Warts In Males Research Articles

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.

Comparison of different human papillomavirus (HPV) vaccine types and dose schedules for prevention of HPV-related disease in females and males.

Comparison of different human papillomavirus (HPV) vaccine types and dose schedules for prevention of HPV-related disease in females and males.

Self-reported genital warts among sexually-active university students: a cross-sectional study

BackgroundGenital warts are one of the most common forms of sexually-transmitted disease, but their epidemiology has yet to be thoroughly elucidated. The present study was designed to shed light on the prevalence of clinically-confirmed, self-reported genital warts (GWs) in a representative sample of the university population.MethodsIn 2015, a cross-sectional survey was conducted on 11,096 individuals approached at the Students Information Bureau where they came to enroll for a university degree course. Participants completed an anonymous, self-administered questionnaire providing information on their sociodemographic characteristics, sexual behavior, and any history of clinically-diagnosed genital warts. Multivariate logistic regression was then used to identify any factors associated with the disease.ResultsOur analysis was conducted on 9259 questionnaires (83.4%). Participants were a mean 21.8 ± 4.8 years of age, and 59.6% were female. Overall, 124 individuals (1.3%, 95%CI: 1.0–1.6) reported having been diagnosed with genital warts: 48 men (1.3%, 95%CI: 0.9–1.6), and 76 women (1.4% 95%CI: 1.1–1.7). Overall, 22.5% of the sample were vaccinated (1.3% of the males and 36.8% of the females). The group of respondents aged 30 years or more had the highest incidence of genital warts (males: 5.6%, 95%CI: 2.5–8.6; females: 6.9%, 95%CI: 3.4–10.4). The independent risk factors associated with a history of disease were (for both genders) a history of other sexually-transmitted diseases, and ≥2 sex partners in the previous 24 months. A protective role emerged for routine condom use. Additional risk factors associated with genital warts in males concerned men who have sex with men, bisexuality vis-à-vis heterosexuality, and smoking.ConclusionsThe findings emerging from our study help to further clarify the epidemiology of genital warts in young people, and may be useful to public health decision-makers. This study showed that genital warts occur in men as well as women, and suggests that both genders should be monitored for this disease to ascertain the effects of the free HPV vaccination offered to all girls in the Veneto in their 12th year of life since 2008, and to all boys of the same age since 2015.

Human Papillomavirus (Cervical Cancer) Vaccine Update

• There has been a paradigm shift in cervical cancer prevention strategies since the availability of the first cervical cancer vaccine, Gardasil.

A study on the predictors of Korean male students' intention to receive human papillomavirus vaccination.

The objective was to survey the current state of human papillomavirus (HPV) vaccination and the predictors of vaccination intention among Korean male students of high school (ages 15-19) and university (ages 17-27). Human papillomavirus is a sexually transmitted infectious agent causing uterine cervical, anal, and/or penile cancer and genital warts in males and females. Infection rate of human papillomavirus increases from the age when sexual intercourse first occurs. Therefore, motivation to receive human papillomavirus vaccination is needed to protect infection. Cross-sectional descriptive survey was performed only in male students. They are less aware of human papillomavirus than females, because human papillomavirus vaccination has been targeted on females for preventing cervical cancer in Korea. Data were collected using a self-reporting questionnaire for male high school and university students sampled from a city in Korea. Human papillomavirus vaccine-related knowledge, health beliefs, demographic, and sexual history information variables relating to intentions to vaccinate were assessed. The human papillomavirus vaccination rate was very low and the levels of knowledge and health beliefs were low. The significant predictors that raised the intention of human papillomavirus vaccination were a university student, experience of sexual intercourse and perceiving the benefits of human papillomavirus vaccination. To promote human papillomavirus vaccination, educational programming targeting males should include health beliefs and knowledge, emphasising that vaccination is important to prevent uterine cervical cancer and to role as a preventative measure against common male diseases. Male high school students should be included as a major target population for school human papillomavirus education programmes, as they are at the age of commencing sexual intercourse. In addition, public health policies including human papillomavirus vaccination in the national immunisation programme are warranted.

Recommended Managements for the Male Human Papillomavirus Infection

Genital human papillomavirus (HPV) is a common, usually transient, dermatologic infection transmitted by genital contact which can cause a variety of anogenital diseases, including warts (condyloma), dysplasia (cervical, vaginal, vulvar, anal), and squamous cell carcinoma. A number of treatment modalities are available for treatment of anogenital warts, both patientand provider-applied. Genital warts are benign and resolve spontaneously in some patients, and removal of lesions does not guarantee elimination of all organisms or confer protection from recurrence. Treatment consists of diverse drug application locally and surgical therapy. Urethral warts are an uncommon presentation of HPV and could be treated by endoscopic surgery accompanied by intraurethral instillation of medications. Bivalent and quadrivalent vaccines are approved for prevention of HPV infection. Both are indicated for prevention of cervical cancer, while the quadrivalent vaccine is also approved for prevention of vaginal/vulvar cancers as well as genital warts in males and females.

Parental beliefs and knowledge about male human papillomavirus vaccination in the US: a survey of a pediatric clinic population

The purpose of this study is to examine US parental knowledge of human papillomavirus (HPV) in males, views on vaccination, and correlation to vaccination rates. The survey was conducted of clinic population about parental knowledge and beliefs of male HPV health outcomes and vaccination. There were a total of 102 participants who completed the survey. Perceived parental knowledge about the virus was reported as "a lot" by 11%, "some" by 50%, and "very little/nothing" by 38% of the participants. However, knowledge of HPV was moderate, with only 14% of the respondents answering all knowledge questions correctly; 64% of the respondents correctly identified HPV as a cause of genital warts in males, 43% identified at least one HPV-related cancer, and 30% were unable to identify any health outcomes in males. There was a statistically significant correlation between perceived and actual knowledge, with >15% of the survey respondents correctly identifying that HPV does not clear up on its own (p=0.004). Of the participants who did not vaccinate, reasons included the following: 54% fulfilled the child's wish not to be vaccinated, 38% reported belief vaccine is unsafe, and 38% indicated that their children are too young and/or expressed fear that the vaccine would negatively affect behavior. This study supports the fact that parental beliefs and attitudes are more important than actual knowledge about HPV or HPV vaccination. The implication to physicians is to tailor discussions to address fears about the dangers or complications, emphasize the safety of the vaccine, and address sources of misinformation.

Human Papillomavirus in Men

HPV 6 and 11 cause greater than 90% of genital warts in males and females. Data show that approximately 3–4 million cases of genital warts in men occur each year with a peak rate of 500 per 100,000 in the 25–29 year old group. (1) The majority of these genital warts are diagnosed in men under the age of 30 years. In addition to genital warts, men are at risk for several HPV-related morbidities including penile, anal and oral cancers.

An overview of human papillomavirus infection for the dermatologist: disease, diagnosis, management, and prevention

Genital human papillomavirus (HPV) is a common, usually transient, dermatologic infection transmitted by genital contact that can cause a variety of anogenital diseases, including warts (condyloma), dysplasia (cervical, vaginal, vulvar, anal), and squamous cell carcinoma. A number of treatment modalities are available to treat anogenital warts, both patient- and provider-applied. Treatment is efficacious, but lesions can recur. Bivalent and quadrivalent vaccines are approved to prevent HPV infection. Both are indicated to prevent cervical cancer, while the quadrivalent vaccine is also approved to prevent vaginal/vulvar cancers as well as genital warts in males and females. Providers should clearly explain the natural history and potential sequelae of HPV disease, counsel patients on prevention strategies, and recommend vaccination as an effective method of prevention to their patients.

Comparison of cryotherapy to imiquimod 5% in the treatment of anogenital warts

The aim of this study was to compare the efficacy of crotherapy versus imiquimod 5% in the treatment of anogenital warts. Eighty HIV-negative males were included in the analysis; 35 of them were treated with imiquimod 5% three times a week for 6-10 hours and 45 of them with cryotherapy once in three weeks. Follow-up appointments were arranged every month for the first three months and then at six and 12 months, or in between whenever the patients noticed any signs of recurrence. Treatment for both groups was continued for a total of 12 weeks or until the warts cleared. At the end of three months, irrespective of the type of treatment, 78.8% of the patients demonstrated 100% improvement. Cryotherapy was more effective, as 86.7% of patients showed 100% improvement compared with 68.6% of patients in the imiquimod group. On the contrary, 17.1% of the imiquimod group did not show any signs of improvement, compared with 2.2% of the cryotherapy group (P = 0.017). However, patients treated with imiquimod tended to improve earlier than patients on cryotherapy (P = 0.012). No statistically significant difference was observed regarding the recurrence rate between the two groups (P = 0.138). Treatment with imiquimod was less painful than cryotherapy (P = 0.034). Cryotherapy was more effective than imiquimod 5% for the treatment of anogenital warts in males but was more inconvenient.

Treatment of genital warts in males by pulsed dye laser

Objective: To determine the safety and efficacy of the flashlamp‐pumped pulsed dye laser for the treatment of uncomplicated genital warts in adult males. Methods: This was a prospective observational study set in the outpatient clinics of the Department of Andrology and Sexually Transmitted Diseases, National Institute of Laser Enhanced Sciences, the Dermatology Clinic, Cairo University, and the Department of Dermatology and Venereology, Suez Canal University. A total of 174 adult male patients with 550 uncomplicated anogenital warts were included. Selective photothermolysis and photocoagulation of the lesions with the flashlamp‐pumped pulsed dye laser was carried out. A pulsed dye laser (wavelength 585 nm, 450 s pulse duration; Cynosure, USA) was used with the following settings: spot size 5–7 mm; fluence 9–10 J/cm2. Results: Complete resolution of treated warts was achieved in 96% of lesions. Side effects were limited, transient and infrequent. Lesion recurrence rate was 5%. Conclusion: The pulsed dye laser has been found to be safe, effective and satisfactory for the treatment of anogenital warts in males. It could be used to selectively destroy warts without damaging the surrounding skin.

Treatment of External Genital Warts in Men with Imiquimod 2% in Cream. A Placebo-controlled, Double-blind Study

Objective: The purpose of this double-blind, placebo-controlled study was to evaluate the safety, clinical efficacy and tole-rability of imiquimod (2%) in cream to cure external genital warts in males.Methods: Preselected male patients (n=60) ranging between 18 and 50 years of age (mean 24.2) harbouring 558 lesions (mean 9.3) with clinical, histopathological and polymerase chain reaction (PCR) confirmed diagnosis of human papilloma virus (HPV) infection were randomized to two parallel groups. Each patient was allocated a precoded 25g tube, and instructions on how to apply the trial medication to their lesions at home once daily for three consecutive days per week (max. 12 application in 4 weeks). To evaluate the safety, clinical efficacy and tolerance, patients were exa-mined on a weekly basis. Cure was defined as the total elimination of treated warts with PCR, and Southern blot hybridization confirmed negative HPV DNA.Results: By the end of the treatment, 40% (24/60) patients and 49.8% (278/558) warts were cured. Breaking the code revealed that imiquimod cream had cured 70% (21/30) patients and 86.8% of warts, while placebo healed three subjects and 28 warts (P=0.0001). Eleven patients (18.3%), predominantly in the imiquimod cream group, experienced mild to moderate, non-objective, drug-related side effects with no dropouts. The study was followed up for 18 months from the first day of the treatment, and among the 26 cured patients, one in the imiquimod cream group and two in the placebo had a relapse after 14 months.Conclusion: The study demonstrated that 2% imiquimod in cream with mild non-objective side effects is safe, tolerable and significantly more effective than placebo in curing external genital warts in males.

Editorial

Journal of the European Academy of Dermatology and VenereologyVolume 3, Issue 2 p. 196-197 Free Access Editorial Raymond D. Maw, Raymond D. Maw Consultant Physician, Department of Genitourinary Medicine, The Royal Victoria Hospital, Belfast, Northern IrelandSearch for more papers by this author Raymond D. Maw, Raymond D. Maw Consultant Physician, Department of Genitourinary Medicine, The Royal Victoria Hospital, Belfast, Northern IrelandSearch for more papers by this author First published: March 1994 https://doi.org/10.1111/j.1468-3083.1994.tb00098.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1 Von Krogh G. Genitoanal papillomavirus infection: diagnostic and therapeutical objectives in the Light of current epidemiological observations. Int J STD AIDS 2: 391– 404. 2 Oriel JD. Genitoanal papillomavirus infection: a diagnostic and therapeutic dilemma. Semin Dermatol 1990; 141– 147. 3 Reid R. Treatment of HPV-associated disease. Papilloma Virus Report 1992; 3(5): 133– 139. 4 Handley JM, Maw RD, Horner T, Lawther H, Dinsmore WW. Self treatment of primary anogenital warts in males with Podophyllin 0.5 in Ethanol vs Podophyllotoxin 0.5%: a randomised double blind comparative study. Venereology 1991: 4(3): 84– 87. 5 Williams NR. Absence from work due to treatment for genital warts. J Soc Occup Med 1994: 41: 117– 118. Volume3, Issue2March 1994Pages 196-197 ReferencesRelatedInformation

Topical idoxuridine for treatment of genital warts in males. A double-blind comparative study of 0.25% and 0.5% cream.

Fifty heterosexual male patients with histologically verified genital warts of short duration (less than 3 months) were randomly allocated to treatment with either 0.25% or 0.5% idoxuridine cream. The application of the cream to the warts was performed twice daily for an initial period of 14 days, whereafter patients with partial improvement or no response were retreated in the same way for another period of 14 days. Patients not completely healed after 28 days were regarded as treatment failures and withdrawn from the study. After the initial treatment period of 14 days, 19 of 25 patients (76%) treated with 0.5% idoxuridine cream, and 9 of 25 patients (36%) treated with 0.25% idoxuridine cream were completely healed. This difference is significant (p less than 0.01). The corresponding figures at the second follow-up examination (28 days after start of the study) were 19 of 25 (76%) and 13 of 25 (52%), respectively. At the last follow-up examination three months after start of treatment, four patients treated with 0.5% idoxuridine cream and five patients treated with 0.25% idoxuridine cream had a relapse. Thus, the overall rate of complete healing was 15 of 25 (60%) for the patients treated with 0.5% idoxuridine cream and 8 of 25 (32%) for those treated with 0.25% idoxuridine cream. The difference is significant (p less than 0.01). No adverse reactions were observed or reported by the patients.