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Background: Intralesional immunotherapy has been reported to be effective for warts and to show good safety profiles, but this has not yet been systematically studied. Aims: To determine the efficacy and safety of intralesional immunotherapy for treating non-genital warts. Methods: We comprehensively searched the MEDLINE, Embase, Web of Science and Cochrane Library databases from the times of their inception to January 3, 2020. The primary outcome was the rate of complete response of all lesions. The distant complete response rate of warts located in an anatomically different body part and the recurrence rate were also analyzed. Results: A total of 54 prospective studies was ultimately included. The immunotherapeutic agents used were Mycobacterium w vaccine, measles, mumps and rubella vaccine, purified protein derivative, Candida antigen, interferon, bacillus Calmette-Guérin vaccine and others. The pooled rate of complete response among all patients with non-genital warts treated using intralesional immunotherapy was 60.6% (95% confidence interval 54.8–66.5%). The pooled recurrence rate was 2.0% (95% confidence interval, 1.1–2.9%). All reported adverse events were mild and transient. Limitations: The heterogeneity among studies Conclusion: Intralesional immunotherapy is suggested for use in patients with multiple warts, given its promising results, good safety profile and low recurrence rate.
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Siddha system of medicine is the philosophy-based medicine that deals with holistic approach to health and soul basically it is a way of life that emphasizes positive mindfulness. The essential life style for healthy living has been instructed in Siddha system, according to the geographical and seasonal varieties. As per Siddha concept there is 32 internal and 32 external medicines. Thylam (medicated oil) was popularly used for various ailments us Mudi thylam, Kudi thylam, Pidi thylam, Thulai thylam, Silai thylam. Sirattai Thylam is prepared by Kuzhi thylam method (destructive distillation method). It can be used for Naatpatta thole noigal (chronic skin diseases), Sori (itches), Padar thaamarai (ring worm), Padaigal (eczema), Thole thadippu (thickening of skin), Useful in mosquito bite scars, sun tan, white heads, sensitive skin, fungal infections. This case study addresses the successful treatment “the wart" (It's a local outgrowth of the epidermal layer of the skin) using Sirattai Thylam.
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Resumen INTRODUCCIÓN: El tumor de Buschke-Löwenstein se asocia con el virus del papiloma humano por lo que se considera una infección de transmisión sexual. Se caracteriza por un condiloma gigante, verrugoso, exofítico, con forma de coliflor, de crecimiento lento, pero que durante el embarazo puede crecer rápidamente y formar condilomas solitarios que afectan las estructuras vecinas. CASO CLÍNICO: Paciente de 18 años, primigesta, con 35 semanas de embarazo, sin antecedentes de importancia para el padecimiento actual. Cuatro meses previos inició con verrugas en el perineo, con aumento acelerado de su tamaño en los últimos 30 días, asociado con dolor intenso a la movilización, secreción fétida, eritema e irritación interglútea y formación de un tumor friable con tendencia al sangrado y áreas de necrosis. CONCLUSIONES: El tumor de Buschke-Löwenstein es una alteración poco frecuente causada por el virus del papiloma humano, que puede tener crecimiento acelerado por el estímulo hormonal, propio del estado gestacional. El tratamiento de primera línea es la resección quirúrgica. El seguimiento de las pacientes debe ser estrecho, debido al alto índice de recidiva.
Abstract BACKGROUND: Buschke-Löwenstein tumor is associatted with the human papillomavirus (HPV), which is considered a sexually transmitted infection, characterized by the presence of a giant wart, exophytic condyloma with the shape of a cauliflower, slow growth, but during pregnancy it can grow fast as a solitary condyloma, affecting other structures. This case provides a better understanding of an unusual pathology, which with surgical treatment was obtained aesthetic results and with adequate functionality of external genitalia. CLINICAL CASE 18-year-old female, primiparous with 35 weeks pregnant, with no significant history, 4 previous months begins with the presence of warts in the perineal region with accelerated increase in size in the last 30 days, associated with intense pain on mobilization, fetid discharge, and area oferythema and intergluteal irritation, friable tumor with a tendency to bleed with areas of necrosis. CONCLUSIONS: The Buschke-Löwenstein tumor is a rare pathology caused by HPV, which can present accelerated growth due to the hormonal stimulus of the gestational state, this tumor does not resolve spontaneously, so the surgical approach is considered top of the line. The follow-up of these patients must be close due to the high rate of recurrence.
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Summary@#Despite a variety of therapeutic options that is available, treatment of warts remains challenging and rate of recurrence is high. Intralesional immunotherapy is an emerging therapy for warts. Tuberculin purified protein derivative (PPD) is one of the immunotherapeutic antigens used for the treatment of warts. Here we report a case of recalcitrant periungual wart successfully treated with tuberculin immunotherapy.
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Abstract: Epithelioma cuniculatum is characterized as a slow growing lesion on the sole of the foot. A diagnosis is usually delayed by a low clinical suspicion and misdirection due to its similarity to an infection. This tumor rarely metastasize but a local invasion of adjacent soft tissues is common, requiring ample surgical resection or even amputation in advanced cases. We report a case a 76-year-old patient with a 5-year-old lesion on the sole of the foot, which was originally treated as a wart without improvement while the lesion slowly evolved. The patient was referred to our center with a diagnosis of chronic osteomyelitis. An excisional biopsy revealed an invasive keratinizing squamous carcinoma. In this advanced phase of the disease the only possible treatment was a Syme amputation.
Resumen: El epitelioma cuniculatum se caracteriza por una lesión de crecimiento lento en la planta del pie cuyo diagnóstico suele retrasarse por la baja sospecha clínica y por su similitud con una infección. Este tumor raramente metastatiza, pero es común que produzca una invasión local a los tejidos blandos adyacentes, requiriendo una amplia resección quirúrgica o incluso una amputación en casos avanzados. Presentamos un caso de un paciente de 76 años con una lesión de 5 años de edad en la planta del pie, que originalmente fue tratada como una verruga plantar común sin mejoría, mientras que la lesión evolucionó lentamente. El paciente fue remitido a nuestro centro con un diagnóstico de osteomielitis crónica. Una biopsia excisional reveló un carcinoma escamoso queratinizante invasivo. En esta fase avanzada de la enfermedad el único tratamiento posible fue una amputación de Syme.
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To clarify the functions of Coix-seed Reactive Derivatives(CRD), we observed 2 cases of plantar wart (case 1. 8 years of age, female/ case 2. 26 years of age, female) successfully cured by intake of CRD for several months. Although CRD intake seemed to be effective in these cases, further studies are needed to define the optimal dose and duration.
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A verruga viral representa uma das dermatoses mais prevalentes. O quadro clínico varia de lesão única com cura espontânea até múltiplas lesões recalcitrantes. O sulfato de bleomicina é uma droga de ação citotóxica, aprovada para o tratamento quimioterápico de algumas malignidades. Há mais de 45 anos existem trabalhos demonstrando sua utilidade na dermatologia, em especial na terapia intralesional para verrugas virais, que constitui excelente opção para as lesões em topografias de difícil manejo e para os casos não responsivos a outras abordagens.
Viral warts are one of the most prevalent dermatoses. The clinical picture varies from a single lesion with spontaneous cure to multiple recalcitrant lesions. Bleomycin sulfate is a cytotoxic action drug approved for the chemotherapeutic treatment of some malignancies. There are a number of studies that have been carried out during the last 45 years demonstrating its usefulness in dermatology, especially in intralesional therapy for viral warts, meaning it is an excellent option for lesions in difficult-to-handle topographies and for cases that do not respond to other approaches.
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[Objective]To investigate the efficacy and safety of ALA-PDT following CO2laser preconditioning for recal-citrant plantar warts.[Methods]Patients with recalcitrant plantar warts were enrolled in this study,and received ALA-PDT treatment following CO2laser preconditioning. Cure rate and side effects were observed.[Results]Twenty patients were en-rolled and 85%(17/20)showed complete clearance of plantar warts after one to three times of ALA-PDT. PDT treatment time was once in two patients(10%),twice in five patients(25%)while three times in 10 patients(50%).No infection or scar tissue was observed.Five(25%)patients were infected with one type of HPV,while 15(75%)patients with two or mul-tiple types of HPV. No difference was observed in complete clearance rate between patients with single or multiple HPV gen-otypes infection.[Conclusions]Superpulse carbon dioxide laser pretreatment enhanced the efficacy of ALA-PDT treatment on recalcitrant plantar warts.Further study is needed to determine the association of HPV genotype with outcome of recalci-trant plantar warts.
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[Purpose]To summarize and discuss Professor WANG Yue's unique methods of using traditional Chinese medicine to treat HT.[Methed]In the process of diagnosing and treating HT with Prof.WANG in recent years, observing the method of seeking pathogenesis,treating with syndrome differentiation and selecting preferable medicine carefully, summarising Prof.WANG 's viewpoints about HT in the aspects of pathogenesis, treatment and medicine, to conclude Prof.Wang's some experience on HT. [Results]Prof. WANG treats HT from the liver and spleen. On the one hand, Prof. WANG distinguishes the etiology and pathogenesis ,on the other hand he observes the clinical manifestations.In the early stage,he smoothes and refreshes the liver or regulates the spleen with drugs,then nourishes and relaxes the liver or strengthens the spleen medicinally, together with the method of dissipating phlegm and removing blood stasis, tonifying qi and yin,embodying the law of pattern identification and treatment administration to treat the illness,which have made great effects.Modern pharmacology experiments have also confirmed the mechanism of some Chinese medicine in treating HT, providing further supports for the treatment of HT in Chinese medicine.[Conclusion] Prof. WANG treats HT from the liver and spleen and combines the actual and visual conditions together. He not only signifies the feature of traditional Chinese medicine,but also combines with modern pharmacology achievements about the Chinese medicine which has the effect of regulating immune.Prof. Wang follows the principle of integrating Chinese and western medicine,considerating both the illness itself and patients' symptoms to treat HT which is remarkable and worthy of promotion.
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Objective To investigate effect of BCG polyose nuclear acid combined with adapalene Gel in the treatment of flat wart.MethodsFrom January 2015 to May 2016, 100 flat wart patients were selected in our hospital, the patients were divided into observation group and control group, each group 50 cases, the control group was given Adapalene Gel therapy, the treatment group was treated with BCG polyose nuclear acid on the basis of control group, the therapeutic effect of the two groups were observed.ResultsThe total effective rate of the treatment group was 84.0%(42/50), and the control group was 60.0%(30/50)The treatment effect of observation group was significantly better than the control group (P< 0.05);The skin lesion score of observation group after treatment was (4.22±1.05) scores, which was significantly lower than that in the control group (P< 0.05);There was no significant difference in T lymphocyte subsets between the observation group and the control group;After treatment, the lgG and lgM in observationgroup were higher than before treatment (P< 0.05);The adverse reaction rates of the observation group and the control group were 14.0%(7/50) and 18.0%(9/50), the difference was not statistically significant.ConclusionThe therapeutic effect of BCG polyose nuclear acid combined with adapalene gel in the treatment of flat wart is better, it can improve the humoral immune function of patients, and it is safe and reliable.
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Introduction: Cryotherapy and salicylic acid ointment are the two most common treatments used for treating plantar warts. The aim of this study is to compare the clearance rate of plantar warts at 12 weeks between liquid nitrogen cryotherapy and 20% salicylic acid ointment. Methods: Patients with plantar warts were randomized into cryotherapy and 20% salicylic acid groups. Patients assigned into cryotherapy group received a maximum of four treatments given two weeks apart. Patients recruited into 20% salicylic acid group were instructed to apply the salicylic acid ointment onto the wart nightly and to cover the treated area with a hypoallergenic plaster. Both groups were also provided with a personal foot file to thin out the surrounding callus daily at home. Digital pictures were taken at first visit and 12 weeks after enrolment to assess the resolution of plantar wart. Results: Eighty patients with plantar warts were included. Thirty-nine patients were randomized into cryotherapy group and forty-one patients were randomized into 20% salicylic acid ointment group. Thirteen (33.3%) patients had a complete clearance of the warts with cryotherapy whereas eleven (26.8%) patients had a complete clearance of the warts with topical 20% salicylic acid ointment (p=0.526). Nine patients were lost to follow-up. With cryotherapy, two patients reported blister formation and one patient developed hyperpigmentation. No side effects were reported with 20% salicylic acid ointment. Conclusion: There is no difference in effectiveness between cryotherapy and 20% salicylic acid ointment in the treatment of plantar wart.
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Background: Warts are known to clear spontaneously with the development of cell-mediated immunity (CMI) to the virus. Purifi ed protein derivative (PPD) of tuberculin bacilli has been used as a non-specific stimulant of CMI to achieve this outcome. Aim: To study the effect of PPD in the treatment of warts. Methods: Patients with difficult-to-treat warts were selected for immunotherapy. Each patient received 2.5 TU of PPD intralesionally in a few warts. A total of four sessions were given at 2 weekly intervals and patients were followed up for 6 months after the last dose. Results: Sixty-one patients were recruited of which 55 completed 6 months follow up and were available for analysis. Of these, 25 had verruca vulgaris, 18 had verruca plana and 12 had plantar warts. Forty two (76%) patients showed complete clearance after four sessions while the remaining 13 (24%) patients were non-responders. One patient developed a recurrence after total clearance during the follow-up period. Adverse effects were erythema, edema and pain at the site of injections. Limitations: As this was an uncontrolled trial, there is no comparison with a non-intervention group. Also, a Mantoux test was not done due to practical difficulties. Conclusion: Immunotherapy with PPD is helpful in the treatment of cutaneous warts.
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Quince familias de papa (824 genotipos) provenientes de cruzas inter-específicas entre especies de Solanum stenotomum, S. goniocalyx y S. phureja fueron genotipadas, con el objetivo de asociar seis marcadores moleculares (GP94, HC, Nl25, Gro 1-4, RYSC3 y CP60) con genes mayores de resistencia para tizón tardío (Phytophthora infestans), verruga (Synchytrium endobioticum), nematodo - quiste (Globodera pallida y G. rostochiensis) y virus PVY y PVX. Los resultados mostraron que cinco de los marcadores aplicados fueron polimórficos y amplificaron en más del 80% de las familias. El marcador RYSC3 que co-localiza con el gen Ry adg no amplificó en ninguna de las familias evaluadas. La familia 8 amplificó la banda para tres marcadores (CP60, GP94 y NL25) en la totalidad de sus clones. La prueba de χ² se utilizó para determinar el ajuste de las proporciones de segregación de cada familia para cada marcador y genotipar los progenitores. Nueve caracteres agronómicos y morfológicos fueron evaluados en la cosecha. Mediante agrupamiento cluster fueron seleccionados 107 clones con resistencia a PVX, P. infestans, G. rostochiensis y S. endobioticum, alto rendimiento y volumen de tubérculos, elevado número de tubérculos y ojos superficiales. Sobre la base de estos resultados, aspectos prácticos para la aplicación eficiente de la selección asistida por marcadores moleculares son discutidos en este artículo.
Fefteen families of potato (824 genotypes) originated from inter-specific crosses among Solanum stenotomum, S. goniocalyx and S. phureja were genotyped in order to associate six molecular markers (GP94, HC, Nl25, Gro 1-4, RYSC3 y CP60). These molecular markers are linked to major genes for resistance to late blight (Phytophthora infestans), wart (Synchytrium endobioticum), root cyst nematode (Globodera pallida and G. rostochiensis) and viruses PVY and PVX. Results showed that five of six molecular markers were polymorphic and primers amplified in more than 80 % of the families. Molecular marker RYSC3 that is linked to Rya dg gene did not amplify in any family. All individuals in Family 8 scored positive for three markers (CP60, GP94, and NL25). χ² test was used to determine the significance of the segregation ratios of each marker in every single family; so to the possible genotype of its parents was inferred. Nine morphological and agronomical characters were assessed during the harvest. Cluster analysis classified and selected 107 genotypes by putative resistance to PVX, P. infestans, G. rostochiensis and S. endobioticum, high yield, tuber volume and tuber number and shallow eyes. According to our results, practical aspects of efficient use of marker assisted selection in potato are discussed in this paper.
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Abstract: Malignant melanoma is a rare malignancy of the external auditory canal. The vast majority of them occur in the areas of the body that are exposed to the sun. Early histological examination may possibly favor better prognosis. We report a case of a 38-year-old female who presented with a small mass in right ear canal, earache and minimum discharge since 4 months. Initially scraping was done in the ENT clinic. Subsequently she had a wide excision done by the end aural approach at a different hospital. A year later the patient presented with a swelling involving the ear canal which extended to the helix and supratemporal region with the histology report as malignant melanoma. A literature review of the disease, radiological findings, immunohistochemical features and treatment options are discussed.
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MelanomaABSTRACT
A 81-year-old female presented with a giant cutaneous horn (1.5×2×4 cm sized) over the right hand, rapid growth recent 6 months. Cutaneous horn was excised and split thickness skin graft of the defect was done under regional anesthesia. Histopathology showed overlying a wart. In the current study, we report the case of a patient with giant wart as a giant cutaneous horn in a dorsal side of hand.
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Aged, 80 and over , Animals , Female , Humans , Anesthesia, Conduction , Hand , Horns , Skin , Transplants , WartsABSTRACT
BACKGROUND: Although several traditional treatments have been applied for recalcitrant viral warts, these treatments have rarely resulted in complete recovery. To treat the recalcitrant viral wart, alternative therapies are required. OBJECTIVE: This study aimed to evaluate the efficacy and safety of quadrivalent HPV vaccine for recalcitrant wart treatment. METHODS: From 2012 to 2014, 17 patients who provided informed consent were enrolled. All patients received 3 doses of quadrivalent HPV vaccine at 0, 2, and 6 months, respectively. During clinic visits, doctors checked the grade of improvement, patient satisfaction, and treatment side effects. After completion of the 3 doses, the patients were followed up for 5 months with outpatient visits and telephone inquiries. RESULTS: After the third dose, 58.8% of patients showed complete remission and 41.2% showed no response after 5 months. There were no statistically significant differences in sex, age, disease duration, number, anatomic site, and previous treatment between the complete remission group and the no-response group. An adverse effect (syncope) was observed in one patient. CONCLUSION: Compared with traditional aggressive therapies, quadrivalent HPV vaccine is a simple method and does not usually interfere with the patient's work or social life. Quadrivalent HPV vaccine is an effective and safe alternative treatment for recalcitrant warts.
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Humans , Ambulatory Care , Clinical Study , Complementary Therapies , Informed Consent , Methods , Outpatients , Papillomaviridae , Patient Satisfaction , Telephone , WartsABSTRACT
No abstract available.
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Condylomata Acuminata , Dermoscopy , Diagnosis, Differential , Lymphangioma , VulvaABSTRACT
Objective To investigate the safety and efficacy of CO2 fractional laser combined with 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (ALA-PDT) for the treatment of refractory flat wart.Methods The 80 patients with facial flat wart were randomly divided into observation group (40 cases) and control group (40 cases).The observation group was treated with CO2 fractional laser combined with 5-ALA-PDT,and the control group was treated with 5-ALA-PDT only.Those with residual lesions after the first treatment were treated with the second or third times.The interval duration between treatments was 2 weeks.The efficacy and the adverse reaction were evaluated after the 2-week,4-week and 6-month after the last treatment.Results Compared with prior treatment,the facial lesions achieved complete response and improvement.The total effective rate of the observation group were 90.0％ (36/40) and 72.5％ (29/40) for the control group,the difference was statistically significant (P＜0.05).There were 2 cases of pigmentation occurred in observation group and 3 cases in control group.The complications including infection and hypertrophic scar were seldom occurred in the two groups.Conclusions The safety and efficacy of CO2 fractional laser combined with ALA-PDT are better than that with ALA-PDT only in the treatment of refractory flat wart.
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La infección por el Virus del Papiloma Humano es una afección altamente prevalente a nivel mundial y una de sus consecuencias es la verruga genital externa o condiloma genital. El tratamiento de estas lesiones ha sido tradicionalmente difícil, debido a la alta recurrencia de las lesiones. Se revisan los aspectos más novedosos del tratamiento de las verrugas genitales. Las sinecatequinas y una nueva formulación de Imiquimod al 3,75% resaltan como las terapéuticas más novedosas, mientras que la terapia fotodinámica carece de evidencia científica adecuada como para recomendar su uso rutinario. Las vacunas profilácticas y terapéuticas parecen poseer un gran potencial pero aún se encuentran en fases iniciales de investigación. Es deseable estudios con un mayor número de pacientes y un seguimiento más prolongado, que permita una comparación directa de la efectividad entre las diferentes técnicas terapéuticas a corto y largo plazo.
Human Papillomavirus infection is a highly prevalent condition worldwide whose frequent consequence is the external genital wart or genital condyloma. The treatment for this condition has been traditionally difficult due to the recurrence of the lesions. The most innovative aspects of the treatment of genital wart, are reviewed. The sinecatechins and a new formulation of Imiquimod 3.75% stand out as the most innovative therapeutic, while photodynamic therapy lacks adequate scientific evidence to recommend its routine use. The prophylactic and therapeutic vaccines seem to have great potential but are still in early stages of research. Studies should be conducted with larger patient samples and longer follow-ups to allow comparison of the effectiveness among the different therapeutic techniques in the short and long term.