genital warts
[Preliminary report of podophyllotoxin in the treatment of genital warts in China]

[Article in Chinese]

Wang H.

PUMC Hospital, Beijing.

Sixty-five patients with various types of genital warts were treated with 0.5% podophyllotoxin ethanol solution provided by Conpharm AB Sweden including 49 male and 16 female patients. The patients were treated topically bid, for 3 days as one treatment. If the desired effect was not achieved following one treatment, it was repeated in weekly intervals for no more than 3 treatments. Cumulative cure rates of 73.85%, 80% and 81.54% were obtained with podophyllotoxin treatment after the 1st, 2nd and 3rd treatments respectively. The genital warts cured by podophyllotoxin relapsed after one month at a rate of 14.9%. None of the patients treated with podophyllotoxin showed any systemic side effects, but mild local superficial erosions and slight pain appeared in most of the patients on the 3rd day of therapy. It is our opinion that external use of 0.5% podophyllotoxin for treating genital warts should be the method of choice for its high cure rate, time saving, safety and convenience.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1831715&dopt=Abstract genital wart


genital warts
Human papillomavirus segregation patterns in genital and nongenital warts in prepubertal children and adults.

Nuovo GJ, Lastarria DA, Smith S, Lerner J, Comite SL, Eliezri YD.

Department of Pathology, Columbia Presbyterian Medical Center, New York, New York.

This study compared the segregation patterns of human papillomavirus (HPV) in genital and nongenital warts in prepubertal children and adults. HPV 2 was detected in most nongenital warts in children and adults, whereas neither HPV 6 or 11 was detected at nongenital sites in either group with the use of in situ or Southern blot hybridization analyses. Of nine genital tract lesions in children. HPV 2 was detected in two and HPV 6 or 11 in six. More than 90% of cases of regional tract condylomata in adults contained HPV 6 or 11. HPV 2 was not detected in any of 99 genital tract lesions in adults. It is concluded that HPV 6/11 cannot proliferate at nongenital cutaneous sites and HPV 2 can proliferate in the genital tract of children but not adults. Thus, the detection of HPV 6 or 11 in a genital wart in a child implies, assuming cutaneous transmission, infection from a genital site, whereas the detection of HPV 2 presumes nongenital transmission.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1849698&dopt=Abstract genital wart


genital warts
Correlation of HPV antigen and type of genital warts with atypia.

Kumar B, Gupta R, Sehgal S.

Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Five clinical types of genital warts were identified, studied histopathologically and stained for human papilloma virus (HPV) antigen. HPV antigen was found in all degrees of koilocytosis and it was present more often in the hyperplastic warts than in other types of genital warts. However, as reported earlier, the presence of HPV antigen did not decrease proportionately as the degree of atypia increased.

PIP: No correlation was found between the clinical type, histopathology, and immunohistological characteristics of human papilloma virus (HPV)-induced warts in 50 patients. Represented in this sample were the 5 clinical wart types: 1) hyperplastic or classical, 2) sessile, 3) verruca vulgaris-like, 4) pigmented papules, and 5) giant condylomata acuminata. Stained biopsy sections were screened for HPV antigen using immunohistochemical methods, and histopathological sections were specifically tested for koilocytosis and dysplasia. The degrees of hyperkeratosis was found to vary from high in hyperplastic type genital warts to low in sessile type warts. Also observed was an inverse association between koilocytosis and atypia. There was no association between the extent of koilocytosis and percentage positivity for HPV antigens. Papilloma virus was detected most frequently in the classical type of hyperplastic warts (19/23 cases), followed by sessile warts (6/13), and finally by warts of the verruca vulgaris type (1/3 cases). Viral antigens were found in 53% of specimens with no atypia, 83% of specimens showing type 1 changes, 38% with type 2 atypia, and in 40% of specimens with type 3 atypia. These findings diverge from earlier reports of a proportionate decrease in the presence of HPV antigen with increases in the degree of atypia.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1851721&dopt=Abstract genital wart


genital warts
Cryotherapy in the management of histologically diagnosed subclinical human papilloma virus (HPV) infection of the cervix.

Mohanty KC, Lowe JW.

St Luke's Hospital, Bradford.

The aim of the study was to establish the efficacy of cryotherapy in the management of histologically diagnosed subclinical human papilloma virus (HPV) infection of the cervix. Women with genital warts who had subclinical HPV infection of the cervix and no other sexually transmitted diseases were followed up at six weeks, 12 weeks, six months, 12 months and 18 months after treatment with cryotherapy. They came to the out-patient department of genito-urinary medicine (GUM) at St Luke's Hospital, an open clinic without any appointment system. Two hundred and fifty-five patients with genital warts took part in the study. They underwent clinical genital examination, along with cytology, colposcopy and colposcopically directed cervical punch biopsies. Sixty-three of them had subclinical HPV infection of the cervix only, and were considered suitable for cryosurgery. Twelve weeks after treatment only one patient developed clinical warts on the cervix, which increased to three patients (4.8%) after 12 months. No further patients developed any clinical cervical warts. In the untreated group development of clinical warts was noticed in five patients (20%) after 18 months. The difference was significant. The failure rate for the histologically diagnosed subclinical HPV infection was 38% in the treated group, whereas it persisted in 76% of the untreated group. Cryotherapy was found to be successful in the treatment of subclinical HPV infection and prevented the development of clinical disease. There were no serious side-effects and the treatment can be administered easily in an out-patient setting after histological confirmation.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1966312&dopt=Abstract genital wart


genital warts
The patient with refractory genital warts in the STD-clinic. Treatment failure with CO2-laser.

Larsen J, Petersen CS.

Department of Dermato-venereology, Bispebjerg Hospital, Copenhagen.

Sixty two patients with refractory genital warts attending a VD-clinic were treated with CO2-laser. Residual warts or new wart formation was observed in 45 of them (72%), two weeks after operation, resulting in an immediate cure rate of 27%. The cure rate obtained was independent of location, duration, and previous treatment of warts. Reoperation with CO2-laser was performed in 12 patients, and all had remaining lesions two weeks after operation. It is concluded that a single CO2-laser treatment often is an insufficient procedure for eradication of disseminated refractory genital warts.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2111758&dopt=Abstract genital wart