A five year study on differential diagnosis of verruciform penile lesions

Background: Verruccous lesions of the penis are difficult to classify. Materials and methods: The present study included 60 verruccous lesions of the penis in a period of 5 years, at Kakatiya Medical College, Warangal. Ours was a prospective study of 5 years duration. Results: In our study the age group ranges from 30 years to 80 years. Majority of the lesions were observed between 60-69 years age group. Warty lesions constituted 40 (66.7%), Cauliflower like growths constituted 14 (23.3%), and diffusely infiltrating constituted 6 (10%). Histopathological examination findings showed out of 60, 24 biopsies diagnosed as condyloma accuminata, 9 as simple verruccous hyperplasia, and remaining 27 are diagnosed as carcinomas out of which verruccous carcinoma were 12 followed by condylomatous carcinoma and papillary carcinomas each 6, squamous cell carcinomas were 3 in number. Conclusion: Each and every grossly visible verruccous lesions of the penis should be adequately biopsied for the early diagnosis of carcinoma.

Association of Immune Status with Recurrent Anal Condylomata in Human Immunodeficiency Virus-Positive Patients

PURPOSE: An anal condyloma is a proliferative disease of the genital epithelium caused by the human papillomavirus. This condition is most commonly seen in male homosexuals and is frequently recurrent. Some reports have suggested that immunosuppression is a risk factor for recurrence of a condyloma. Thus, we investigated the risk factors for a recurrent anal condyloma in human immunodeficiency virus (HIV)-positive patients. METHODS: We retrospectively analyzed 85 consecutive patients who were diagnosed with and underwent surgery for an anal condyloma from January 2007 to December 2011. Outcomes were analyzed based clinical and immunologic data. RESULTS: Recurrent anal condylomata were found in 25 patients (29.4%). Ten cases (40.0%) were within postoperative 3 months. At postoperative 6 months, the CD4 lymphocyte count in the recurrent group was lower than it was in the nonrecurrent group (P = 0.023). CONCLUSION: CD4-mediated immunosuppression is a risk factor for recurrent anal condylomata in HIV-positive patients.

Human Papillomavirus Infection in Anal Carcinoma, Anal Condylomata and Rectal

In order to examine the association of human papilloma virus(HPV) infection with anal carcinoma, the authors used polymerase chain reaction(PCR) and in situ hybridization technique to detect HPV DNA in formalin fixed, paraffin-embedded tissues from 46 anal carcinoma patients. At the same time, 28 condyloma accuminata specimens and 25 rectal adecarcinomas were examined for HPV DNA with in situ hybridization(ISH). By PCR analysis, using type specific primers and probes for HPV 6, 11, 16, 18 and 33, HPV type 16 DNA was demonstrated in 30(65.2%) of 46 anal carcinoma specimens, but HPV type 6, 11, 18 or HPV type 33 was not identified. HPV DNA Positivity was different according to the site of the anal carcinoma. In anal marginal squamous celt carcinoma, 3(27.3%) of 11 contained HPV DNA but 27(77.1%) of 35 anal canal carcinoma contained HPV DNA. Among the anal canal carcinomas, the cloacogenic carcinoma contained HPV DNA in 11(84.6%) of 13 and squamous cell carcinoma contained in 16(72.7%) of 22 specimens. Two of six local recurrences and three of nine lymph node metastases had HPV-16 DNA. When the anal carcinomas were analysed using ISH technique for HPV type 6, 11, 16, 18, the frequency of Positivity decreased to 4(11.4%) of 35 and stained only for HPV type 16/18. Among the 28 condyloma accuminata specimens, 24(85.7%) contained HPV DNA type 6/11 and only 2(7.1%) contained type 16/18 by ISH technique. In contrast to anal carcinoma, male was predominent in condyloma accuminata patient(82.1% of 28) and 6 patients were homosexual man. HPV DNA was not demonstrated in all the cases of rectal adenocarcinoma by ISH. We conclude that HPV infections are associated with the development of anal canal carcinoma but are not associated with adenocarcinoma of the rectum. In anal carcinomas, anal canal carcinoma is more closely associated with HPV infection than anal marginal carcinoma. Among the HPV types studied, type 16, 18 are more closely linked with malignant transformation.