Anogenital Condyloma Research Articles

Uncommon Presentation of Perianal Condyloma Acuminata in a Young Male: A Case Report

<div class="WordSection1"><p><strong>Background:</strong> Perianal warts, also known as anogenital warts or condyloma acuminata, represent a significant health concern in the young male population. Here, we present a unique case of a large perianal wart in a 26-year-old male patient.</p><p><strong>Case Description:</strong> The patient came to the surgical clinic with complaints of an anal lump for 7 months ago. The lump first appeared in February 2019 as big as a green bean, it increased in size, bled easily and painful to be touched. The patient had a history of anal intercourse 1 month before the lump appeared. The lump size was about 8 x 5 cm and resembled “cauliflower”. Diagnosis of suspected anal papilloma was made. In July 2019, an incisional biopsy was performed, and the result showed papilloma squamosa with condyloma acuminata as a differential diagnosis. In September 2019, perianal soft tissue tumor excision with advancement flap was performed and the result showed condyloma acuminata. </p><p><strong>Discussions:</strong> The case highlights the importance of careful evaluation and diagnosis in such clinical scenarios, as the initial diagnosis of anal papilloma was later refined to condyloma acuminata based on the biopsy and surgical findings. Early detection and appropriate management are crucial in cases like this to ensure the best possible patient outcomes.</p></div>

Efficacy and Safety Profile of Tuberculin Protein Purified Derivative Injection As Immunotherapy For the Treatment of Cutaneous and Anogenital Warts: A Review Article.

Various treatments available today for anogenital and cutaneous warts have limitations, including time-consuming, challenging to perform, and the risk of scarring. A new treatment using tuberculin purified protein derivative (PPD) has been developed, which is expected to generate cellular immunity against HPV. To assess the evidence for the efficacy and safety of PPD treatment for cutaneous and anogenital warts. A literature search was performed with the keyword-based search on digital libraries, including the National Library of Medicine, Cochrane Controlled Register of Trial, and Google Scholar, using the following terms: anogenital warts, condyloma acuminata, cutaneous warts, human papillomavirus, immunotherapy, and tuberculin purified protein derivative. Original studies on treating cutaneous or anogenital warts with PPD were included. The results were 47 clinical trials and 4 case reports. Most of the research was done in countries with common Mycobacterium tuberculosis infection. The treatment showed good efficacy. Comparative studies showed that the treatment has similar efficacy with other immunotherapies. No significant side effects were reported, with evidence of the safety use on the pregnant population. Based on good efficacy and safety, PPD can be considered an alternative therapy, especially in countries where tuberculosis is frequent.

Association of tobacco use and the presence of anal warts in people who attend the anal Neoplasia clinic in Puerto Rico

BackgroundLimited research exists regarding the association between smoking and anal warts. In this study, we evaluated this association among a clinic-based Hispanic population in Puerto Rico. MethodsCross-sectional study among eligible patients seen at the Anal Neoplasia Clinic of the University of Puerto Rico Comprehensive Cancer Center (2016–2023) (n = 920). Sociodemographic and clinical variables were collected from medical records. Patients underwent a high-resolution anoscopy (HRA) during the clinical visit; physicians assessed anal condylomas on HRA. Poisson regression models with robust standard errors were used to evaluate the association between smoking and anal warts. Demographic and clinical factors were also assessed. ResultsThe mean age of participants was 45.8 ± 13.1 years, 66.4 % were men, and 21.6 % were current smokers. While 10.8 % self-reported a history of anogenital condylomas, 18.9 % had anal condylomas on clinical evaluation. A higher prevalence of anal condylomas was observed among current smokers (PR = 1.28, 95 % CI: 0.94–1.75) in comparison to non-smokers in adjusted analysis, but this was not statistically significant. However, a higher prevalence of anal condylomas was observed among younger individuals (PR = 0.96, 95 % CI: 0.96–0.98) and individuals with anal high-grade squamous intraepithelial lesions (HSIL) as compared to those with benign histology (PR = 1.74. 95 % CI: 1.09–2.77). ConclusionsAlthough current smoking seemed to be positively associated with anal condylomas in this high-risk Hispanic population, this finding was not statistically significant as the power to detect an association was limited. However, younger age and HSIL diagnosis were associated with a higher prevalence of anal condylomas.

Impact of Human Papillomavirus Vaccination on Male Disease: A Systematic Review.

Human papillomavirus (HPV)-related diseases are highly prevalent in men worldwide, comprising external anogenital condyloma, anal intraepithelial neoplasia (AIN), penile intraepithelial neoplasia (PIN), and anogenital and oropharyngeal cancers. There is exceptionally low vaccine coverage in the male population. Only 4% of men were fully vaccinated, worldwide, as of 2019. The aim of this review is to assess the impact of HPV vaccination on male disease. Three databases (MEDLINE, Web of Science, Scopus) and Clinical Trials.gov were searched. We included thirteen studies, eight randomized controlled trials (RCTs), and five cohorts, comprising a total of 14,239 participants. Regarding anal disease, seven studies reported HPV vaccine efficacy ranging from 91.1% to 93.1% against AIN1, and ranging from 89.6% to 91.7% against AIN2|3 and anal cancer. Five studies showed an efficacy against genital condyloma of 89.9% in HPV-naïve males, varying between 66.7% and 67.2% in intention-to-treat populations. Studies reporting no efficacy have included older participants. These results support vaccination of young men previously infected, beyond HPV-naïve males. The evidence quality was moderate to low for most outcomes, namely genital diseases. RCTs are needed to assess the efficacy of HPV vaccination on male oropharyngeal cancer.

Surgical Treatment of a Severe Anogenital Condyloma Acuminata – Case Report

Surgical Treatment of a Severe Anogenital Condyloma Acuminata – Case Report

Evaluation of Some Effective Factors in Response to Cryotherapy in Women with Condyloma Acuminata

Background and Objective: Condyloma acuminata is treated in different ways, each of which may have advantages and disadvantages. The present study aimed to evaluate the effective factors in response to cryotherapy treatment in women with condyloma acuminata. Materials and Methods: This case-control study was conducted on 200 women with condyloma acuminata who were candidates for cryotherapy and were referred to Farshchian Hospital (Sinai) in 2021-2022. Before starting cryotherapy, a biopsy sample was taken from the lesions to perform a polymerase chain reaction (PCR) and determine the genotype of the human papillomavirus. Based on the extracted subtype, the lesions were classified into three high-risk, medium- and low-risk groups. Cryotherapy was performed for each lesion once every two weeks and up to six sessions at most. Patients were examined one month after the last cryotherapy session in terms of recovery with no recovery. Non-response to treatment was considered the case group, and response was regarded as the control group. Results: In terms of genotype, 43% were high risk, 24.5% were intermediate, and 32.5% were low risk. The frequency of response to treatment was 37%. A response to cryotherapy of condyloma acuminata in the anogenital area of participating showed a significant correlation with age (P=0.008), lesion size (P=0.001), duration of disease (P=0.001), genotype (P=0.001), and lesion location (P =0.014). Conclusion: Response to cryotherapy treatment in anogenital condyloma acuminata warts is relatively low. Lesions in the vaginal area, younger age, the smaller size of lesions, and shorter duration of infection had a better prognosis after cryotherapy

Urinary Bladder Squamous Cell Carcinoma In-Situ in a Background of Condyloma Acuminatum – A Diagnostic Challenge

Abstract Introduction/Objective Condyloma acuminatum is a rare lesion of the urinary bladder and urethra, usually associated with extensive anogenital condyloma acuminatum and immunosuppression. It is considered a risk factor for developing urinary bladder squamous cell carcinoma. Methods/Case Report We report a case of an 80-year-old male with a history of invasive squamous cell carcinoma of the anus, status-post chemoradiation ten years prior, and renal transplantation for end-stage renal disease 15 years prior. He presented with a lesion adjacent to the neoureteral orifice at the bladder dome. Biopsy revealed nonkeratinizing, hyperplastic papillary fronds of squamous epithelium with koilocytic change and viral atypia. The tumor was positive for p16, GATA3, and p40 and negative for high-risk and low-risk Human Papilloma Virus by in-situ hybridization. However, the morphology was consistent with squamous cell carcinoma in-situ arising in a background of condyloma acuminatum, which was concurred by an outside expert. Bladder condyloma acuminata are often challenging to recognize, given their extreme rarity and the possibility of negative low-risk and high-risk Human Papilloma Virus tests. Lack of prior history of anogenital condylomas can further obscure this diagnosis. Results (if a Case Study enter NA) NA. Conclusion This case raises awareness of condyloma acuminatum as a rare entity that needs to be considered in the differential diagnosis of bladder tumors, especially in immunosuppressed patients. Given that the treatment strategies for squamous cell carcinoma arising from condyloma acuminatum differ from that for urothelial carcinoma with squamous differentiation, distinguishing these lesions from one another is imperative.

Successful treatment of giant anogenital condyloma accuminata with combined cryotherapy and intralesional tuberculin purified protein derivative: a case report

To show the effectiveness of combined cryotherapy and intralesional tuberculin purified protein derivative (PPD) in the treatment of giant condyloma accuminata. A 57-year-old female was presented with an extensive verrucous, ulcerated, cauliflower-like 10 × 5 cm mass of the perianal area with extension to labia majora. The mass had evolved progressively for 2 years and resulted in perianal discomfort, itching and bleeding. Histopathological examination ruled out the presence of malignancy and confirmed the diagnosis of condyloma accuminata.The lesions were treated by 6 sessions of combined cryotherapy (2 freeze thaw cycles 25 seconds each) and intralesional PPD with a dose of (0.3 ml each session) at two-week interval. The mass resolved completely after 3 months and the quality of life of the patient has improved dramatically. There was no recurrence within 1 year of follow-up. Although most case reports suggest surgical excision as the treatment of choice of giant condyloma accuminata, our case was successfully treated with a highly effective and safe combined modality of cryotherapy and intralesional PPD, with the advantage of preserving the normal anatomy and avoidance of post-surgical disfigurement. No conflict of interest to declare.

Successful treatment of giant anogenital condyloma accuminata with combined cryotherapy and intralesional tuberculin purified protein derivative: a case report

Successful treatment of giant anogenital condyloma accuminata with combined cryotherapy and intralesional tuberculin purified protein derivative: a case report

PSY7-3 HPV infection as STI, and neoplasia in genitourinary/private parts – Current status and problems

HPV-related neoplasms in genitourinary/private parts mainly include penile cancer, anogenital condyloma acuminatum, bladder cancer, and anal cancer. According to our study and other report (25 countries worldwide), 30-40% of penile cancers were associated with HPV, with HPV16 being the most commonly detected HPV type, followed by HPV6. Anogenital condyloma acuminatum is caused by so-called low-risk HPV. The Cancer Genome Atlas (TCGA) reveals that some bladder cancers are associated with HPV, and recent studies have shown a particular association with HPV16.

The effects of anogenital condylomas on female sexuality and psychology: a case-control study

Objective: HPV is a sexually transmitted virus with over two hundred subtypes. It can cause anogenital condyloma, cervical dysplasia, and cervical cancer. HPV types 6 and 11 are responsible for anogenital condylomas. The effect of condylomas on female sexual life and psychological state is investigated in our study. 
 Material and Methods: Seventy-six vulvar condyloma patients and 80 participants as the control group were included in the study after excluding the subjects not meeting the inclusion criteria. After an initial evaluation, condylomas excised using carbon dioxide laser followed by a medical assessment in the 3rd post-excisional month. FSFI and BDI scales were used on a group of healthy patients with anogenital condyloma at 0-3 months.
 Results: There was a statistically significant difference in the FSFI scores at 0 and 3 months between the case and control groups (p

Prevalence of anogenital condylomas in patients with HIV infection in a center for sexually transmitted infections in Leon, Guanajuato, Mexico

Condylomas are the most frequent sexually transmitted infection worldwide, and thus, have a close relation to HIV infection. The site and serology vary, and some pose higher risk of malignancy. To describe the prevalence, characteristics and associated factors to the presence of anogenital condylomas in patients with HIV/AIDS. Descriptive cross-sectional study conducted in the period from June to December 2014. Adult HIV/AIDS positive patients from "CAPASITS" in Leon, Mexico, from both sexes were included. A questionnaire was performed that included: identification data, and risk factors related to anogenital condylomas. Anogenital area was examined for condylomas. Descriptive statistics were carried out according to the type and distribution of the variables, and the CD4 lymphocyte medians of patients with and without condylomas were compared using U- Mann-Whitney test. A total of 213 HIV/AIDS patients were included; 181 (85%) were male. The prevalence of anogenital condylomas was 30% (IC95%: 23-36%), predominating in the anal region, observed in 21% of the cases. A significant difference was found between median CD4 cell count of patients with and without condylomas (425 vs 510 CD4/mL, p= 0.034). A high prevalence of patients with anogenital condylomas was obtained. The presence of condylomas was higher in patients with lower CD4 count. Considering the high prevalence, the application of the vaccine is recommended in this patient group.

Topical Mucoadhesive Alginate-Based Hydrogel Loading Ketorolac for Pain Management after Pharmacotherapy, Ablation, or Surgical Removal in Condyloma Acuminata.

Condyloma acuminata is an infectious disease caused by the human papilloma virus (HPV) and one of the most common sexually transmitted infections. It is manifested as warts that frequently cause pain, pruritus, burning, and occasional bleeding. Treatment (physical, chemical, or surgical) can result in erosion, scars, or ulcers, implying inflammatory processes causing pain. In this work, a biocompatible topical hydrogel containing 2% ketorolac tromethamine was developed to manage the painful inflammatory processes occurring upon the removal of anogenital condylomas. The hydrogel was physically, mechanically, and morphologically characterized: it showed adequate characteristics for a topical formulation. Up to 73% of ketorolac in the gel can be released following a one-phase exponential model. Upon application on human skin and vaginal mucosa, ketorolac can permeate through both of these and it can be retained within both tissues, particularly on vaginal mucosa. Another advantage is that no systemic side effects should be expected after application of the gel. The hydrogel showed itself to be well tolerated in vivo when applied on humans, and it did not cause any visible irritation. Finally, ketorolac hydrogel showed 53% anti-inflammatory activity, suggesting that it is a stable and suitable formulation for the treatment of inflammatory processes, such as those occurring upon chemical or surgical removal of anogenital warts.

Peripheral inflammatory biomarkers as predictors of recurrence in surgically-treated anogenital condylomata acuminata patients.

The aim of this study was to examine the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) in patients with anogenital condylomata acuminata (CA) and their association with recurrence and squamous intraepithelial neoplasia development. We conducted a descriptive study in 95 patients that had undergone surgical treatment for CA. The descriptive data, disease characteristics, and pre-treatment peripheral inflammatory biomarkers (PIBs) were recorded retrospectively. All parameters were compared in those with recurrent and non-recurrent CA. All PIBs were significantly higher in patients with the greatest genital wart size of >2 cm in the squamous intraepithelial lesion (SIL) group. Human papillomavirus (HPV) types 16, 18, 31 and 33, known to carry high risk for anogenital cancer, were significantly related to higher SII. Greater wart size, high-grade squamous intraepithelial lesion (HSIL), and higher PLR and SII values were highly associated with recurrent disease (p = 0.003, 0.006, 0.005 and 0.000, respectively). Of all recurrences, 34.1% were explained by HSIL and increased PLR and SII values. The prediction of CA recurrence is important to determine those patients at high risk. PLR and SII can be used for risk analysis in selected patient groups.

Enfermedades dermatológicas de pacientes en seguimiento ambulatorio por VIH en Manizales, Colombia

Introducción: las dermatosis infecciosas y no infecciosas tienen una alta prevalencia en pacientes con infección por el virus de la inmunodeficiencia humana (VIH) y son importantes para su diagnóstico y seguimiento clínico. A pesar de que hay extensa documentación de dichas dermatosis en otras poblaciones y especialmente en países desarrollados, la información es escasa en pacientes de nuestro medio.
 Objetivos: describir los hallazgos dermatológicos de pacientes con VIH en la ciudad de Manizales, Colombia, y determinar la distribución de estos según el estado inmunológico y virológico.
 Métodos: estudio de corte transversal. Se recolectaron los datos mediante interrogatorio, revisión de historia clínica y examen físico de pacientes con diagnóstico confirmado de VIH atendidos en la consulta especializada de dermatología de la Universidad de Caldas en Manizales, Colombia, entre 2012 y 2013.
 Resultados: se incluyeron 123 pacientes (26 mujeres y 97 hombres) con una mediana (rango intercuartílico [RIQ]) de edad de 40 (19) años. El 93% recibían terapia antirretroviral (TAR) y la mediana (RIQ) del recuento de linfocitos T CD4+ (LT CD4) fue 350 (326) por mL. De cada 10 pacientes 9 tenían por lo menos una dermatosis, 73,2% alguna no infecciosa y 68,3% alguna infecciosa. Las dermatosis infecciosas más frecuentes fueron tinea pedis (37%), condilomas anogenitales (25%) y onicomicosis (19%), mientras que las no infecciosas más frecuentes fueron der­matitis seborreica (18%), xerodermia (10%) y lipoatrofia (8%). La melanoniquia y la erupción papular prurítica fueron más frecuentes en sujetos con recuentos más bajos de LT CD4 y las dermatosis infecciosas en aquellos que tenían mayor carga viral.
 Conclusiones: las manifestaciones cutáneas (infecciosas y no infecciosas) son altamente prevalentes en pa­cientes con VIH en nuestro medio, siendo más frecuentes las no infecciosas. Algunas de ellas podrían encon­trarse con mayor frecuencia en los sujetos con mayor deterioro de su estado inmunológico o virológico.

Aspects of Langerhans cells and TNF-α in the cutaneous immunity of anogenital warts

BackgroundAnogenital warts are the leading sexually transmitted infection in patients seeking care at specialized clinics. They may display a vast array of forms, according to the interaction of the virus with the host's immunity. Cellular immunity is the epithelium's main form of defense against the virus, involving an active participation of the Langerhans cells and pro-inflammatory cytokines such as TNF-α. ObjectiveTo assess the epithelial immune response of anogenital warts in males, according to the number of lesions presented. MethodsThis is a prospective, cross-sectional study carried out at the dermatology outpatient clinic in a tertiary hospital. We included male patients over 18 years of age without comorbidities who had anogenital condylomata and no previous treatments.In order to evaluate the local epithelial immunity, the lesions were quantified, then removed and employed in CD1a immunohistochemistry assays for assessing the morphometry and morphology of Langerhans cells; TNF-α; reaction was used for determining cytokine positivity in the epithelium. Results48 patients were included in the study. There was no statistically significant difference as to the number of Langerhans cells, in their morphology, or the presence of TNF-α. However, patients presenting with more Langerhans cells in the lesions had cells with a star-like and dendritic morphology, whereas in those with a lower cell count had cells with a rounded morphology and no dendrites (p<0.001). Study limitationsSmall number of patients analyzed. ConclusionThere was no difference in epithelial immunity between patients having few or many anogenital condyloma lesions as measured by the morphology and morphometry of Langerhans cells and TNF-α; positivity. Such an assessment employing immunity markers differing from the usual ones is expected to yield useful results.

Validation and Clinical Use of the CECA, a Disease-specific Quality of Life Questionnaire for Patients with Anogenital Condylomata Acuminata

The aim of this validation study was to assess the measurement properties of the CECA (Spanish acronym for the Specific Questionnaire for Condylomata Acuminata) in patients with anogenital condylomas. A total of 247 patients aged > 18 years completed the questionnaire on 2 occasions as well as the Dermatology Life Quality Index (DLQI). The CECA questionnaire showed good internal consistency (Cronbach's alpha values of 0.86 and 0.91 in the emotional and sexual activity dimensions) and good testretest reliability (intraclass correlation coefficient 0.76 emotional dimension, 0.82 sexual activity dimension). Patients with de novo lesions and those with more extensive lesions and larger number of warts showed poorer health-related quality of life. CECA and DLQI scores correlated moderately. Patients whose lesions cleared at follow-up or with a reduction of >or= 50% showed a better improvement of health-related quality of life. The CECA questionnaire is a valid, reliable and sensitive tool for the assessment of health-related quality of life in patients with anogenital warts.

The Outcome of Combined Electro-fulguration and Surgical Excision Techniques in the Management of Anogenital Condylomas

The Outcome of Combined Electro-fulguration and Surgical Excision Techniques in the Management of Anogenital Condylomas

Characteristics of Anogenital Condyloma Acuminatum Patients with Human Immunodeficiency Virus (HIV) in Haji Adam Malik General Hospital January 2012 - December 2017 Period

Characteristics of Anogenital Condyloma Acuminatum Patients with Human Immunodeficiency Virus (HIV) in Haji Adam Malik General Hospital January 2012 - December 2017 Period

Condyloma Acuminatum of Urinary Bladder: Relation to Squamous Cell Carcinoma.

Condyloma acuminatum rarely occurs in the urinary bladder and is considered to be a risk factor for squamous cell carcinoma, although there are only a few publications with limited cases. We studied 51 cases of condyloma acuminatum of the urinary bladder from transurethral resections of the urinary bladder of 38 patients from the consult files of one of the authors. Transurethral resections of the urinary bladder were obtained from 25 males with a median age of 73 years (range: 41 to 87 y) and 13 females with a median age of 68 years (range: 30 to 86 y). The follow-up period ranged from 15 months to 20 years (median: 6 y). Bladder lesions were accompanied by urethral lesions in 4 men. Eight patients (8/38; 21.0%) had a history of immunosuppression. Seven patients (7/8; 87.5%) from this group had multiple and/or recurrent condylomas. One patient (1/38; 2.6%) with renal transplantation had 10 separate bladder condylomas over time. One patient (1/38; 2.6%) had extensive anogenital condylomas and anal intraepithelial neoplasia grade 3. One patient (1/8; 12.5%) with renal transplantation presented with a solitary condyloma with synchronous squamous cell carcinoma in situ. Three female patients (3/38; 7.9%) had a history of premalignant vagina/cervix lesions. In total, 17 patients (17/38; 44.7%) had squamous cell carcinoma of the bladder, either invasive or in situ. In all cases, the squamous cell carcinoma (either in situ or invasive) was diagnosed either concurrent with the diagnosis of bladder condyloma or within 1 year of the condyloma diagnosis). In total, 9 of 38 (23.7%) patients had invasive squamous cell carcinoma with or without in situ squamous cell carcinoma. Eight of 38 (21.0%) patients had squamous cell carcinoma in situ only (without a definitive invasive component-in 3 cases invasive squamous cell carcinoma could not be excluded with certainty). In total, 19 patients (19/38; 50%) were positive for either low-risk human papillomavirus (LR-HPV) or high-risk human papillomavirus (HR-HPV) or both (3 were positive for both LR-HPV and HR-HPV, 12 patients for only LR-HPV, and 4 for only HR-HPV). Of the 19 patients that were negative for both LR-HPV and HR-HPV, 9 of 19 (47.4%) patients had associated squamous cell carcinoma. Of the 12 patients with only LR-HPV, 4 (33.3%) had associated squamous cell carcinoma (either invasive or in situ). Of the 7 patients with HR-HPV (with or without LR-HPV), 4 (57.1%) has associated squamous cell carcinoma. In summary, condyloma acuminatum of the urinary bladder shows a strong association with squamous cell carcinoma of the bladder, regardless of the condyloma's HPV in situ hybridization results. Immunosuppression is associated with condylomas of the bladder. It is important to distinguish bladder condylomas from papillary urothelial carcinoma, given their different risks for panurothelial disease and risk of squamous cell carcinoma. Recognition of bladder condylomas histologically is often challenging given their rarity, and that they can be negative for both LR-HPV and HR-HPV. The lack of a history of other anogenital human papillomavirus-related lesions further increases the difficulty in establishing the correct diagnosis.