Genital Warts Research Articles

Study of the Prevalence of Human Papillomavirus Genotypes in Jeddah, Saudi Arabia

Human papillomavirus (HPV), a common sexually transmitted infection, includes over 200 types, some linked to genital warts and various cancers, including cervical, anal, penile, and oropharyngeal cancers. In Saudi Arabia, an estimated 10.7 million women aged 15 years and older are at risk of HPV-related cervical cancer. This study assessed HPV prevalence, genotype distribution, awareness, and health behaviors among females in Jeddah, Saudi Arabia. Pap smear samples were collected from 106 women attending gynecology clinics at King Abdulaziz University Hospital and were analyzed using nested PCR and Sanger sequencing. Results showed a 15.1% HPV positivity rate, with genotypes of HPV 16, 6, and 58 identified. HPV 16 was the most prevalent (43.75%), particularly among women aged 35–44. In addition, over 60% of the participants were unaware of the link between HPV and cervical cancer, or the availability of vaccines, indicating significant knowledge gaps in the population. These findings underscore the urgent need for comprehensive HPV surveillance and targeted public health interventions in Saudi Arabia. This study emphasizes the importance of HPV vaccination programs, increased screening, and educational campaigns to address the high prevalence of high-risk genotypes, particularly HPV 16. Tailored strategies are crucial to reducing HPV-related health risks, especially for high-risk age groups and under-informed populations. The data provide a foundation for improving HPV prevention and reducing the burden of related diseases in the Saudi population.

HPV and Genital Warts: Mapping Awareness Through Google Trends in the United States Trends

Background: Human Papillomavirus is a sexually transmitted infection in the United States with an estimated 40% prevalence. Methods: This study assessed Google Trends data for genital warts related search terms from 2004 to 2023. The latest Centers for Disease Control-reported National Immunization Survey for 2022 were compared to Google Trends data for patterns or correlations. Results: Average annual searches for genital warts decreased by 73.7% from 2004 to 2023 with the largest reduction (-23.14%) occurring between 2019 and 2020. West Virginia had the highest twenty-year average searches for genital warts related search terms (94), while Utah was found to have the lowest. Minnesota, Massachusetts and Washington were reported on top ten states with the highest HPV vaccination coverage ( ≥ 1 dose) also were found on top ten states with the lowest twenty-year average Google Trend search inquiries for genital warts. Conversely, West Virginia, South Carolina, Oklahoma, Kentucky and Mississippi were found to be on the top ten states with the lowest reported ≥ 1 HPV dose vaccination coverage and among top ten states with highest genital wart searches. Conclusion: Google Trends data can help identify at-risk regions and guide efforts to improve HPV vaccination rates in the United States.

The Oncogenic Human Papillomavirus Involvement as a Risk Factor of Measles, Mumps, and Rubella Vaccine Immunotherapy Failure in Anogenital Warts

The Oncogenic Human Papillomavirus Involvement as a Risk Factor of Measles, Mumps, and Rubella Vaccine Immunotherapy Failure in Anogenital Warts

Cost-effectiveness of nonavalent HPV vaccination in the Netherlands

ABSTRACT Background A bivalent human papillomavirus vaccine (2vHPV) is currently used in the Netherlands; a nonavalent vaccine (9vHPV) is also licensed. Research design and methods We compared the public health and economic benefits of 2vHPV- and 9vHPV-based vaccination strategies in the Netherlands over 100 years using a validated deterministic dynamic transmission metapopulation model. Results Compared to 2vHPV, the 9vHPV strategy averted an additional 3,245 cases of and 825 deaths from 9vHPV-strain-attributable cancers, 4,247 cases of and 190 deaths from recurrent respiratory papillomatosis (RRP), and 1,009,637 cases of anogenital warts (AGWs), with an incremental cost-effectiveness ratio (ICER) of €4,975 per quality-adjusted life year (QALY) gained. The ICER increased in a scenario with increased HPV vaccination coverage rates and was relatively robust to one-way deterministic sensitivity analyses, with variation in the disease utility parameter having the most impact. When catch-up vaccination for individuals ≤26 years of age was added to the model, vaccinating with 9vHPV averted additional cancers and AGWs compared to 2vHPV vaccination. Conclusion Our analyses predict that transitioning from a 2vHPV- to a 9vHPV-based vaccination strategy would be cost-effective in the Netherlands.

Estimates and determinants of HPV non-vaccination in 14-year-old Canadians: Results from the childhood national immunization coverage survey, 2019

ABSTRACT Human papillomavirus (HPV) infections, the most common sexually transmitted infections, are associated with various health outcomes including anogenital warts and cancers. Despite significant investments in HPV vaccination programs, ensuring adequate vaccination coverage for adolescents remains a challenge in Canada. This analysis used data collected through the 2019 Childhood National Immunization Coverage Survey (CNICS) to determine national estimates of HPV non-vaccination and investigate determinants of HPV non-vaccination for adolescents aged 14-years old in Canada, both overall and stratified by gender. The primary outcome of interest was HPV vaccination status, categorized as vaccinated with at least one dose or unvaccinated. Simple and multiple logistic regression models were used to investigate determinants of HPV non-vaccination. In 2019, an estimated 19.8% of the 14-year-olds in Canada were unvaccinated for the HPV vaccine, with males having higher non-vaccination rates than females (27.0% compared to 12.9%). In the unstratified analysis, factors associated with HPV non-vaccination for 14-year-olds were gender and region of residence. These factors differed by gender – for males, region of residence and respondent’s age were significant factors, whereas for females, total household income was a significant factor. These results could help public health officials and policymakers develop and implement tailored interventions to enhance the delivery of HPV vaccination programs for male and female adolescents. By targeting populations that are under-vaccinated, vaccine uptake could be better facilitated to help reduce inequalities in access to the HPV vaccine, which could also potentially reduce disparities in HPV-related health outcomes.

Mengenal Lebih Dekat Apa Itu Penyakit Kondiloma Akuminata

Condyloma acuminata (KA), also known as genital warts or genital warts, is a sexually transmitted disease caused by the Human Papilloma Virus (HPV). The HPV subtypes that most often cause KA are 6 and 11, while subtypes 16 and 18 have the potential to cause cervical cancer. In the United States, there are more than 19.7 million new cases of sexually transmitted infections each year, with 14.1 million cases being HPV infections. In Indonesia, KA was ranked third largest in 12 teaching hospitals in the 2007-2011 period, with a high prevalence in the cities of Medan, Jakarta, Bandung, Semarang, Jogja and Denpasar, especially among those aged 25-45 years. HPV transmission occurs through sexual contact and can also occur through direct contact with contaminated objects. This disease can attack various genital areas and shows symptoms such as warts, itching, and discomfort. State Senior High School (SMAN) 3 Bengkulu City needs health education to increase students' awareness about the importance of maintaining the health of the genital area. Many students still take their genital health for granted, which can trigger deviant behavior. Therefore, the Service Team from the Faculty of Health Sciences, Muhammadiyah University of Bengkulu conducted outreach at the school in July 2024. This activity included a site survey, education about KA prevention, and evaluation. The results of the counseling show an increase in students' understanding of KA. The enthusiasm from the school and students is very good. Suggestions are given for the school to better control and accompany students to prevent trivialization of the disease, and students are expected to be more social and sensitive to the environment.

Vulvar Epidermolytic Hyperkeratosis: A Comprehensive Systematic Review of Case Reports and Series

Background: Vulvar epidermolytic hyperkeratosis (EHK) is an exceedingly rare dermatological condition, often presenting as solitary or multiple lesions in the vulvar region. Due to its clinical resemblance to other vulvar disorders, such as condyloma acuminatum, Bowenoid papulosis, and squamous cell carcinoma, vulvar EHK poses significant diagnostic challenges. While individual case reports and small case series have documented instances of vulvar EHK, comprehensive studies systematically consolidating the clinical, histopathological, and therapeutic aspects of this condition remain lacking. Objectives: To address this gap, this systematic review consolidates all available case reports and case series on vulvar EHK. The review aims to provide a comprehensive analysis of clinical presentations, histopathological features, diagnostic challenges, treatment approaches, and patient outcomes. Methods: We conducted a systematic review following the PRISMA guidelines. We searched multiple databases (PubMed, Web of Science, Scopus) for studies published up to 30 September 2024. Only case reports and case series with histopathologically confirmed vulvar EHK were included, as no higher-level studies (e.g., randomized controlled trials or cohort studies) were available due to the rarity of this condition. Exclusion criteria were male cases, oral EHK or other unrelated conditions, and literature reviews. We extracted and analyzed data on: patient demographics, time to diagnosis, anatomical distribution, clinical presentation, associated symptoms, histopathological features, patient history, risk factors, HPV status, treatment, and outcomes. Risk of bias was assessed using the CARE checklist and JBI Checklist for Case Series. Additionally, original clinical and histopathological images from our department were included to enhance the review. Results: A total of 19 studies, encompassing 30 cases of histopathologically confirmed vulvar EHK, were identified. Most cases presented with hyperkeratotic plaques and papules localized on the labia majora. Histopathological analysis consistently revealed hyperkeratosis, acanthosis, and vacuolar degeneration in the granular and spinous layers. Misdiagnosis was common, with lesions frequently mistaken for condyloma acuminatum or other vulvar neoplasms. Conservative management, including observation and topical therapies, was associated with disease stability in asymptomatic cases, while surgical excision demonstrated complete remission in all cases where it was employed. The rarity of vulvar EHK and reliance on case reports and series limit the generalizability of findings. Conclusions: Vulvar EHK is often misdiagnosed due to its similarity to malignancies and sexually transmitted infections. This review, the first of its kind, highlights the importance of prompt histopathological diagnosis to avoid the psychological impact of a cancer or sexually transmitted disease diagnosis and unnecessary, distressing, or aggressive treatments. Further research is needed to explore the role of HPV in vulvar EHK and to establish standardized diagnostic and treatment guidelines.

Artificial Intelligence-Aided Diagnosis System for the Detection and Classification of Private-Part Skin Diseases: Decision Analytical Modeling Study.

Private-part skin diseases (PPSDs) can cause a patient's stigma, which may hinder the early diagnosis of these diseases. Artificial intelligence (AI) is an effective tool to improve the early diagnosis of PPSDs, especially in preventing the deterioration of skin tumors in private parts such as Paget disease. However, to our knowledge, there is currently no research on using AI to identify PPSDs due to the complex backgrounds of the lesion areas and the challenges in data collection. This study aimed to develop and evaluate an AI-aided diagnosis system for the detection and classification of PPSDs: aiding patients in self-screening and supporting dermatologists' diagnostic enhancement. In this decision analytical modeling study, a 2-stage AI-aided diagnosis system was developed to classify PPSDs. In the first stage, a multitask detection network was trained to automatically detect and classify skin lesions (type, color, and shape). In the second stage, we proposed a knowledge graph based on dermatology expertise and constructed a decision network to classify seven PPSDs (condyloma acuminatum, Paget disease, eczema, pearly penile papules, genital herpes, syphilis, and Bowen disease). A reader study with 13 dermatologists of different experience levels was conducted. Dermatologists were asked to classify the testing cohort under reading room conditions, first without and then with system support. This AI-aided diagnostic study used the data of 635 patients from two institutes between July 2019 and April 2022. The data of Institute 1 contained 2701 skin lesion samples from 520 patients, which were used for the training of the multitask detection network in the first stage. In addition, the data of Institute 2 consisted of 115 clinical images and the corresponding medical records, which were used for the test of the whole 2-stage AI-aided diagnosis system. On the test data of Institute 2, the proposed system achieved the average precision, recall, and F1-score of 0.81, 0.86, and 0.83, respectively, better than existing advanced algorithms. For the reader performance test, our system improved the average F1-score of the junior, intermediate, and senior dermatologists by 16%, 7%, and 4%, respectively. In this study, we constructed the first skin-lesion-based dataset and developed the first AI-aided diagnosis system for PPSDs. This system provides the final diagnosis result by simulating the diagnostic process of dermatologists. Compared with existing advanced algorithms, this system is more accurate in identifying PPSDs. Overall, our system can not only help patients achieve self-screening and alleviate their stigma but also assist dermatologists in diagnosing PPSDs.

Treatment and Prevention of HPV-Associated Skin Tumors by HPV Vaccination.

HPV-associated dermatological diseases include benign lesions like cutaneous warts and external genital warts. In addition, HPV infection is associated with the development of epithelial skin cancers, in particular cutaneous squamous cell carcinoma (cSCC). In contrast to anogenital and oropharyngeal cancers caused by mucosal HPV types of genus alpha papillomavirus, cSCC-associated HPV types belong to the genus beta papillomavirus. Currently available HPV vaccines that target mucosal HPV types associated with anogenital cancer and genital warts are type-specific and provide no cross-protection against beta HPV. When implementing vaccination to beta HPV to prevent skin tumors, it must be considered that acquisition of these HPV types occurs early in childhood and that the risk for cSCC increases with growing age and decreasing immune surveillance. Thus, individuals considered for beta HPV vaccination usually have pre-existing infection and are largely immunocompromised. On the other hand, worldwide increasing incidence rates of epithelial skin cancer reflect an urgent need for skin cancer prevention measures. Based on the pathogenic involvement of beta HPV, vaccination may represent a promising prevention strategy. Indeed, various procedures of prophylactic and therapeutic vaccination have been developed, and some of them have shown efficiency in animal models. Thus far, however, none of these vaccine candidates has been approved for application in humans.

Updates in Human Papillomavirus Vaccination to Improve Medical Readiness in Active Duty Service Members.

Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and is associated with the development of genital warts, precancerous lesions, and cancers of the oropharynx, anus, penis, vulva, vagina, and cervix. HPV-associated diseases are preventable through vaccination. An Australian nationwide vaccination program will effectively eliminate cervical cancer as a public health concern by the year 2035. Despite safety and efficacy data, vaccination against HPV is not mandatory for military service members. Active duty service women are more likely to test positive for HPV when compared to dependents, and veterans diagnosed with HPV-associated cancers have higher health care resource utilization and costs. Even if a patient has a prior HPV infection, vaccination at the time of HPV diagnosis or following treatment can reduce recurrence of HPV and dysplasia. In addition, patients with a history of cancer have a higher incidence of secondary HPV-associated malignancies and should be offered vaccination or re-vaccination if they received a hematopoietic stem-cell transplant. Improving HPV vaccination rates within the military health system requires a multidisciplinary approach. Providers should use every opportunity to recommend HPV vaccination, including recommending HPV vaccines for individuals who do not have a record of HPV vaccination. The electronic health record can be utilized to generate prompts for vaccine reminders, and clinics should stock HPV vaccines to allow for easy administration. Additionally, adoption of an opt-out policy for HPV vaccines rather than mandatory vaccination may be an acceptable alternative to increase HPV vaccination while allowing active duty service members to retain autonomy.

Accuracy of symptom checker for the diagnosis of sexually transmitted infections using machine learning and Bayesian network algorithms

BackgroundA significant proportion of individuals with symptoms of sexually transmitted infection (STI) delay or avoid seeking healthcare, and digital diagnostic tools may prompt them to seek healthcare earlier. Unfortunately, none of the currently available tools fully mimic clinical assessment or cover a wide range of STIs.MethodsWe prospectively invited attendees presenting with STI-related symptoms at Melbourne Sexual Health Centre to answer gender-specific questionnaires covering the symptoms of 12 common STIs using a computer-assisted self-interviewing system between 2015 and 2018. Then, we developed an online symptom checker (iSpySTI.org) using Bayesian networks. In this study, various machine learning algorithms were trained and evaluated for their ability to predict these STI and anogenital conditions. We used the Z-test to compare their average area under the ROC curve (AUC) scores with the Bayesian networks for diagnostic accuracy.ResultsThe study population included 6,162 men (median age 30, IQR: 26–38; approximately 40% of whom had sex with men in the past 12 months) and 4,358 women (median age 27, IQR: 24–31). Non-gonococcal urethritis (NGU) (23.6%, 1447/6121), genital warts (11.7%, 718/6121) and balanitis (8.9%, 546/6121) were the most common conditions in men. Candidiasis (16.6%, 722/4538) and bacterial vaginosis (16.2%, 707/4538) were the most common conditions in women. During evaluation with unseen datasets, machine learning models performed well for most male conditions, with the AUC ranging from 0.81 to 0.95, except for urinary tract infections (UTI) (AUC 0.72). Similarly, the models achieved AUCs ranging from 0.75 to 0.95 for female conditions, except for cervicitis (AUC 0.58). Urethral discharge and other urinary symptoms were important features for predicting urethral gonorrhoea, NGU and UTIs. Similarly, participants selected skin images that were similar to their own lesions, and the location of the anogenital skin lesions were also strong predictors. The vaginal discharge (odour, colour) and itchiness were important predictors for bacterial vaginosis and candidiasis. The performance of the machine learning models was significantly better than Bayesian models for male balanitis, molluscum contagiosum and genital warts (P < 0.05) but was similar for the other conditions.ConclusionsBoth machine learning and Bayesian models could predict correct diagnoses with reasonable accuracy using prospectively collected data for 12 STIs and other common anogenital conditions. Further work should expand the number of anogenital conditions and seek ways to improve the accuracy, potentially using patient collected images to supplement questionnaire data.

Determining the Knowledge Levels of University Students About HPV and HPV Vaccine

Objective: The purpose of this study is to determine the knowledge levels of university students about human papillomavirus (HPV) and the HPV vaccine. Methods: This descriptive study was conducted with 802 university students staying in the student dormitory of a foundation university on the Anatolian Side of Istanbul. The data of the study were collected using the "Student Information Form" and the "Human Papilloma Virus Knowledge Scale". Results: 16.5% of the participants had previous sexual experience, 5.1% had genital wart problems before, 15.8% had the HPV vaccine, the total score average of the "HPV Knowledge Scale" was 10.142±7.364 (Min:0-Max:33). When the sub-dimension mean scores are examined, the "general HPV knowledge" sub-dimension mean score is 6.657±4.276, the "HPV screening test knowledge" sub-dimension mean score is 1.029±1.316, the "general HPV vaccine knowledge" sub-dimension mean score is 1.591±1.737, the "current HPV knowledge" sub-dimension mean score is 1.591±1.737. The mean score of the "information about vaccination program" subscale was found to be 0.865±1.240. Conclusion: In this study, the level of knowledge about HPV and HPV vaccine among university students is quite low, and it is seen that this situation may affect general health awareness and protective behaviors.

Perigenital Defect Reconstruction Post Giant Condyloma Acuminata Resection: Experience With The Double Keystone Flap

Abstract: Due to its high recurrence, genital condyloma acuminata should be widely excised to include the full dermal thickness. Currettage is not advisable, as the rate of recurrence is high. The bigger the lession, the bigger donor area needed to close the defect. The reconstructive options do not merely depend on the defect area, but also on selecting a tissue donor of similar color, thickness, sensation and durability. The ease of donor transfer is equally important. Not many case of giant genital condyloma acuminata wide excision and reconstruction has been reported. For coverage of larger soft tissue defect, skin graft is the most common option; however durability is of concern and the perigenital area is a challenging area to graft. Two cases of perigenital reconstruction after giant genital condyloma excision is reported in this paper, using random perforator based flaps, the double keystone flap. Patient and Method: Both cases of giant genital condyloma underwent wide excision by the urologist and referred to our division for reconstruction. Both patients are male, and the defects were reconstructed using the double keystone flap. One patient needed a split thickness skin graft to cover remaining defect on the penile shaft. Result: In both cases, the double keystone flap successfully covered for the defects on the perigenital with tissue quality similar to its original characteristics. No complication ensued. All flaps were vital, no dehisence nor local infection occurred. Summary: The double keystone flap is a reliable option for the reconstruction of large defects on the perigenital region.

HPV Vaccines Among University Students: Understanding Barriers and Facilitators of Vaccine Uptake.

Human papillomavirus (HPV) is the most common sexually transmitted infection and plays a significant role in cervical, penile, anal, vaginal, vulvar, and oropharyngeal cancers as well as non-cancerous genital warts and genital dysplasia. In the United States, there are approximately 46,000 new HPV-related cancers a year. There is an effective vaccine to prevent over 90% of these cancers and other HPV-related diseases; however, those that are aged 18-26 have the lowest vaccine rates among eligible age groups. The objective of this study was to examine student knowledge and perceptions about HPV vaccine hesitancy in university students and their notions of barriers and facilitators for HPV vaccine uptake. We aimed to identify components for an evidence-based community-oriented educational intervention to increase HPV vaccination uptake. The researchers recorded 10 focus groups featuring students from a Northeastern United States university, aged 18-26, which were analyzed using grounded theory and inductive thematic analysis to identify recurring themes. The participants mentioned many barriers and facilitators for attaining the HPV vaccine, with health literacy being prominent for both. They demonstrated some knowledge of what HPV is and ways to avoid it. They also expressed a desire for further information and felt that the way in which this information is presented to the public is vital for increasing vaccine uptake and designing future interventions. In order to increase HPV vaccination rates in the general population and overcome barriers such as family, religious, and cultural values, it is important to emphasize the link between HPV and cancer and its preventative benefits.

High Risk of HPV Related Preneoplastic and Neoplastic Vulvar Lesions in Women Living With HIV.

We aimed to investigate the epidemiology of human papilloma virus (HPV)-related preneoplastic and neoplastic vulvar lesions in a large cohort of women living with HIV (WLWH). We retrospectively selected 1,796 WLWH who had a gynecological examination, cervical cytology, high-risk (HR-) HPV test, vulvoscopy, and colposcopy with targeted biopsies when necessary between 1987 and 2020 at 2 Italian institutions. Univariable and multivariable regression analyses were carried out to test the association of the anamnestic and clinical data with the development of precancerous and cancerous lesions. At baseline, 348 (19.4%) of 1,796 WLWH had genital warts, 30 (1.7%) had vulvar high-grade intraepithelial neoplasia (VHSIL), and 2 (0.1%) had squamous cell carcinoma of the vulva. Among 895 WLWH who had more than 1 year of follow-up, we found 40 (4.5%) new cases of VHSIL and 7 (0.8%) cases of vulvar cancer. The cumulative incidence of VHSIL and vulvar cancer was respectively 0.56 and 0.10 per 100 person-years. Risk factors independently associated with the development of vulvar HSIL and cancer included history of injection drug use (p < .01), genital warts at baseline (p < .001), HR-HPV test positivity at diagnosis (p < .001), and severe immunodepression (CD4 cell count <200 cells/mL) at diagnosis (p < .01). WLWH are at high risk of vulvar high-grade intraepithelial neoplasia and cancer, especially those with severe immunodepression. A careful inspection of vulva, perineum and anus, possibly with the aid of colposcopy, should become part of the surveillance protocol of HIV-infected women.

Comparison of clinical profile and demography of sexually transmitted infections (STIs) among patients attending an STI clinic in the pre-coronavirus disease-2019 (COVID-19), COVID-19, and post-COVID-19 era: A retrospective data analysis

Objectives: The objectives of this study were to compare between the clinical profile and demography of patients with sexually transmitted infections (STIs) who attended the STI clinic of our tertiary care institution during comparable timelines in pre-coronavirus disease-2019 (COVID-19) (2018 June–2019 May) and COVID-19 (2020 June–2021 May) periods and between pre-COVID-19 and post-COVID-19 (2022 June–2023 May) periods. Materials and Methods: Using a pre-set pro forma, we collected data on the demography and clinical profile of patients with STIs who attended our STI clinic during comparable timelines during pre-COVID-19, COVID-19, and post-COVID-19 periods. Results: In comparison to the pre-COVID-19 period, a significant decline and a significant rise were noted in the total number of STI cases during the COVID-19 period and post-COVID-19 period, respectively. Compared to the pre-COVID-19 period, post-COVID-19 period witnessed an increase in the actual number of all STIs, except condylomata acuminata. Limitations: Data from a single center and retrospective design were the major limitations. Conclusion: We observed a post-COVID-19 surge in the number of STIs. The pattern of STIs in the post-pandemic era assumes importance in planning future strategies.

Prevalence and Risk Factors of Sexually Transmitted Infections in a Tertiary Hospital in Surakarta, Indonesia

Background: Sexually transmitted infections (STIs) remain a significant public health concern globally, with millions of new cases occurring annually. Understanding the prevalence and risk factors associated with STIs is crucial for effective prevention and control programs. This study aimed to investigate the prevalence and risk factors of STIs among patients attending the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital, a tertiary hospital in Surakarta, Indonesia. Methods: A retrospective descriptive study was conducted using secondary data from medical records of patients diagnosed with STIs between January 2020 and December 2023. Data collected included sociodemographic characteristics, sexual behaviors, clinical diagnoses, and HIV status. Descriptive statistics and chi-square analysis were used to analyze the data. Results: A total of 249 patients were diagnosed with STIs during the study period. The most common STI was condyloma acuminata (51%), followed by male genital discharge (18.1%), female vaginal discharge (16%), other STIs (10.9%), and genital ulcers (4%). The majority of patients were male (62.2%), aged 25-44 years (49.1%), had a high school education (49.5%), and reported heterosexual orientation (67.1%). Multiple sexual partners were reported by 62.7% of the participants, and 36.1% were HIV positive. The correlation analysis reveals that various sociodemographic, behavioral, and health-related factors are associated with different STIs. Conclusion: Condyloma acuminata was the most prevalent STI among patients attending the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi General Hospital. The correlation analysis reveals that various sociodemographic, behavioral, and health-related factors are associated with different STIs. Understanding these correlations can help healthcare providers identify individuals at higher risk for specific STIs and implement targeted prevention and intervention strategies. Targeted interventions focusing on these high-risk groups are needed to reduce the burden of STIs in Surakarta, Indonesia.

Cotton swabs for the measurement of NF-ĸB, IFN-γ, and FOXP3+Treg from lesions of anogenital wart patients

BACKGROUND Local tissue immunity plays a significant role in anogenital warts’ (AGW) pathomechanism and persistence. Assessing biomarkers from lesions instead of serum is recommended to evaluate therapeutic response. Since biopsy is invasive, it is necessary to find less invasive and more comfortable methods. This study aimed to assess the reliability of cotton swabs and tape stripping for evaluating AGW’s lesions biomarkers. METHODS We compared cotton swab versus tape stripping method to quantify nuclear factor-κappaB (NF-ĸB), interferon-gamma (IFN-γ), and FOXP3+regulatory T cell (FOXP3+Treg) from 3 patients with AGW in the preliminary study. The method was selected based on contamination possibility, side effects, and a simpler approach. The main study examined 48 patients with AGW for reliability and reproducibility using the best sampling method from preliminary result and Spearman’s Rho analysis, while considering the HIV status and CD4+ counts. RESULTS Both cotton swabs and tape stripping obtained adequate protein content for biomarkers examination. However, the tape stripping method was causing serum contamination and painful for patients due to the stripping. The total lesion volume in cotton swab method was positively correlated with all patients’ NF-ĸB (p = 0.001). IFN-γ had a negative correlation in all reactive HIV patients (p = 0.012). FOXP3+Treg and CD4+ counts were negatively correlated with total volume in reactive HIV patients (p = 0.046 and 0.017, respectively). CONCLUSIONS The cotton swab method was reliable in examining NF-ĸB, IFN-γ, and FOXP3+Treg due to its convenience and lack of serum contamination from AGW lesions, potentially improving patient comfort and practical benefits.

EE724 Healthcare Resources Utilization and Costs of Treatment Associated With Anogenital Warts in South Africa: Public and Private Perspective

EE724 Healthcare Resources Utilization and Costs of Treatment Associated With Anogenital Warts in South Africa: Public and Private Perspective

The emerging role of photodynamic therapy in the treatment of cutaneous infections.

Cutaneous infections pose ongoing challenges to standard treatments due to resistance and limited efficacy. Photodynamic therapy (PDT) emerges as a promising supplement or an alternative to address complicated cases. In this review, we comprehensively review PDT's safety and efficacy in treating cutaneous infections. A PubMed systematic review with search terms for PDT treatment, hair, skin, and nail infections. There were a total of 43 studies on the use of PDT in cutaneous infections which discussed the treatment of viral (N.=20), bacterial (N.=11), fungal (N.=9), and protozoal (N.=3) infections. There is evidence for using PDT, mostly 5-aminolevulinic acid (5-ALA) and methyl aminolevulinate (MAL), in the treatment of cutaneous infections. Most evidence for viral infections involved treatment with 5-ALA PDT in condyloma acuminatum (CoAc), verruca vulgaris, and molluscum contagiosum. In bacterial infections, 5-ALA and MB PDT have been used to achieve complete remission in refractory Pseudomonas and atypical mycobacteria infections without recurrence. In onychomycosis, MAL PDT achieved a 40.9% cure rate and MB PDT showed a 77.8-100% cure rate with no reports of recurrence. Parasitic infections, such as leishmaniasis have also been successfully treated with both 5-ALA and MAL PDT. PDT is a promising treatment option for cutaneous infections, with growing evidence for its utility in treating cutaneous bacterial, viral, fungal, and parasitic infections, particularly those that fail standard treatments. Side effects were mostly limited to localized pain with good outcomes and low recurrence rates.