genital warts
Human papillomavirus types in anogenital warts of children.

Gibson PE, Gardner SD, Best SJ.

Virus Reference Laboratory, London, England.

Tissue from anogenital warts of 25 children, 10 of whom were suspected of being victims of sexual abuse, was investigated by dot blot and Southern blot techniques for human papillomavirus (HPV) types. HPV DNA was detected in 22 children, two of whom had double infections. The genital HPV types 6 and/or 11 were detected in 20 children, and in three children other HPV types were found. One had HPV 18 (as well as 11); in a second child a possible skin type, HPV 2, was detected; and the third child was infected with an unidentified type. In three cases genital wart material was available from one of the parents, and in all three the HPV type was the same as that of the child. For nine other children one or both parents were reported to have genital warts. The source of infection appeared to be the adult genital tract, but sexual contact might not be the only means of transmission.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2156007&dopt=Abstract genital wart


genital warts
Human papillomaviruses in anogenital warts in children: typing by in situ hybridisation.

Padel AF, Venning VA, Evans MF, Quantrill AM, Fleming KA.

Nuffield Department of Pathology, John Radcliffe Hospital, Oxford.

OBJECTIVE--To identify the types of human papillomaviruses found in anogenital warts in children and to relate these to clinical and social information. DESIGN--In situ hybridisation using biotin labelled DNA probes to 11 types of human papillomavirus was performed on biopsy specimens from 17 children with anogenital warts. SETTING--Nuffield department of pathology and the department of dermatology, Oxford. PATIENTS--Children in one group were referred by general practitioners or paediatricians to the dermatology department, where biopsies were performed. The other children were seen in four different hospitals, and biopsy specimens were submitted to the laboratory at the physician's or pathologist's request. RESULTS--Of the 17 biopsy specimens, 10 contained cells positive with a probe to a genital human papillomavirus type (types 6 or 11), while six were positive with a skin virus type (types 2 or 3). One was negative. The virus type present bore no relation to the site or appearance of the warts. The virus type did, however, appear to correlate with groups of children. Skin types were commoner in older children (over 4 years), in those with a relative who had skin warts, and in children with warts elsewhere; there was no relation with the child's sex and no suspicion of sexual abuse in these children. These circumstances suggested non-sexual transmission, such as autoinoculation. In contrast, genital types were commoner in girls, in children under 3 years, in children with relatives with genital warts, and in those with no warts elsewhere. Nevertheless, there was suspicion or evidence of sexual abuse in only half these children, suggesting that other routes of transmission--for example, perinatal--might have been implicated. CONCLUSION--Anogenital warts in children may contain either skin or genital wart virus type. Although the type of human papillomavirus present may give some indication of the likely mode of transmission, this can be interpreted only in conjunction with all available clinical and social information. The type of virus does not provide proof of the presence or absence of sexual transmission.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2164854&dopt=Abstract genital wart


genital warts
New patient-applied therapy for anogenital warts is rated favourably by patients.

O'Mahony C, Law C, Gollnick HP, Marini M.

Department of Genito-Urinary Medicine, The Countess of Chester Hospital, Countess of Chester Health Park, Liverpool Road, Chester CH2 1UL, UK. dr.o'mahony coch-tr.nwest.nhs.uk

Our objective was to determine patient attitudes to having genital warts, and their perceptions of their treatment with imiquimod and other therapies. As an adjunct to a clinical trial in which patients with external genital warts were treated with imiquimod 5% cream until their warts cleared or for up to 16 weeks, quantitative questionnaires consisting of multiple choice questions and 5-point rating scales were completed prior to, and at the end, of the study period. Pre-study and post-study questionnaires were completed by 902 and 629 patients, respectively. Patients expressed a definite concern about genital warts. The majority of patients (70%) had been previously treated for genital warts, and expressed dissatisfaction with their previous therapies. Of patients treated with imiquimod in this study, 82% reported that their warts decreased in size; this occurred within the first 4 weeks for 78% of patients. Sixty-one per cent of patients perceived that their warts completely cleared within the 16-week treatment period. Patients rated imiquimod 5% cream as better than other genital wart therapies in terms of overall satisfaction, time to clearance, convenience and lack of associated pain. In conclusion, patients rated imiquimod 5% cream as an effective treatment which clears warts in an acceptable length of time causing minimal pain and is convenient to use.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11516364&dopt=Abstract genital wart


genital warts
Combination of laser-therapy with 0.5% idoxuridine cream in the treatment of therapy-resistant genital warts in male patients: an open study.

Happonen HP, Lassus A, Santalahti J, Forsstrom S, Lassus J.

Out-Patient Department of Venereology, University Central Hospital, Helsinki, Finland.

Forty heterosexual male patients with therapy resistant penile warts of long duration (mean 12.9 months) were treated with carbon dioxide laser, immediately followed by topical application of 0.5% idoxuridine cream twice daily for 14 days. In case of incomplete or no response to the initial treatment, the treatment procedure was repeated once. All patients had previously been repeatedly treated with podophyllotoxin 0.5% solution and/or carbon dioxide laser surgery. After two weeks of treatment, 32 patients (80%) were completely healed. The remaining eight patients were retreated and four weeks after the start of the study 35 patients (87.5%) showed complete response. Three months after the study had been initiated 34 patients (85%) were still completely healed. No adverse reactions were observed. It was concluded that laser surgery followed by topical application of 0.5% idoxuridine cream for two to four weeks seems to be highly effective in the treatment of longstanding, therapy-resistant genital warts in men. Because of the uncontrolled nature of the present study and the relatively small number of patients treated, it would be important to carry out controlled studies in larger study populations and to carry out a follow-up examination of at least six months after treatment.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2174190&dopt=Abstract genital wart


genital warts
Anogenital warts in children. Clinical and virologic evaluation for sexual abuse.

Cohen BA, Honig P, Androphy E.

Department of Dermatology, University of Pittsburgh (Pa) School of Medicine.

Seventy-three children with anogenital warts were examined for sexual abuse during a 2-year period. Our data suggest that nonsexual transmission is common, particularly in children under 3 years of age. Approximately 25% of these children were younger than age 1 year, and another 50% were between the ages of 1 and 3 years. No evidence of sexual abuse was detected in 66 children.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2175163&dopt=Abstract genital wart