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We herein present the case of a patient with anal condylomatosis concomitant with histoplasmosis, whose diagnosis was only possible through the collection of material and the subsequent evidence of a primary pulmonary focus. Histoplasmosis is a fungal disease whose contamination occurs through the respiratory route, and it can spread to the digestive tract, but the anus is rarely affected. It is important to have a high degree of suspicion to make the diagnosis, especially in immunosuppressed patients.
Subject(s)
Humans , Male , Adult , Histoplasmosis/diagnosis , Anal Canal/injuries , Histoplasmosis/etiology , Histoplasmosis/therapyABSTRACT
@#Abstract: Objective The purpose of this study is to find out the epidemiological and clinical characteristics of male patients with condyloma acuminatum (CA) in Liaocheng area, as well as to improve the understanding of human papillomavirus (HPV) infection and put forward targeted prevention and treatment measures. Methods The clinical data of 159 male CA patients who admitted to Liaocheng People's Hospital from January 2021 to January 2022 were collected, and the epidemiological characteristics, clinical manifestations, infection sites, HPV gene subtypes and other information were analyzed retrospectively. Results Most of the 159 CA patients (range from 15 to 77 years old) were 31-40 years old (31.45%, 50/159), more than half of them had smoking history, and more than 60% had low income (<5 000 yuan/month), multiple sexual partners (≥2) and no condom use habit, 70.44% of the patients had prepuce long combined with prepuce balanitis. 91 cases (57.23%) were single infection, 102 cases (64.15%) were simple low-risk HPV infection. The analysis of risk factors between mixed infection and simple low-risk infection found statistically significant differences in age≤ 40 years old, unmarried, or less affected by education duration of 15 years or less, engaged in the business or service industry, the number of sexual partners or 2, knew not to clean and not to use condoms, while differences in smoking history, alcohol history, monthly income level, and age at first sexual intercourse were not statistically significant. Low-risk HPV6 and/or HPV11 were detected in 139 cases (87.42%). Fifty-seven patients (35.85%) were infected with at least one high-risk HPV. 72.33% of the patients had multiple warts, and the most common sites were around the coronal sulcus and frenulum of the penis Conclusions The incidence of multiple infections and high-risk subtypes is high in male CA patients in Liaocheng area, and most of the patients have low income, low education level and multiple sexual partners. Strengthening the treatment and education follow-up of this population may contribute to the treatment and prognosis of male CA in this area.
ABSTRACT
Objetivos: A infecção pelo papiloma vírus humano dos tipos 6 e 11 pode evoluir para Condiloma Acuminado. Sua transmissão é principalmente via sexual, de forma que a presença dessas verrugas em crianças deve ser consi-derada sinal de alarme para investigação de abuso. Eventualmente, contudo, ocorre por autoinoculação ou fômites. O tratamento é desafiador, dado que apesar do extenso arsenal, a recorrência se faz comum. A presente revisão siste-mática advém a comparar taxas de sucesso das estratégias terapêuticas, objetivando fornecer substrato para escolhaacertada no tratamento da doença em crianças e adolescentes. Métodos: Foi realizada Revisão Sistemática baseada no GuidelinePreferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA), registrada na Plataforma PROSPERO sob identificação CRD42021262090. Resultados: 211 estudos foram encontrados nasdatabases con-sultadas, de forma que 30 atenderam as propostas de critérios estabelecidos na pesquisa sistematizada. Esses pas-saram extração de dados para síntese qualitativa, demonstrando eficácia de métodos não-invasivos a invasivos.Conclusões: Mediante bons resultados em resolução da doença e reduzidos efeitos adversos, a terapia mais popular entre os autores foi o Imiquimode. A pesquisa chamou atenção à necessidade de estudos mais robustos e metodo-logias mais complexas acerca das abordagens terapêuticas do Condiloma Acuminado em crianças e adolescentes. (AU)
Objectives: Infection with human papillomavirus types 6 and 11 can progress to Condyloma acuminata. Its transmission is mainly sexual, so these warts in children should be considered an alarm signal for abuse investigation. Eventually, however, it occurs by autoinoculation or fomites. Treatment is challenging, given that despite the extensive arsenal, recurrence is common. The present systematic review compares the success rates of therapeutic strategies, aiming to provide a substrate for the right choice in the treatment of the disease in children and adolescents. Methods: Asystematic review was performed based on the guideline for Preferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA), registered on the PROSPERO Platform under identification CRD42021262090. Results: 211 studies were found in thedatabasesconsulted, and 30 met the proposed criteria established in the systematic research. These passed data extraction for qualitative synthesis, demonstrating the effectiveness of non-invasive to invasive methods. Conclusions: Due to good results in disease resolution and reduced adverse effects, the most popular therapy among the authors was Imiquimod. The research called attention to the need for more robust studies and more complex methodologies about the therapeutic approaches of Condyloma Acuminatum in children and adolescents. (AU)
Subject(s)
Humans , Child , Adolescent , Condylomata Acuminata/therapy , Papillomavirus Infections/drug therapy , Imiquimod/therapeutic useABSTRACT
Introdução: O Condiloma uretral é uma infecção sexualmente transmissível comum associada ao vírus do papiloma humano. O acometimento na uretra é raro, principalmente quando trata-se de um paciente HIV positivo com carga viral indetectável. Objetivo: Tem como objetivo discutir sobre o acometimento uretral do papiloma vírus e as possíveis formas de tratamento, assim como revisar a literatura. Relato de caso: O paciente em questão apresentou suspeita de carcinoma de células de transição, sendo encaminhado para tratamento, porém afastado essa suspeita e fechando diagnóstico para lesão condilomatosa uretral, sendo realizado tratamento por ressecção endoscópica das lesões com energia monopolar. Discussão: O acometimento uretral ocorre em até 5% dos casos, e o mesmo apresenta alta probabilidade de malignização. Não existem diretrizes específicas sobre o manejo do condiloma intra-uretral, pois trata-se de uma patologia rara. O objetivo dos tratamentos é remover as verrugas e induzir períodos livre de lesões, sendo que o conservador com crioterapia e o ácido tricloroacético nem sempre são aplicáveis à uretra devido ao difícil acesso. A ressecção endoscópica das lesões tem se mostrado mais eficaz. Conclusão: Urologistas e patologistas devem estar cientes dessa rara possibilidade, a fim de evitar erros de diagnóstico acerca dessa entidade predominantemente benigna. Desta forma apresentamos um caso de ressecção endoscópica de extensa lesão condilomatosa em uretra peniana de uma paciente masculino hemofílico e HIV positivo. [au]
Introduction: Urethral condyloma is a common sexually transmitted infection associated with the human papillomavirus (HPV). Affection in the urethra is rare, especially when dealing with an HIV positive patient with an undetectable viral load. Objective: It aims to discuss the urethral involvement of the papillomavirus and the possible forms of treatment, as well as to review the literature. Case report: The patient in question presented suspicion of transitional cell carcinoma, being referred for treatment, but this suspicion was removed and the diagnosis of urethral condylomatous lesion was closed, with treatment by endoscopic resection of the lesions with monopolar energy. Discussion: Urethral involvement occurs in up to 5% of cases, and it has a high probability of malignancy. There are no specific guidelines on the management of intra-urethral condyloma, as it is a rare condition. The goal of treatments is to remove warts and induce injury-free periods, the conservative with cryotherapy and trichloroacetic acid not always being applicable to the urethra due to difficult access. Endoscopic resection of the lesions has been shown to be more effective. Conclusion: urologists and pathologists should be aware of this rare possibility, in order to avoid diagnostic errors about this predominantly benign entity. Thus, we present a case of endoscopic resection of an extensive condylomatous lesion in the penile urethra of a male patient with hemophilia and HIV positive. [au]
ABSTRACT
A infecção genital pelo papilomavírus humano ocorre em 65% das vezes após contato com pele e mucosa contaminadas. A maioria das pessoas elimina o vírus através do sistema imune. Fatores individuais, como tabagismo, idade, multiparidade, uso prolongado de contraceptivos hormonais, comportamento sexual e infecção por outras doenças sexualmente transmissíveis, ocasionam perpetuação viral e lesões genitais, em sua maior parte, assintomáticas. As regiões mais afetadas são anogenitais. O tratamento deve ser individualizado. O tratamento agressivo pode ocasionar distúrbios cicatriciais. Relatamos um caso de múltiplos tratamentos para retirada de condiloma genital com consequente formação de extenso queloide vulvar
Genital infection by Human Papillomavirus occurs 65% of the time after contact with contaminated skin and mucosa. Most people eliminate the virus through the immune system. Individual factors such as smoking, age, multiparity, prolonged use of hormonal contraceptives, sexual behavior, and infection by other Sexually Transmitted Diseases cause viral perpetuation and genital lesions, most of them asymptomatic. The most affected regions are anogenital. Treatment should be individualized. Excessive treatment can lead to scarring. We report a case of multiple treatments for removal of genital condyloma with consequent formation of extensive vulvar keloid
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Objective@#To investigate the distribution of the gene subtypes of human papillomavirus (HPV) in male patients with condyloma acuminatum (CA) and analyze the characteristics of the gene subtypes.@*METHODS@#We extracted genomic DNA of the HPV virus from the genital tissue of 70 male CA patients, detected the DNA subtypes of HPV using the PCR-reverse dot hybridization technique, and analyzed the rates of different subtypes identified and their characteristics of distribution in different age groups.@*RESULTS@#The male HPV-positive patients were mainly infected at the age of 20－39 years, primarily with high- and low-risk mixed infection of various subtypes, which accounted for 61.54% in the 20- to 29-year-olds and 42.86% in the 30- to 39-year-olds. Among the 70 CA patients, 22 HPV subtypes were identified, the top five subtypes including HPV 11 (21.08%), HPV 6 (19.46%), HPV 42 (6.49%), HPV 59 (6.49%) and HPV 53 (5.95%); 20 infected with a single subtype (28.57%), 19 with two subtypes (27.14%) and 31 with three or more (44.29%); and 30 infected with a low-risk single subtype (42.86%) and 40 with both high- and low-risk multiple subtypes (57.14%).@*CONCLUSIONS@#Male patients with CA are mainly infected with HPV 11 and HPV 6, with a significantly higher rate of multi-subtype than single-subtype infection, and the multi-subtype patients chiefly with high- and low-risk mixed infection. Men aged 20－39 years old are most commonly affected by CA.
Subject(s)
Adult , Humans , Male , Young Adult , Condylomata Acuminata/virology , DNA, Viral/genetics , Genotype , Papillomaviridae/genetics , Papillomavirus Infections/virologyABSTRACT
ABSTRACT Host immunogenetic setting is involved in the regulation of human papillomavirus (HPV) infection and development of condyloma acuminatum (CA). We investigated the correlation of two common single nucleotide polymorphisms (SNPs) (−607C/A and −137G/C) of IL-18 with the susceptibility of CA in a large Chinese cohort. Out of 408 CA patients analyzed, 300 had HPV infection transmitted through sexual contact (SC) and 108 through non-sexual contact (NSC). In addition, 360 healthy volunteers were enrolled as controls. SNPs at positions −607C/A and −137G/C in IL-18 promoter were analyzed. Comparing CA patients to healthy controls, no dominant relevance was found between the IL-18 promoter −607 C/A or −137G/C polymorphisms and the CA disease either identified genotypically (p > 0.05) or by allelically (p > 0.05). However, the IL-18 promoter −137G/C polymorphism genotype and allele frequencies in the NSC CA group, but not between in the SC group, were significantly higher than in the controls. There was no dominant relevance between IL-18-607C/A polymorphism genotype and allele frequencies among SC, NSC CA patients, and controls. Our study demonstrates that polymorphism −137G/C in IL-18 promoter is significantly correlated with risk of CA in NSC patients.
Subject(s)
Humans , Male , Female , Condylomata Acuminata/genetics , Interleukin-18/genetics , Polymorphism, Single Nucleotide/genetics , Papillomavirus Infections/complications , Polymorphism, Genetic , Condylomata Acuminata/virology , China , Cohort Studies , Promoter Regions, Genetic , Genetic Predisposition to Disease , Papillomavirus Infections/transmission , Asian People/genetics , Alleles , GenotypeABSTRACT
Introduction: Some viral warts are refractory to treatment, some others tend to recur. Oral isotretinoin is useful against warts to varying degrees. Objective: To determine the efficacy of oral isotretinoin for treating mucocutaneous human papillomavirus infections. Methods: A systematic review and meta-analysis of studies published from the date of inception of the databases to December 30, 2017 were conducted. Randomized controlled trials or case series with ≥10 patients with mucocutaneous human papillomavirus infection who had received oral isotretinoin treatment were analyzed. The meta-analysis estimated the pooled odds ratio and pooled response rate. Results: The review included eight studies. Trials of oral isotretinoin versus placebo treatment revealed that isotretinoin effectively treated mucocutaneous human papillomavirus infections (odds ratio: 43.8, 95% confidence interval: 9.7–198.8). The pooled estimate of the complete response rate of oral isotretinoin to mucocutaneous human papillomavirus was 67.7% (95% confidence interval: 49.5–81.7%). Another pooled estimation revealed that 83.9% (95% confidence interval: 59.7–94.9%) of patients exhibited at least 50% lesion clearance, whereas 12.3% with complete response experienced recurrence. Limitations: This meta-analysis had a small sample size and high inter-study heterogeneity. Conclusion: Oral isotretinoin is superior to placebo for treating mucocutaneous human papillomavirus infections, particularly plane warts. The recurrence rate and risk of severe side effects are low.
ABSTRACT
Condyloma acuminatum (CA) is a benign tumor primarily caused by infection with human papillomavirus (HPV) type-6 or type-11, lesions of which are most frequently found on the genital, perianal squamous mucosa, and skin. CA outside the anogenital region is not common. Here, we report a case showing simultaneous presence of CA on the vaginal orifice, areola, groin, and umbilicus in a 32-year-old pregnant woman. Histopathological examination and HPV detection are essential in making a definitive diagnosis of CA on multiple sites. The patient was treated with microwave and liquid nitrogen cryotherapy, but repeated relapse of the lesions were observed. Patients with CA during pregnancy represent a special risk group. These cases are usually characterized by fast-growing warts, multi-site or special site warts, a reduced tolerance, and poor response to treatment. Hence, we should pay more attention to CA in pregnant women in the process of diagnosis and treatment, especially cases outside the anogenital region.
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Objective@#To analyze the clinical features of perianal condyloma acuminatum in HIV infected men who have sex with men (MSM) and assess the effects of combined treatment of microwave and photodynamic therapy.@*Methods@#Clinical and laboratory data of 260 male patients with perianal condyloma acuminatum were collected and microwave combined with photodynamic therapy was applied on them.@*Results@#The majority of the patients with perianal condyloma acuminatum were young people (243/260). Warts were mainly located in the anus or from the outside to inside of the anus (245/260). Among them, the proportion of warts position of extraanal in HIV-infected group (8/220) was lower than that of non-HIV-infected group (7/40). HPV types 11 (70/118), 6 (44/118) and 16 (40/118) were the most common types of HPV infection. People with HIV infection were more likely to develop high-risk, mixed types HPV infection and multiple HPV infection than those without HIV infection. More than half of the patients (146/260) needed only 1-3 sessions of photodynamic treatments. There was no significant difference in the times of photodynamic treatments and the numbers of photosensitizers required between the HIV-infected and non-HIV-infected groups. The recurrence rate of HIV-infected group (13.6%, 30/220) was also similar to that of non-HIV-infected group (15.0%, 6/40), but far lower than those who underwent microwave therapy alone (45%, 18/40).@*Conclusions@#The combination therapy significantly reduced the recurrence rate of perianal condyloma acuminatum in HIV infected MSM.
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Objective@#To explore human papillomavirus (HPV) infection and genotype distribution in male patients with condyloma acuminatum (CA).@*Methods@#Totally 332 male patients with CA were enrolled from March 2015 to September 2017 at Henan Provincial People′s Hospital. By means of flow-through hybridization after polymerase chain reaction (PCR), the wart tissue HPV DNA genotypes were detected by gene chip. χ2test was used to perform statistical analysis.@*Results@#Among 332 male CA patients, 239 was positive for HPV with the positive rate of 71.99% (95%CI: 67.16%-76.82%). A total of 37 kinds of genotypes, except for genotypes 26, 45, 69, 70, the others were all detected. The positive rate of genotype 6 was the highest in all detected genotypes (39.46%, 95%CI: 34.20%-44.72%) and the second one was genotype 11 (22.59%, 95%CI: 18.09%-27.09%), and the difference was significant (χ2=22.070, P<0.05). Among 239 HPV-positive CA patients, 158 were single infection and 139 were low-risk genotype (low-risk vs hight risk genotype: χ2=182.3, P<0.05), and 81 were multiple infection and 55 were mixed genotype (mixed vs low-risk genotype: χ2=32.241, P<0.05; mixed vs high-risk genotype: χ2=60.201, P<0.05). The CA patients mainly distributed in those aged 20 to 29 years, followed by those aged 30 to 39 years.@*Conclusions@#The genotypes of HPV infection in male patients with CA are mainly low-risk genotypes 6 and 11. Single infection is common, and the age of patients mainly distributes among 20 to 29 years old.
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Objective To investigate the effect of combined antiretroviral therapy (cART) on anal human papillomavirus (HPV) infection in human immunodeficiency virus (HIV)-infected men who sex with men (MSM).Methods HIV-infected MSM naive of cART who visited Wuhan Dermatological Hospital from June 2012 to December 2013 were enrolled in a longitudinal study before starting cART,including 81 HIV-positive and 50 HIV-negative cases.HPV infection situations between HIV-positive and HIV-negative MSM were compared.And anal HPV infection rate and condyloma acuminate incidence of HIV-positive MSM before and after cART were also compared.HPV genotyping was performed by universal primer PCR and reverse dot hybridization.The statistical analysis was done by t test or x2 test.Results The prevalence rates of HPV infection,high-risk HPV infection and multiple HPV subtypes infection in HIV-positive MSM were all significantly higher than those in HIV-negative MSM (91.4 ％ vs 62.0 ％,75.3 ％ vs 30.0 ％,56.8 ％ vs 20.0 ％,respectively,x2 =16.75,26.05,and 19.10,respectively,all P＜0.05).The prevalence rates of anal HPV infection,high-risk HPV infection and multiple HPV subtypes infection in 77 HIV-positive MSM at month 36 of cART were all significantly decreased than baseline (90.9％ vs 74.0％,75.3％ vs 44.2％ and 57.1％ vs 41.5％,respectively,x2 =7.590,15.551,and 3.741,respectively,all P＜0.05).HPV16 and HPV43 infection rates were reduced from 27.3％ at baseline to 15.6％ and 13.0％,respectively at month 36 of cART (x2 =16.92 and 14.86,respectively,both P＜0.05).Condyloma acuminate incidence also reduced from 16.9％ at baseline to 5.2％ at month 36 (x2 =4.069,P＜0.05).Conclusions The prevalence of anal HPV infection in HIV-positive MSM is higher than HIV-negative MSM.cART could reduce the prevalence of anal HPV infection rate and condyloma acuminate incidence,especially high-risk HPV infection.
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Objective To investigate the clinical significance of IL -2 and IL-6 detection in the diagnosis and treatment of patients with condyloma acuminatum .Methods 45 patients with condyloma acuminatum were selected,and 45 healthy people were selected as control .Enzyme linked immunosorbent assay (ELISA) and transcrip-tion polymerase chain reaction ( RT-PCR) were used to detect the levels of IL -2 and IL-6 in patients before and after treatment,and the levels of IL-2 and IL-6 were detected in healthy controls .Results Before treatment,the serum contents of IL-2 and IL-6 in patients with condyloma acuminatum ,after treatment were (3.28 ±0.97)μg/L, (4.98 ±1.83)pg/L,respectively,the serum IL-2,IL-6 contents were (6.01 ±0.42)μg/L,(7.05 ±1.94)pg/L, respectively.The serum IL-2 and IL-6 levels of control group were (8.09 ±1.36)μg/L,(9.12 ±2.51) pg/L, respectively,the differences between the two groups were statistically significant (t=5.82,5.46,P<0.05,0.01). Before treatment ,the IL-2 and IL-6 mRNA expression in skin tissue of patients with condyloma acuminatum after treatment were (0.327 ±0.048),(0.457 ±0.093),which were (0.512 ±0.021),(0.641 ±0.154),respectively. The IL-2 and IL -6 mRNA expression in skin tissue of the control group were (0.859 ±0.125),(0.932 ± 0.063),the differences between the two groups were statistically significant ( t =4.68,6.74;P <0.05,0.01). Conclusion There are serious defects in the cellular immune function of patients with condyloma acuminatum .The detection of IL-2 and IL-6 levels in patients with condyloma acuminatum has important clinical value for the occur -rence,treatment and prognosis of the disease .
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Presentamos el caso de un hombre de 21 años de edad, infectado por el virus de la inmunodeficiencia humana (VIH) que presenta lesiones verrucosas gigantes compatibles con un tumor de Buschke-Lowenstein (TBL) que afectaban la región perineal, anorrectal y genitales externos. También existía afectación del párpado superior derecho. (AU)
We report the case of a 21-year-old male patient, infected with human immunodeficiency virus (HIV) that presents giant warty lesions compatible with a Buschke-Lowenstein tumor (BLT) that affected the perineal, anorectal and external genital region. He also had a right upper eyelid lesion. (AU)
Subject(s)
Humans , Male , Young Adult , Anus Neoplasms/surgery , Buschke-Lowenstein Tumor/surgery , Anus Neoplasms/pathology , HIV Infections , Papillomavirus InfectionsABSTRACT
Objective To investigate the expression of platelet-derived growth factor B(PDGF-B) and PDGFR-α mRNA in the skin lesion of recurrent condyloma acuminatum(CA) and to explore its relationship with recurrent condyloma acuminatum.Methods The expressions of PDGF-B and PDGFR-α mRNA in the lesions of recurrent CA and Nonrecurrent CA were investigated by Real-Time-PCR,and the normal foreskins weretaken as controls.Results The PDGF-B and PDGFR-α mRNA levels in the re current CA group and non-recurrent CA group were significantly higher than those in the normal control group,the differences were statistically significant(P＜0.05).The expressions of PDGF-B and PDGFR-α mRNA in the recurrent CA group were higher than those in the non-recurrent CA group(P＜0.01).Furthermore,the expressions of PDGF-B and PDGFR-α mRNA before treatment in the recurrent CA group were higher than those after treatment(P＜0.01).Conclusion PDGF-B and PDGFR-α mRNA might haue a certain relation with CA recurrence.
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Objective To investigate anorectal infection with Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) among men who have sex with men (MSM) with anorectal condyloma acuminatum(CA),and provide evidence for the clinical diagnosis and treatment of anorectal CA.Methods Anorectal swabs were obtained from MSM who were diagnosed with anorectal CA(trial group) and without CA(control group),nucleic acid fragments of NG and CT were detected by fluorescent quantitative polymerase chain reaction.Data about social demographic characteristics and sexual behaviors of investigated people were collected,compared and analyzed.Results A total of 158 patients were enrolled in this study,63 were in trial group and 95 in control group.Among 63 patients in trial group,infection rate of NG and CT were 17.46％ and 28.57％ respectively,co infection rate of NG and CT was 12.70％;in control group,infection rate of NG and CT were 6.32 ％ and 9.47 ％ respectively,co-infection rate of NG and CT was 2.16％;infection rate of NG and CT,as well as co-infection rate of NG and CT in trial group were all significantly higher than control group(all P＜0.05).Conclusion Infection rate of NG and CT is high in MSM with anorectal CA,suggesting that more attention should be paid to the screening of NG,CT and other sexually transmitted infection among those who were clinically diagnosed with anorectal CA.
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Objective To evaluate the role and significance of Treg/Th17 cells imbalance in pathogenesis and recurrence mechanism of condyloma acuminatum (CA).Methods 52 patients with CA were selected as study group (CA group,27 with initial occurrence of CA,25 with recurrence of CA),30 healthy persons were as control group,flow cytometry was used to detect the proportion of Treg cells and Th17 cells in the peripheral blood,the expression level of Foxp3 mRNA and RORyt mRNA in peripheral blood mononuclear cells was determined by real-time quantitative polymerase chain reaction.Results The proportion of Treg cells and the expression level of Foxp3 mRNA in peripheral blood in CA group was higher than that in control group,recurrence CA group was higher than initial occurrence CA group,difference was significant(both P＜0.05);the proportion of Th17 cells and expression level of RORyt mRNA in CA group was significantly lower than that in control group,proportion of Th17 cells in recurrence CA group was lower than initial occurrence CA group,there was significant difference (both P＜0.05).The proporation of Treg/Th17 in CA group was higher than that in healthy controls(4.60[3.20,8.68] vs 1.39[1.05,2.05],P＜0.05),recurrence CA group was higher than initial occurrence CA group (8.19[4.21,10.81] vs 3.52 [2.47,4.85],P＜0.05).Conclusion There is an imbalance between Treg cells and Th17 cells in patients with CA,especially in patients with reccurrence of CA,the imbalance of Treg/Th17 cells may play an important role in the pathogenesis and recurrence mechanism of CA.
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BACKGROUND: Condyloma acuminatum is a sexually transmitted disease (STD) associated with the human papillomavirus (HPV). Although it is a relatively common disease, there has been no epidemiological and clinical study of condyloma acuminatum performed in Korea since 1978. OBJECTIVE: We aimed to evaluate the clinical features of condyloma acuminatum in Korean patients, to identify the genotypes of HPV, as well as determine factors associated with recurrence of condyloma acuminatum. METHODS: We studied 80 patients (60 men and 20 women) diagnosed with condyloma acuminatum. We analyzed age, sex, duration of the disease, number and locations of lesions, underlying diseases and co-infection with STDs, treatment modalities, and number of relapses. Additionally, 26 patients were analyzed for HPV subtypes. We also evaluated factors affecting recurrence of condyloma. RESULTS: Mean age at the time of diagnosis was 36.9±17.7 years and mean duration of disease was 7.2±16.5 months. The most common sites of involvement were found to be the penile shaft in men and the labia majora in women. We observed that 28 patients showed relapse with a mean duration of 1.5±4.5 months. HPV genotyping revealed that type 6, 11, and 44 genotypes that are associated with a low risk of malignancy were detected in 76.9% of cases, and type 16, 18, 51, 52, and 66 genotypes associated with a high risk of malignancy were detected in 15.3% cases. A significant relationship was observed between the recurrence rates of condyloma acuminatum and the rates of co-infection with STDs and the number of lesions. CONCLUSION: We report a recent epidemiological and clinical review analyzing genotypes of HPV in Korean patients presenting with condyloma acuminatum.
Subject(s)
Female , Humans , Male , Clinical Study , Coinfection , Diagnosis , Genotype , Korea , Recurrence , Sexually Transmitted DiseasesABSTRACT
Vulvar vestibular papillomatosis (VVP) is a benign condition that can be viewed as the female equivalent of male pearly penile papules. Clinically, VVP is quite often misdiagnosed as condyloma acuminatum. As opposed to condyloma, VVP lesions arise from a distinct mucosal base, match the color of the surrounding mucosa, show symmetrical distribution, and are limited to the inner aspect of the labia minora. Although VVP is quite well known in the gynecological field, this disease entity is not commonly recognized in dermatology settings. Furthermore, a literature search for VVP revealed only nine reports in dermatological journals including one report from Korea. Therefore, through our report we wish to create awareness among dermatologists regarding the occurrence of this frequent but often ignored entity. Recognizing and understanding that papillomatosis of the vulvar vestibule is a normal variant will help dermatologists to avoid incorrect diagnosis and repeated unnecessary treatment.