Condyloma Acuminate Research Articles

Remission of HPV-Related Diseases by Antivirals for Herpesvirus: Clinical Cases and a Literature Review.

Epidemiological studies have shown that HPV-related diseases are the most prevalent sexually transmitted infections. In this context, this report will present various clinical cases demonstrating the effectiveness of Acyclovir (ACV) or its prodrug Valaciclovir (VCV), both acyclic guanosine analogs commonly used for the treatment of HHV-1 and HHV-2, for the treatment of HPV-related diseases. The report shows the remission of five cases of penile condyloma and a case of remission in a woman affected by cervical and vaginal condylomas and a vulvar giant condyloma acuminate of Buschke and Lowenstein. The literature review shows that ACV is effective in treating skin warts when administered orally, topically, and intralesionally, suggesting its therapeutic potential in other diseases associated with HPV. ACV was also used successfully as an adjuvant therapy for juvenile and adult forms of laryngeal papillomatosis, also known as recurrent respiratory papillomatosis, prolonging the patient's symptom-free periods. Although the prevention of HPV infections is certainly achieved with the HPV vaccine, ACV and VCV have shown to be effective even against genotypes not included in the current vaccine and can be helpful for those problematic clinical cases involving unvaccinated individuals, immunocompromised patients, people who live with HIV, or non-responders to the vaccine. We and others concluded that randomized clinical trials are necessary to determine the efficacy of ACV and VCV for HPV-related diseases.

Effect of topical 5-aminolevulinic acid-mediated photodynamic therapy combined with CO2 laser pretreatment for vaginal condyloma acuminate

BackgroundCondyloma acuminatum (CA) of the vagina is a sexually transmitted disease due to infection by human papilloma virus (HPV). The treatment efficacy of the conventional methods for vaginal CA is often unsatisfactory with a high recurrence rate. Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) combined with CO2 laser pretreatment is a feasible approach for vaginal CA, but the effectiveness and safety need further evaluation. MethodsThis study enrolled 15 patients with vaginal CA. All patients underwent CO2 laser ablation and then ALA-PDT for two or three cycles. The clinical efficacy and side effects were evaluated and analyzed during the treatment and 6 months after the treatment. ResultsThe wart lesions in 4 cases (26.7 %) disappeared after the first treatment. The wart lesions in 5 cases (33.3 %) disappeared after the second treatment. And 6 cases (40 %) needed three treatment cycles before the lesions disappeared completely. The complete response (CR) rate was 93.3 % (14/15) at 2 weeks after three treatment cycles. There were 5 cases (83.3 %) which have complete remission after 2 treatments in warts diameter <1 cm group. There were only 4 cases (44.4 %) which have complete remission after 2 treatments in diameter>1 cm group. All patients had CR without reoccurrence at 6 months after treatment. The side effects mainly included a mild or moderate burning or stinging sensation (26.7 %). There were no infection, ulcers and scars after treatment. ConclusionTopical 5-aminolevulinic acid-mediated photodynamic therapy combined with CO2 laser pretreatment is a safe and effective treatment for vaginal CA.

Giant genital wart during pregnancy: A challenging case

Genital warts, commonly known as condyloma acuminate (CA), caused by the proliferation of squamous epithelial cells in the presence of sexually transmission of human papilloma virus (HPV) infection. There are several modalities of treatment options available for genital warts, medical and/or surgical. We present a case of 23-year-old primigravida who presented with giant extensive genital warts. Lesions were treated using; cryotherapy, sub-lesional vitamin D3, acyclovir, and Trichloro-acetic acid 50% (TCA).

CRISPR/CAS9 untuk Modifikasi Gen E7 pada HPV-6 dan HPV-11 sebagai Tatalaksana Kuratif Condyloma Acuminata

Sexually Transmitted Diseases (STDs) or Venereal Diseases (VD) are diseases that are transmitted through sexual intercourse, either vaginal, anal, or oral. HPV infection has a large number of about one million cases every day. One study conducted by WHO stated that 31% of women in Indonesia were exposed to infection from this virus. The HPV that can cause Condyloma Acuminata are HPV-6 and HPV-11. Although pharmacological and preventive therapies such as vaccines have been carried out, the number of sufferers is still increasing and becomes a burden for the country because in general this disease attacks the productive age population, so it is time to take a more sophisticated approach to the curative treatment of this disease. Looking for the latest curative methods that can stop condyloma acuminate permanently in each individual. The research method used is by conducting a literature study through several journal databases such as Pubmed, Cinahl, Google Scholar, and others. Based on several studies, it was found that CRISPR/Cas9 proved to be effective in suppressing the expression of the E7 protein and its sequence, proliferation and at the same time inducing apoptosis through the caspase-3 pathway in the conservative genome-specific proteins E7 HPV-6 and HPV-11. Not only decreasing expression and increasing deletion of the target genome, CRISPR/Cas9 has also been shown to be very efficient in suppressing cell proliferation. Keratin cells that have been exposed to the E7 HPV-6 and HPV-11 genomes will cause uncontrolled cell proliferation. With this method, the treatment of Condyloma Acuminata can be carried out effectively and efficiently so that it does not cause recurrence in the sufferer.

The Role of Dermatoscopy to Differentiate Vestibular Papillae from Condyloma Acuminate in a Pregnant Woman

The vestibular papillae (VP) represent an anatomical variant of the normal genital epithelium and are probably the female equivalent of pearly penile papules. It is thought that they are present in 1% of women, and this low percentage may be due to their lack of knowledge by practitioners since their diagnosis are often wrongly spotted as condyloma acuminates warts and this can lead to aggressive investigations, therapy, and anxiety in patients hence the role of dermoscopy.

Two-step irradiance schedule for condyloma acuminatum and the influencing factors of analgesic effect: A prospective randomized study.

The two-step irradiance schedule in photodynamic therapy (PDT) is an emerging treatment method with a remarkable analgesic effect. We evaluated the influencing factors of pain in condyloma acuminate (CA) treatment with a two-step irradiance schedule. All patients were randomly divided into a two-step irradiance group and control group. The two-step irradiance group used 40mW/cm2 for the first 8min, followed by 80mW/cm2 for 16min, while the control group used 80mW/cm2 for 20min. The Numerical Rating Scale (NRS) scores and pain-influencing factors were recorded accordingly. In the two-step irradiance and control groups, 64 and 63 patients completed the treatment, respectively. The NRS scores of the two-step irradiance group were significantly lower than that of the control group (p<.001), with a low fluence rate inducing less pain compared with a high fluence rate (p<.001). Moreover, when the total fluence accumulated to 57.6J/cm2 , the pain experienced by patients reached its peak. The NRS score of the urethral orifice group was the highest, and the male external genitalia group was the lowest. The NRS score was at its lowest in the first session and highest in the second session. There was a linear relationship between pain and wart size. Among these influencing factors, the fluence rate had the greatest impact on pain. The two-step irradiance schedule provides better analgesic effects than standard treatment irradiation while showing similar treatment efficacy. Factors that influence pain include high fluence rate, CA at the urethral orifice, second therapy session, wart size, and the interval between CO2 laser and ALA-PDT.

P16INK4A Expression in Condyloma Acuminata Lesions Associated with High-Risk Human Papillomavirus Infection.

Objective:The objective of this study was to discover the possible correlation between p16INK4A expression and the LR/HR-HPV infection in condyloma acuminate (CA) lesions. Materials and Method:This cross-sectional study was conducted during January-December 2017 on 33 CA patients. The expression of p16INK4A was detected by immunohistochemistry (IHC) staining. The positive interpretation was carried out by scoring which score 0 was negative, score 1 was sporadic, score 2 was focal, and score 3 was diffuses. The HPV genotypes were identified by reverse line blot, and 40 genotypes of HPV detected, including HR-HPV (HPVs 16, 18, 26, 31, 33,35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68a, 68b, 69, 73, and 82) and LR-HPV (HPVs 6, 11, 40, 42, 43, 44, 54, 55, 61, 62, 64, 70, 71, 72, 81, 83, 84, 87, 89, and 90). Results:The expression of p16INK4A was significantly correlated with HR-HPV infection. Patients infected with HR-HPV had 0.644 times higher possibility to express p16INK4A gene compared to those infected with LR-HPV. LR-HPV genotypes detected in CA patients were HPVs 6, 11, 42, 61, 54, 81, 87, 89, and 90 and HR-HPV genotypes were HPVs 18, 26, 45, 51, 52, 67, 68B, 69, and 82. LR-HPV was found in 19/33 of patients and HR-HPV was in 14/33 of patients. The expression of p16INK4A in CA lesions was diffuse in15.2% of patients, was focal in 24.2% of patients , was sporadic in 39.4% of patients were, and was negative in 21.2% of patients . In LR-HPV group, there was no diffuse expression, focal expression was observed in 15.8%, sporadic in 47.4%, and negative in 36.8%, while in HR-HPV group, p16INK4A expression was detected in all lesions , in a way that its expression was diffuse in 35.7%, focal in 35.7%, and sporadic in 28.6%. Conclusion:IHC is a routine method in histopathological diagnosis, therefore the detection of p16INK4A expression by IHC can be used as a biomarker for HR-HPV infection diagnosis.

Clinical Pattern Of Sexually Transmitted Infections And Sexual Behavior In Patients With Genital Symptoms- A Cross Sectional Descriptive Study”

Background: Sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), continue to present major health, social, and economic problems in the developing world, leading to considerable morbidity, mortality, and stigma. Despite the availability of effective treatment and preventive measures, incidence of STIs is increasing even in developed countries. STIs, acting as a facilitator for the spread of HIV have become a globally important issue at present context. Objectives: To determine the pattern of sexually transmitted infections along with their sexual behaviour in patients presenting with genital symptoms. Material and Methods: A cross sectional, descriptive study was carried out in the department of Dermato-venereology, Medical College for Women & Hospital (MCW&H), Uttara, Dhaka, Bangladesh. During one year period, a total of 130 consecutive cases were enrolled in this study. The diagnosis of infections was made clinically with relevant laboratory investigations and they were interviewed for their sexual behaviour after taking consent and assuring confidentiality. Results: The average age of this population was 27.84 years. Majority belonged to age group 15-24 years, with male to female ratio of 3.19:1. Many (52.3%) were married. The most common infection was condyloma acuminate (29.2%). The mean age of sex debut was 18.95 years and majority (50.8%) belonged to 15-19 years group. The median number of life time partners was 2.0. Only 43 (33.1%) were on monogamous relationship. The 15-34 age groups had maximum number of sexual partners. Married person living singly had more frequent extramarital contact. Only 10 (7.7%) used condom consistently. Conclusions: Younger people should be educated about monogamous relationship along with correct and consistent use of condom for the prevention of STIs.

PREVENTION AND EARLY DETECTION OF CONDYLOMA ACUMINATA IN HUMAN IMMUNODEFICIENCY VIRUS/ACQUIRED IMMUNODEFICIENCY SYNDROME

Abstract Human Immunodeficiency Virus infection/Acquired Immunodeficiency Syndrome in Indonesia continues to increase. HIV is a sexually transmitted infection that is often accompanied by condyloma acuminata or genital warts. The incidence of condyloma acuminata in HIV/AIDS patients is reported to vary from 10 to 30% and is associated with low CD4+ levels or at an advanced stage of HIV/AIDS. Condyloma acuminata is caused by the Human Papilloma virus which can develop into malignancy. The purpose of this activity were to increase knowledge about the disease, risk factors, and efforts to prevent condyloma acuminata, as well as to conduct early detection of condyloma acuminate disease in HIV/AIDS patients. The service was carried out through direct education to HIV/AIDS patients who went to the VCT polyclinic at dr. H. Abdul Moeloek. Early detection was done by screening new cases of HIV/AIDS patients. This activity was held for three months and was attended by 112 participants. The results of the activity showed that education could increase the knowledge about the disease, risk factors, and efforts to prevent condyloma acuminata and found 14.3% of condyloma acuminata diseases in the screening program for early detection of disease. The continuity of education and screening program for condyloma

Clinical Appearance Of Tinea Corporis Resembles With Tinea Imbricata And Condyloma Acuminata Genital In A Reproductive Woman With HIV : A Case Report

Background: HIV (human immunodeficiency virus) is a virus that attacks the body’s immune system that can cause immunodeficiency. Immunodeficiency results in increased susceptibility to fungal infections. The other opportunistic infection, condyloma acuminate is prevalent in groups at high risk for HIV acquisition and in HIV-infected individuals. Case: There were ring-shaped reddish patches with scaly and itchy on the right back since 3 weeks ago. Patients often scratch it especially when sweating and hot weather. The itchy reddish patches with scaly were increased in number and size on the right back then spreading over the edge to form ring-like patches. Patient complained ring-shaped reddish patches getting more red, scaly, itchy, and wider. 6 months ago, there was a lump that sometime felt itchy in below part of vulva. Patient in reproductive age and not married yet, but sexually active. Patient had a sexual relation with male who HIV 2 years ago. Patient also suffered HIV and got ARV since 6 month ago. There was no protection (condom) during the sexual intercourse. Dermatologic state in right back with efflorescence is plaque erythema with annular concentric ring forms, scale, and blackish crust. Venereologycal state show vegetation in vulva with size 0,2 - 1,5 x 1 x 0,5 cm with verrucous surface. Acetowhite test is positive result. KOH 10% of skin scrapping show fungal element and fungal culture result is tricophyton rubrum. Patient was diagnosed tinea corporis (TC) and condyloma acuminata (CA) genital griseovulfin 900 mg, cetirizin 10 mg, ketokonazol 2% cream twice a day, tricholoroacetat 90% and showed good improvement.Discussion: Diagnosis tinea corporis and CA genital based on clinical findings and mycological examination. Early diagnosis and proper treatment are important in HIV patients in order to prevent severe infection. After 4 weeks treatment, show improvement on TC however CA lesion no reduced. Keywords: tinea corporis,condyloma acuminate, tinea imbricata, HIV, Reproductive age

Age- and Sex-Related Differences in Morbidities of Sexually Transmitted Diseases in Children

Sexually transmitted diseases (STDs) are causes of public health burden globally. The purpose of this study is to document age-specific and sex-related changes in the morbidity of four representative STDs in children. Japanese national surveillance data from 1999 to 2017 on morbidities of the following four STDs were analyzed by age and sex: Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), condylomata acuminate (CA), and genital herpes simplex virus (GHSV). The morbidities of males and females in each age group were compared through the male-to-female morbidity (MFM) ratios. The MFM ratios were not different from one in infants, less than one in children, and greater than one after puberty in all four STDs. The reversal of MFM ratio less than 1 to greater than 1 for NG infection was observed between 10–14 and 15–19 year of age, i.e., during the puberty, while that for GHSV infection was observed between 35–39 and 40–44 year of age, i.e., during adulthood. In conclusion, the morbidities of the four STDs were similar between the sexes in infants, and were higher in female children than in male children, while the morbidities in all four diseases were higher in men after puberty.

621 A novel painless ALA-PDT in the treatment of skin diseases

Pain during conventional photodynamic therapy (C-PDT) is the main limiting adverse effect in its use in dermatology. During the course of C-PDT, most patients experience sensations of burning and tingling pain that vary in intensity. In some cases, patients have to stop the treatment because of unbearable pain. It is generally believed that C-PDT pain is mediated by free radicals generated by PpIX; ROS can either stimulate nerve endings directly or mediate pain through inflammatory by-products. Pain remains the top obstacle that prevents C-PDT application to all patients. Here, we modified C-PDT into a painless PDT treatment (Modified photodynamic therapy , M-PDT, also named novel painless ALA-PDT) by decreasing ALA incubation time and increasing light dose. Our study showed that pain in M-PDT group was significantly reduced in the treatment of actinic keratosis, acne, and condyloma acuminate. Even, in some cases the pain almost vanished. And M-PDT has better efficacy than C-PDT. Further investigation confirmed that M-PDT also inhibit tumor growth on cutaneous squamous cell carcinoma (SCC). Interestingly, compared with C-PDT, M-PDT induced more ROS which should stimulate nerve endings but not. We elucidated a mechanism that the low average amount of ROS may be the reason why M-PDT is painless. Our findings indicate that M-PDT have wide clinical value in skin disease.

Application of 5‐aminolevulinic acid‐photodynamic therapy in common skin diseases

Abstract5‐Aminolevulinic acid‐photodynamic therapy (ALA‐PDT) is a relatively novel therapeutic technique that is used widely in dermatology. ALA can penetrate the stratum corneum into the skin and convert to the protoporphyrin IX (PpIX) to exert the photodynamic response. Due to its advantages of allowing repetitive application to multiple lesions, non‐trauma and excellent cosmetic results, ALA‐PDT is widely used for the treatment of actinic keratosis, moderate and severe acne, condyloma acuminate and other skin diseases showing a strong or promising effectiveness. However, pain is the main adverse reaction of ALA‐PDT. Daylight PDT (D‐PDT) and an optimized PDT may relieve the pain through the change of light source and therapeutic parameters. Both will be the tendency of the clinical application of ALA‐PDT.

MiR-34a-5p Inhibits Cell Proliferation, Migration and Invasion Through Targeting JAG1/Notch1 Pathway in HPV-Infected Human Epidermal Keratinocytes.

Condyloma acuminate (CA) is a communicable disease caused by human papillomavirus (HPV). This study aimed to study the targeting relationship between miR-34a-5p and Jagged 1 (JAG1), as well as its regulatory effect in HPV-infected cells. Human keratinocyte HaCaT cells were infected with HPV16E6, and CA tissues were collected. The expression level of miR-34a-5p and JAG1 were detected in CA tissues and HPV-HaCaT cells. Cell proliferation, migration and invasion were respectively measured using 3-(4, 5)-dimethylthiahiazo-(-z-y1)-3, 5-diphenytetrazoliumromide (MTT), cell wound healing and Transwell assay. The potential binding sites of miR-34a-5p and JAG1 were predicted by website TargetScan, and confirmed using dual luciferase reporter gene assay. The proteins of Notch1 pathway-related were assessed using western blotting. The results showed that miR-34a-5p expression was decreased, and JAG1 expression was increased in CA tissues and HPV-HaCaT cells. Cell proliferation, migration and invasion were decreased when miR-34a-5p over-expression and JAG1 knock-down in HPV-HaCaT cells. Furthermore, miR-34a-5p had a targeting effect on JAG1. The expression level of Notch1, NICD, Hes1 and Hey1 were increased when miR-34a-5p knock-down. miR-34a-5p could inhibit cell development, and regulate the activity of Notch1 pathway through targeting JAG1 expression in HPV-infected keratinocytes.

Genital Warts, Etiology, Signs, Treatment and Prevention

Genital warts, scientifically known as Condylomata acuminate, are the consequences of Human Papilloma Virus (HPV), probably one of the most occurring sexually transmitted infections. Human Papilloma Virus is non enveloped dsDNA virus and its predilection site are epithelium of genital organs. It belongs to the viral family Papoviridae, which replicates in the basal layer of genital epithelium

PLACE DE LA CHIRURGIE DANS LE TRAITEMENT DE LA TUMEUR DE BUSCHKE-LÖWENSTEIN : à propos d’un cas et revue de la littérature

Buschke Löwenstein tumor is a venereal disease characterized by its degenerative and recurrent risk.. Surgery remains the last therapeutic remedy, but it is the only treatment of voluminous forms. The objective of this study was to report a case of surgery without reconstruction for acuminate giant condyloma. Observation: this patient is 54 years old, without a history of pathology, addressed by dermatology for the management of a giant perineo-vulvarcondyloma. HIV serology was negative. Mass excision was performed followed by a simple suture without muscular-cutaneous interposition. The postoperative course was uneventfull with a discharge on Day6. After 1-year follow-up, there was no recurrence. Conclusion: result of giant condyloma acuminate surgery is suspended to a very probable loss of substance, making random a simple suture. Keywords: giant condyloma acuminate, excision, simple suture.

Effect of combined antiretroviral therapy on the prevalence of anal human papillomavirus infection in human immunodeficiency virus-infected men who have sex with men

Objective To investigate the effect of combined antiretroviral therapy (cART) on anal human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-infected men who sex with men (MSM). Methods HIV-infected MSM naive of cART who visited Wuhan Dermatological Hospital from June 2012 to December 2013 were enrolled in a longitudinal study before starting cART, including 81 HIV-positive and 50 HIV-negative cases. HPV infection situations between HIV-positive and HIV-negative MSM were compared. And anal HPV infection rate and condyloma acuminate incidence of HIV-positive MSM before and after cART were also compared. HPV genotyping was performed by universal primer PCR and reverse dot hybridization. The statistical analysis was done by t test or χ2 test. Results The prevalence rates of HPV infection, high-risk HPV infection and multiple HPV subtypes infection in HIV-positive MSM were all significantly higher than those in HIV-negative MSM (91.4% vs 62.0%, 75.3% vs 30.0%, 56.8% vs 20.0%, respectively, χ2=16.75, 26.05, and 19.10, respectively, all P<0.05). The prevalence rates of anal HPV infection, high-risk HPV infection and multiple HPV subtypes infection in 77 HIV-positive MSM at month 36 of cART were all significantly decreased than baseline (90.9% vs 74.0%, 75.3% vs 44.2% and 57.1% vs 41.5%, respectively, χ2=7.590, 15.551, and 3.741, respectively, all P<0.05). HPV16 and HPV43 infection rates were reduced from 27.3% at baseline to 15.6% and 13.0%, respectively at month 36 of cART (χ2=16.92 and 14.86, respectively, both P<0.05). Condyloma acuminate incidence also reduced from 16.9% at baseline to 5.2% at month 36 (χ2=4.069, P<0.05). Conclusions The prevalence of anal HPV infection in HIV-positive MSM is higher than HIV-negative MSM. cART could reduce the prevalence of anal HPV infection rate and condyloma acuminate incidence , especially high-risk HPV infection. Key words: Combined antiretroviral therapy; Human papillomavirus; Human immunodeficiency virus; Condyloma acuminatum; Infections

The Spontaneous Control of HIV Replication is Characterized by Decreased Pathological Changes in the Gut-associated Lymphoid Tissue.

Background: HIV infection induces alterations in the gut-associated lymphoid tissue (GALT) that constitutes the most important site for viral replication due to the extensive presence of effector memory T-cells. In the case of HIV-controllers, several studies have reported fewer peripheral alterations and conserved immune responses that correlate with viral control; however, the histopatho-logical characterization of GALT in those patients is still missing. In this study, we evaluated patho-logical alterations in GALT, trying to associate them with clinical parameters of HIV infected patients with or without evidence of viral control.Methods: This study included eight HIV-controllers (antiretroviral treatment-naïve patients, with viral loads below 2.000 copies/mL for at least 1 year); 14 Noncontrollers (antiretroviral treatment-naïve pa-tients, with viral loads > 2.000 copies/mL and CD4+ T cells count > 250 cells/µL), and 12 uninfected donors.Biopsy fragments were obtained by rectosigmoidoscopy and stained with hematoxylin and eosin, sil-ver methenamine, Ziehl Neelsen, and modified Ziehl Neelsen.Results: Histopathological findings in HIV-controllers were similar to those observed in the uninfect-ed group. In contrast, noncontrollers exhibited several alterations including condyloma acuminate, squamous metaplasia and acute colitis. These alterations were associated with disease progression.Conclusion: HIV-controllers exhibit lower pathological alterations in the gut tissue, associated with higher CD4 T cell count, and lower viral load.

A giant Condyloma Acuminata of Buschke and Lowenstein extending to the inguinal area and penis

Objective: Anogenital warts (condyloma acuminatum or veneral warts) are a common sexually transmitted disease among males and females. The causal role of human papilloma virus in anogenital wart formation has been firmly established. Case presentation: We report a case of a giant condyloma acuminata involving the penis, inguinoscrotal area and extending to the pubic region in a 30-year-old male patient. It was treated by wide surgical excision. Excision defect was extensive and required cover with fascio-cutaneous flap. The postoperative course of the patient was uneventful. Histological examination confirmed giant condyloma acuminata without evidence of malignancy. Conclusion: While there is no standard treatment for giant condyloma acuminate due to its biological behavior, surgical excision remains the method of choice to achieve local control of the disease. This case report confirms previous observation that extensive giant condyloma acuminate involving the penis or groin areas rarely become malignant compared to that involving the anorectal area of the body.

Condyloma acuminate. Current situation

Condyloma acuminate. Current situation