there are bigger balloon cells i.e. koilocytes containing sometimes bi- or multilobar, hyperchromatin nuclei with packed or granular chromatin. The presence of HPV in koilocytes nuclei can be determined with the electron microscope.

According to Jabłońska and Orthon, susceptibility to HPV infection is connected with disturbances in cellular immunity (3). Significantly more frequent HPV infections in women, with impaired cellular immunity as well as intensification of papilloma lesions in pregnant women, and an induced hormone influence on the immune system, has been observed. The percentage of positive results showing HPV presence increases with the development of pregnancy, and decreases during the 6 months after labour (2). Condylomas situated in the genital canal can be a source of infection for the neonate. In the aftermath of infection, laryngeal papillomatosis may develop even after a few years of virus latency.

We can refer to congenital or intrauterine infection when the virus was transmitted from mother to foetus, and about newborn infection when the neonate is infected during labour. Intrauterine infection takes place when the virus goes through the placenta with the blood flow (2). HPV is not considered as an especially vital virus in foetus and neonate pathology because it does not reveal a direct teratogenic effect.

With reference to papilloma virus infections, evaluation of the virus type, and patient qualification as high, moderate or low risk group of neoplastic disease development is very important. Types 31,33, 35, 51, 52 are numbered among those at moderate risk; types 16, 18, 45, 56 are the high risk group (2, 3).

Types 6 and 11 are the most common papillomas observed in the respiratory system and pointed condylomas of genitourinary system. Among genital and antal papillomas the presence of potentially oncogenic types 16 and 18.

The period between primary infection and invasive cancer diagnosis can be delayed by from 5 to 40 years.

Human papilloma viruses, despite differences in DNA sequence, have in common at least one antigen that can be determined from destroyed virus molecules. Virus presence in tissues can be confirmed by means of immunohistochemic tests, DNA hybridization methods or the PCR method (polymerase chain reaction) with the use of adequate polymers (1, 2, 5)

A old seven month old infant from a second pregnancy (history number 16945/97) was admitted to the Otolaryngology Department in Bydgoszcz because of congenital lesions taking the form of flat papillomatous hypertrophy localized on the right auricle and the skin of right retroauricular area. In the third month of pregnancy mother underwent appendectomy. Later the course of gravidity was normal. The parent´s anamnesis towards HPV infection as well as respiratory system and digestive system papillomas as pointed condylomas of genitourinary system was negative. The labour was normal, through the natural passage. After 2 months of life the infant underwent surgical excision of skin lesions in the form of extensive papillomatous hypertrophic lesions localized in the occipitoparietal area. Histopathologic examination revealed planoepithelial papilloma.

On the day of admission a normal right mastoid process was found. The upper pole of auricle - edge, anthelix and the skin in the retroauricular area to half of its height were covered with lesions looking like planoepithelial papilloma. The auricle was slack and leaning forward, weighed down by proliferating papillomatous hypertrophic growths. A normal external auditory meatus with smooth, unchanged skin and a normal tympanic membrane with reflex was found. The left auricle was normal. Otoscopy did not reveal any lesions. In the occipitoparietal region a scar resulting from the operation to removal changed skin was found. Further examination did not show any more anomalies. The infant was qualified for surgical treatment. A skin incision was made edge of the right auricle, surrounding the papillomatous hypertrophic area. The skin was prepared and removed with the papillomatous lesions situated on the posterior surface of the auricle. The papillomatous changes on the planum mastoideum were also removed. The skin was mobilized and plastic sutures inserted. The auricle because of a lack of on the posterior surface, was sewn into the skin of the retroauricular area, and left for a second stage operation after 6 years. Histopathological examination revealed planoepithelial papilloma for the second time.

Intrauterine HPV infections with full clinical presentation are very rare in neonates. Only a few authors have reported cases where symptoms occurred before the thirdy ear of life. Papillomas have been more often described within the respiratory or genitourinary system in older children before puberty (4).