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1.
J. coloproctol. (Rio J., Impr.) ; 42(1): 63-67, Jan.-Mar. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1375759

ABSTRACT

Objectives: To compare morphological abnormalities on anal colposcopy against histology to determine anal high-grade squamous intraepithelial lesions (HSILs). Methods: This is a retrospective data assessment of HIV-negative and HIV-positive patients undergoing outpatient follow-up. The sample comprised 54 patients presenting acetowhite lesions on anal colposcopy. Acetowhite lesions were classified according to their morphology into punctation, verrucous, mosaic, ulcerated, or hypervascularized, and biopsies of these specimens were classified as anal HSIL, low-grade squamous intraepithelial lesion (LSIL), or normal. The data were analyzed using SPSS forWindows version 13.0 (SPSS Inc., Chicago, IL, USA). The results were analyzed using the nonparametric Mann-Whitney test, the Fisher exact test and the chi-squared parametric test. A 95% confidence interval (CI) was used and a level of significance <5% was adopted for all statistical tests. Results Fifty-four patients (50 males, 80% HIV+) with biopsied acetowhite lesions were assessed. There were 31 punctation lesions, 1 classified as HSIL (3.2%; 95%CI: 0- 40.0), 17 verrucous lesions, 3 HSIL (17.7%; 95%CI: 0-10.7), and 1 ulcerated, classified as HSIL (100%), and 4 mosaic and 1 atypical vessel lesion, all classified as LSIL. The results showed no association of presence of anal HSIL with positivity for HIV infection or with counts above or below 500/µl in HIV+patients. Statistical analysis was performed using the Mann-Whitney nonparametric test, the Fisher exact test, and the chi-squared parametric test. Conclusion: The comparison of morphological findings on anal colposcopy against histology revealed no morphological pattern suggesting anal HSIL. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Anal Canal , Carcinoma in Situ/ultrastructure , Condylomata Acuminata , Papillomaviridae , Colonoscopy , HIV , CD4 Lymphocyte Count
2.
Article in Spanish | LILACS, BDNPAR | ID: biblio-1337802

ABSTRACT

El virus del papiloma humano (HPV) es el agente etiológico de infecciones de transmisión sexual relacionadas con procesos oncogénicos genitales y orales. La biología molecular, mediante la identificación de los tipos virales involucrados, proporciona precisión diagnóstica con un enfoque epidemiológico. El objetivo de este estudio fue determinar la presencia de HPV en la mucosa oral de hombres con verrugas anogenitales y correlacionar los genotipos detectados en ambas muestras. Se estudiaron 26 pacientes varones con verrugas anogenitales que acudieron al Instituto de Dermatología de la ciudad de Resistencia (Argentina). La presencia de HPV en muestras orales y anogenitales se estudió mediante reacción en cadena de la polimerasa (PCR) y la genotipificación se realizó mediante PCR-RFLP. La prevalencia de HPV oral en pacientes con HPV anogenital fue del 46,2% (12/26). Se encontraron dieciocho genotipos con alto riesgo oncogénico en muestras orales de pacientes con infecciones únicas o múltiples y el tipo 16 fue el más frecuente (6 pacientes). Catorce genotipos en muestras orales fueron de bajo riesgo oncogénico, el más frecuente fue el tipo 6 (10 pacientes). En muestras anogenitales el genotipo 6 fue el más frecuente (13 pacientes), solo o en coinfección. Se encontró una alta prevalencia de HPV oral de malignidad de alto grado en nuestra población y coinfección con tipos oncogénicos. Las prácticas de sexo oral fueron la principal conducta de riesgo para la infección, lo que quedó demostrado por el hallazgo simultáneo del mismo tipo de HPV en muestras orales y anogenitales


The human papillomavirus (HPV) is the etiologic agent of sexually transmitted infections related to genital and oral oncogenic processes. Molecular biology provides accurate diagnosis with an epidemiological approach, by identifying the viral types involved. The objective of this study was to determine the presence of HPV in oral mucosa from men with anogenital warts and to correlate the genotypes detected in both samples. Twenty-six male patients suffering anogenital warts who attended to the Institute of Dermatology in Resistencia (Argentina) were studied. The presence of HPV in oral and anogenital samples was studied by PCR and genotyping was performed by PCR-RFLP. The prevalence of oral HPV in patients with anogenital HPV was 46.2% (12/26). Eighteen genotypes with high oncogenic risk were found in oral samples of patients with single or multiple infections and type 16 was the most frequent (6 patients). Fourteen genotypes in oral samples were of low oncogenic risk and the most frequent was type 6 (10 patients). In anogenital samples the genotype 6 was the most frequent (13 patients), alone or in co-infection. A high prevalence of high-grade malignancy oral HPV in our population and co-infection with oncogenic types were found. Oral sex practices were the main risk factor for infection, which was demonstrated by the simultaneous finding of the same HPV type in oral and anogenital samples


Subject(s)
Humans , Male , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Papillomaviridae , Condylomata Acuminata/diagnosis , Papillomavirus Infections , Men's Health , Mouth Mucosa
3.
J. coloproctol. (Rio J., Impr.) ; 41(3): 289-294, July-Sept. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1346420

ABSTRACT

Purpose: Giant perianal condyloma (GPC) is a rare condition. The effective treatment is a multidisciplinary challenge; topical treatments are usually ineffective, and surgical resection has significant morbidity. Podophyllin at 25% in solid petrolatum (25%PSP) can be an effective treatment option for GPC. The aim of the present study was to assess its response and tolerability. Methods: This retrospective, single-center case series evaluated the clinical response of 14 patients with GPC treated with 25%PSP in a public hospital in Buenos Aires between December 2015 and December 2019. After obtaining a full history and performing a physical exam, the lesions were measured and photographed. Biopsies were performed to exclude malignancy, as well as exams to rule out pregnancy. Podophyllin at 25% in solid petrolatum was administered topically in cases of GPC and washed off by the patients at home after 4 hours. The patients underwent at least 4 weekly visits, which included interval history, photodocumentation of the lesions, and provider-applied 25%PSP. The response rate was assessed by comparingmeasurements and the overall decrease in volume of the GPC based on photos from the first and last sessions. Adverse outcomes were noted. Results: In total, 10 men, 3 women, and 1 transgender woman with GPC unresponsive to prior treatments and a mean age of 34.5 years were included. A total of 12 patients were immunosuppressed. All the perianal lesions were circumferential and measured between 8 cm and 20 cm. Overall, 7 patients had genital condyloma outside of the anus and perianus; the histology showed low-grade squamous intraepithelial lesions in all cases. While on treatment, 7 patients reported dermatitis, and 71% of the patients had 75% reduction in lesion size. Conclusions: Podophyllin at 25% in solid petrolatum is an effective, well-tolerated topical treatment option for GPC. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Podophyllin/therapeutic use , Dermatitis/complications , Condylomata Acuminata/therapy
4.
Rev. medica electron ; 43(1): 2977-2985, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156789

ABSTRACT

RESUMEN Se presentó el caso clínico de un paciente seropositivo, en fase sintomática avanzada. Fue atendido en el Servicio de Medicina Interna del Hospital Clínico Quirúrgico Docente "León Cuervo Rubio", de la ciudad de Pinar del Río, por presentar disnea, astenia, anorexia y pérdida de peso. Al examen oral se constató lesión tumoral de la lengua que dificultaba la masticación y deglución. La biopsia mostró sarcoma de Kaposi asociado al VIH/sida. La evolución tórpida y el estadio tan avanzado de la enfermedad, propiciaron el deceso del paciente (AU).


ABSTRACT The authors presented the clinical case of a seropositive patient, in advanced symptomatic phase. The patient attended the Internal Medicine Service of the Teaching Clinical Surgical Hospital Leon Cuervo Rubio of Pinar del Rio, presenting dyspnea, asthenia, anorexia and weight loss. On the oral examination, a tumor lesion was found making difficult to chew and swallow. A biopsy showed Kaposi sarcoma associated to HIV/AIDS. The torpid evolution and disease's advanced stage propitiated the patient's death (AU).


Subject(s)
Humans , Male , Middle Aged , Sarcoma, Kaposi/complications , HIV Seropositivity/complications , Sarcoma, Kaposi/etiology , Sarcoma, Kaposi/mortality , Sarcoma, Kaposi/drug therapy , Sarcoma, Kaposi/epidemiology , Condylomata Acuminata/diagnosis , HIV Seropositivity/mortality , Intensive Care Units
5.
Epidemiol. serv. saúde ; 30(spe1): e2020790, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1154158

ABSTRACT

O artigo aborda a infecção pelo papilomavírus humano (human papillomavirus, HPV), tema constitutivo do Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde. Tal documento foi elaborado com base em evidências científicas e validado em discussões e consenso entre especialistas. São apresentados aspectos epidemiológicos e clínicos, bem como orientações para os gestores e profissionais de saúde no diagnóstico, tratamento e prevenção da infecção pelo HPV. Este tema representa importante problema de saúde pública, haja vista essa infecção sexualmente transmissível ser a mais prevalente no mundo, capaz de desencadear o processo oncogênico do câncer do colo uterino, além de possibilitar a ocorrência de verrugas anogenitais. Neste artigo, são apresentadas informações importantes para o conhecimento do HPV, estratégias de ação para a prevenção e controle da infecção, uma assistência de qualidade e tratamento efetivo da doença.


This article addresses human papillomavirus (HPV) infection, this being one of the topics covered by the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article presents epidemiological and clinical aspects, as well as guidelines for health service managers and health workers about diagnosing and treating people with papillomavirus infection. This theme is an important public health problem, since it is the most prevalent sexually transmitted infection in the world, capable of triggering the oncogenic process of cervical cancer, as well as the possibility anogenital warts occurring. Important information is presented for gaining knowledge about HPV, as well as action strategies for infection prevention and control, provision of quality care and effective treatment of the disease.


El tema del papilomavirus humano (PVH) es uno de los capítulos del Protocolo Clínico y Conductas Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil. Este documento fue desarrollado en base a evidencia científica y validado en discusiones con especialistas. Se presentan aspectos epidemiológicos y clínicos, así como guías para gestores y profesionales de la salud en el diagnóstico, tratamiento y prevención de la infección por papilomavirus. Este tema constituye uno de los principales problemas de salud pública, pues además de ser la infección transmitida sexualmente más prevalente en todo el mundo, puede tener implicaciones para el proceso oncogénico del cáncer de cuello uterino y la posibilidad de presentar verrugas anogenitales. Se presenta información sobre estrategias de acciones de prevención y control, las cuales son importantes para entender el problema, ofrecer asistencia de calidad y tratamiento efectivo.


Subject(s)
Humans , Female , Sexually Transmitted Diseases/prevention & control , Sexually Transmitted Diseases/epidemiology , Papillomavirus Infections/prevention & control , Papillomavirus Infections/epidemiology , Brazil/epidemiology , Condylomata Acuminata , Uterine Cervical Neoplasms/prevention & control , Clinical Protocols , Alphapapillomavirus/pathogenicity
7.
An. bras. dermatol ; 95(2): 144-149, Mar.-Apr. 2020. tab, graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130851

ABSTRACT

Abstract Background: Anogenital warts are the leading sexually transmitted infection in patients seeking care at specialized clinics. They may display a vast array of forms, according to the interaction of the virus with the host's immunity. Cellular immunity is the epithelium's main form of defense against the virus, involving an active participation of the Langerhans cells and pro-inflammatory cytokines such as TNF-α. Objective: To assess the epithelial immune response of anogenital warts in males, according to the number of lesions presented. Methods: This is a prospective, cross-sectional study carried out at the dermatology outpatient clinic in a tertiary hospital. We included male patients over 18 years of age without comorbidities who had anogenital condylomata and no previous treatments.In order to evaluate the local epithelial immunity, the lesions were quantified, then removed and employed in CD1a immunohistochemistry assays for assessing the morphometry and morphology of Langerhans cells; TNF-α; reaction was used for determining cytokine positivity in the epithelium. Results: 48 patients were included in the study. There was no statistically significant difference as to the number of Langerhans cells, in their morphology, or the presence of TNF-α. However, patients presenting with more Langerhans cells in the lesions had cells with a star-like and dendritic morphology, whereas in those with a lower cell count had cells with a rounded morphology and no dendrites (p < 0.001). Study limitations: Small number of patients analyzed. Conclusion: There was no difference in epithelial immunity between patients having few or many anogenital condyloma lesions as measured by the morphology and morphometry of Langerhans cells and TNF-α; positivity. Such an assessment employing immunity markers differing from the usual ones is expected to yield useful results.


Subject(s)
Humans , Male , Anus Diseases/immunology , Condylomata Acuminata/immunology , Langerhans Cells/pathology , Tumor Necrosis Factor-alpha/analysis , Genital Diseases, Male/immunology , Anus Diseases/pathology , Reference Values , Dendritic Cells/immunology , Dendritic Cells/pathology , Immunohistochemistry , Condylomata Acuminata/pathology , Langerhans Cells/immunology , Cross-Sectional Studies , Prospective Studies , Tumor Necrosis Factor-alpha/immunology , Genital Diseases, Male/pathology
8.
Article in English | LILACS | ID: biblio-1123230

ABSTRACT

Introduction: Syphilis and HIV infections are sexually transmitted infections whose diagnosis and treatment contribute toward preventing congenital transmission. Objective: To report a case of three sexually transmitted infections detected in a male partner during Couple Consultation and syphilis in the female partner during prenatal care. Case report: A 34-year-old black female G2P1 pregnant woman was referred to an outpatient clinic of sexually transmitted infections in Vitória, Brazil, reporting a 30-day evolution of painless papular lesions in the external genitalia, suggestive of condylomata lata. Nontreponemal tests were positive for syphilis and negative for HIV. The husband reported unprotected receptive anal intercourse and possessed anal condylomatous lesions and perianal condylomata lata. He was positive for both HIV and syphilis. Histopathological findings showed low-grade HPV lesions and the PCR test found 16, 39, and 53 HPV subtypes. Treatment with benzathine penicillin G was successful for both partners. Conclusion: This study emphasizes the need for Couple Consultation during pregnancy to identify and treat possible sexually transmitted infections.


Introdução: As infecções por sífilis e HIV são infecções sexualmente transmissíveis cujo diagnóstico e tratamento contribuem para a prevenção da transmissão congênita. Objetivo: Relatar um caso de três infecções sexualmente transmissíveis detectadas em um parceiro masculino durante a consulta do casal e sífilis na parceira durante o pré-natal. Relato de caso: Uma gestante, negra, G2P1, 34 anos, foi encaminhada a um ambulatório de infecções sexualmente transmissíveis em Vitória, Brasil, relatando uma evolução de 30 dias de lesões papulares indolores na genitália externa, sugestivas de condiloma lata. Os testes não treponêmicos foram positivos para sífilis e negativos para HIV. O marido relatou relação sexual anal receptiva desprotegida e possuía lesões condilomatosas anais e condiloma lata perianal. Ele testou positivo tanto para HIV quanto para sífilis. Os achados histopatológicos mostraram lesão de HPV de baixo grau e o teste de PCR encontrou subtipos de HPV 16, 39 e 53. O tratamento com penicilina benzatina G foi bem­sucedido em ambos os parceiros. Conclusão: Este estudo enfatiza a necessidade de consultas de casal durante a gravidez para identificar e tratar possíveis infecções sexualmente transmissíveis.


Subject(s)
Humans , Male , Female , Pregnancy , Adult , Sexually Transmitted Diseases/complications , Penicillin G Benzathine/therapeutic use , Prenatal Care , Bisexuality , Condylomata Acuminata/complications , Condylomata Acuminata/pathology , Condylomata Acuminata/drug therapy , Syphilis/complications , Syphilis/pathology , Syphilis/drug therapy , Sexually Transmitted Diseases/pathology , Sexually Transmitted Diseases/drug therapy , HIV Infections/complications , Squamous Intraepithelial Lesions/pathology , Anti-Bacterial Agents/therapeutic use
9.
Rev. Col. Bras. Cir ; 47: e20202543, 2020. tab
Article in English | LILACS | ID: biblio-1136542

ABSTRACT

ABSTRACT Aim: to evaluate the presence of subclinical HPV-induced anal lesions with anal cytology, High-Resolution Anoscopy (HRA) and HPV genotyping by polymerase chain reaction (PCR) in the follow-up of treated condylomata acuminata (CA). Methods: seventy-nine male patients were included. One month after anal CA eradication, the patients underwent brush samples collection for anal cytology and PCR, and HRA with biopsy of acetowhite lesions. These methods were compared within all patients and between groups, according to Human Immunodeficiency Virus (HIV) infection status: HIV-negative; HIV-positive with TCD4 count above and below 350 cells/mm3. Results: the most frequent HPV types were 6 and 16. HPV DNA was isolated in 92%. HIV infection was associated with a higher number of oncogenic HPV types (p=0.038). All patients with negative PCR had negative HRA and cytology. There were no differences in cytological, HRA or histopathological findings between groups. Conclusion: the association of the findings of cytopathology, HRA and genotyping of HPV refined the diagnosis of HPV-induced lesions. The degree of immunodeficiency was not associated with increase in remnant HPV-induced anal lesions.


RESUMO Objetivo: avaliar a presença de lesões anais subclínicas HPV-induzidas com citologia anal, colposcopia anal e genotipagem de HPV por reação em cadeia da polimerase (PCR) no seguimento de condilomas anais tratados. Método: foram incluídos 79 pacientes do sexo masculino. Após um mês da erradicação de lesões condilomatosas anais, os participantes voltaram em consulta para coleta de amostras com escova para citologia anal e PCR, e colposcopia anal com biópsia de lesões acetobrancas. Os métodos de detecção das lesões foram comparados entre os pacientes e entre grupos, de acordo com o status de infecção pelo vírus da imunodeficiência humana (HIV): HIV-negativo; HIV-positivo com TCD4 acima ou abaixo de 350 células/mm3. Resultados: os tipos de HPV mais frequentes foram 6 e 16. Infecção pelo HIV foi associada a maior número de tipos de HPV oncogênicos (p=0,038). Todos os pacientes com PCR negativo apresentaram colposcopia e citologia negativos. Não houve diferença nos achados citológico, colposcópico ou histopatológico entre grupos. Conclusão: a associação dos achados citopatológico, colposcópico e PCR melhorou a acurácia do diagnóstico de lesões anais HPV-induzidas. O grau de imunodeficiência não foi associado a maior frequência de lesões anais HPV-induzidas remanescentes.


Subject(s)
Humans , Male , Anus Neoplasms , Papillomaviridae/genetics , Condylomata Acuminata , Papillomavirus Infections , Anal Canal , DNA , HIV Infections , Polymerase Chain Reaction , Follow-Up Studies , Genotype
10.
National Journal of Andrology ; (12): 906-910, 2020.
Article in Chinese | WPRIM | ID: wpr-880290

ABSTRACT

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 , Condylomata Acuminata/virology , DNA, Viral/genetics , Genotype , Humans , Male , Papillomaviridae/genetics , Papillomavirus Infections/virology , Young Adult
11.
Braz. j. infect. dis ; 23(6): 388-394, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1089306

ABSTRACT

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 , Asians/genetics , Alleles , Genotype
13.
DST j. bras. doenças sex. transm ; 31(2): 66-68, 30-06-2019.
Article in English | LILACS | ID: biblio-1118735

ABSTRACT

Introduction: Giant condylomata acuminata, also known as Buschke-Lowenstein tumor is a rare form of tumor of the anogenital condylomata acuminata, which is a sexually transmitted infection (STI) caused by the human papillomavirus (HPV). Objective: To report a case of giant condylomata acuminata in an immunocompetent patient. Case report: The patient was referred to the Outpatient Clinic for Sexually Transmitted Infections and AIDS at a public hospital in the city of Vitória, Espírito Santo State, Brazil, reporting the onset of progressive growth verrucous lesions on the external genitalia for four months. The patient underwent surgical ablation, and giant condylomata diagnostic confirmation was obtained through histopathology. She was treated with 5% imiquimod cream in routine applications for eight consecutive weeks to avoid recurrence and was also vaccinated for HPV after the procedure. Conclusion: Surgery excision is the treatment of choice in extensive genital condylomata lesions to exclude malignancy. Imiquimod use as adjuvant therapy for reducing recurrence seems to be adequate.


Introdução: O condiloma acuminado gigante, também conhecido tumor de Buschke-Lowenstein, é uma apresentação rara do condiloma acuminado anogenital, que é uma infecção sexualmente transmissível (IST) causada pelo papilomavírus humano (HPV). Objetivo: Relatar um caso de condiloma acuminado gigante em uma paciente imunocompetente. Relato de caso: A paciente foi encaminhada para o ambulatório de infecções sexualmente transmissíveis e AIDS de um hospital público na cidade de Vitória, Espírito Santo, Brasil, relatando o aparecimento de lesões verrucosas de crescimento progressivo na genitália externa por quatro meses. A paciente foi submetida à exérese cirúrgica e a confirmação diagnóstica de condiloma gigante foi obtida através da histopatologia. Ela foi medicada com imiquimode creme a 5% em aplicações rotineiras por oito semanas consecutivas para evitar recorrências e foi também vacinada contra o HPV após o procedimento. Conclusão: Exérese cirúrgica é o tratamento de escolha em lesões condilomatosas extensas para excluir malignidade. O uso de Imiquimode como terapia adjuvante para redução de recidivas mostrou-se adequado.


Subject(s)
Humans , Condylomata Acuminata , Sexually Transmitted Diseases , Buschke-Lowenstein Tumor , Acquired Immunodeficiency Syndrome , Imiquimod , Genitalia
14.
DST j. bras. doenças sex. transm ; 31(2): 62-65, 30-06-2019.
Article in English | LILACS | ID: biblio-1118734

ABSTRACT

Introduction: Anogenital warts are one of the major clinical manifestations of the Human Papillomavirus (HPV). Case reports in children have grown in the last decades; however, there are still difficulties in determining the virus epidemiology and the best therapy for this age group. Objective: To report a case of recurrent vulvar condyloma in a sexually abused infant who presented complete resolution of the lesions after the use of topical imiquimod. Methods: Data research and medical record review were performed in addition to a qualitative study consisted of a wide literature appreciation on the subject. Results: After undergoing extensive therapy, the patient was successfully treated using topical imiquimod. Conclusion: Observation of this particular case suggests that imiquimod may be a safe and effective therapeutic alternative for the treatment of condyloma in the pediatric population. However, theoretical foundations for such conduct are scarce. Thus, the need for further studies on the subject is reinforced.


Introdução: As verrugas anogenitais constituem uma das principais manifestações clínicas da infecção pelo vírus do Papiloma Humano (HPV). Relatos de casos em crianças têm crescido nas últimas décadas; contudo, ainda há dificuldades em determinar a epidemiologia do vírus e definir a melhor terapêutica para essa faixa etária. Objetivo: Relatar um caso de condiloma vulvar recorrente em uma lactente abusada sexualmente que apresentou resolução completa das lesões após o uso de imiquimode tópico. Métodos: Foi realizado levantamento de dados e revisão de prontuário, além de estudo qualitativo composto por apreciação ampla da literatura acerca do tema em questão. Resultados: Depois de ser submetido à extensa terapêutica, a paciente foi tratada com sucesso utilizando imiquimode tópico. Conclusão: A observação desse caso específico sugere que o imiquimode pode ser uma alternativa terapêutica segura e eficaz para o tratamento de condiloma na população pediátrica. Entretanto, embasamentos teóricos para tal conduta são escassos. Assim, reforça-se a necessidade do desenvolvimento de mais estudos sobre a temática.


Subject(s)
Humans , Papilloma , Papillomaviridae , Condylomata Acuminata , Warts , Infant , Infections
15.
Rev. chil. infectol ; 36(3): 283-291, jun. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1013785

ABSTRACT

Resumen Introducción: Los condilomas o verrugas genitales (VG) son la infección de transmisión sexual (ITS) más diagnosticada en los centros de ITS en Chile, pero no existen estadísticas poblacionales. Objetivos: Describir la prevalencia de VG en pacientes de 18-60 años que acuden a consulta ambulatoria de dermatología, ginecología y urología; características demográficas de los pacientes y prácticas de diagnóstico y tratamiento. Material y Métodos: A una muestra de especialistas chilenos estratificados por región, población y sexo de pacientes se les proporcionó un diario de registro y aplicó un cuestionario. Resultados: Prevalencia VG grupo total: 2,4%; en grupo etario 18-34 años: 3,7%; en grupo etario 35-60 años: 1,29% (p = 0,0000). La edad media de los pacientes con VG fue 29,4 años en mujeres y 32,7 años en hombres (p = 0,019); la distribución por edad fue diferente según sexo y sistema de salud. La inspección visual fue el método diagnóstico más frecuente y la crema de imiquimod el tratamiento más común. Hubo diferencias en el uso de herramientas diagnósticas y terapéuticas según sexo del paciente, especialidad del médico y sistema de salud. Conclusiones: Existe una alta prevalencia de VG, que debería ser tomada en cuenta para planificar las intervenciones de salud pública para abordar este problema.


Introduction: Condylomas or genital warts (GW) are the most frequently diagnosed sexually transmitted infection (STI) in STI centers in Chile, but there are no population statistics available. Objectives: To describe the prevalence of GW in patients from 18-60 years of age who attend outpatient dermatology, gynecology and urology practice; the demographic characteristics of the patients and the diagnostic and treatment tools. Methods: A sample of Chilean specialists stratified by region, population and gender of patients was provided with a logbook and answered a questionnaire. Results: The GW prevalence was 2.44% for the whole group; 3.76% for the 18-34 age group and 1.29% for the 35-60 years group (p = 0.0000). The average age of patients with GW was 29.4 years in women and 32.7 years in men (p = 0.019). The distribution by age was different according to gender and health system. Visual inspection was the most frequent diagnostic method used and imiquimod cream the most common treatment, however, there were differences in the use of diagnostic and therapeutic tools according to the patient's gender, specialty of the doctor and health system. Conclusions: The high prevalence of GW confirmed the need and importance of public health interventions to address this problem.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Outpatients/statistics & numerical data , Condylomata Acuminata/epidemiology , Primary Health Care/statistics & numerical data , Professional Practice/statistics & numerical data , Condylomata Acuminata/diagnosis , Condylomata Acuminata/drug therapy , Chile/epidemiology , Demography/statistics & numerical data , Incidence , Prevalence , Health Surveys , Dermatologists/statistics & numerical data , Urologists/statistics & numerical data , Imiquimod/therapeutic use , Gynecology/statistics & numerical data , Health Facilities, Proprietary/statistics & numerical data , Antineoplastic Agents/therapeutic use
16.
Int. braz. j. urol ; 45(2): 361-368, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002194

ABSTRACT

ABSTRACT Objective: To evaluate the treatment effect of genital warts, we investigated the quadrivalent HPV vaccine injection compared with surgical excision. Materials and Methods: This prospective study included 26 patients (M:F = 24:2) who received HPV vaccine or surgical excision. After explanation of surgical excision or HPV vaccine, 16 patients underwent surgical excision and the others received HPV vaccine injections. Based on gross findings of genital warts, treatment outcomes were classified as complete response (no wart), partial response, and failed treatment. Results: Among enrolled patients, 42% (11 / 26) patients had recurrent genital warts. In vaccination group, complete response rates of genital wart were 60% following 3 times HPV vaccine. Partial response patients wanted to excise the genital lesions before the 3 times injection, because they worried about sexual transmission of disease to their sexual partners. One patient underwent surgical excision after 3 times injection. Excision sites included suprapubic lesions, but other sites including mid-urethra and glans showed complete response after injection. At a mean follow-up period of 8.42 ± 3.27 months, 10 patients (100%) who received HPV vaccine did not show recurrence. Conclusion: The response rates after HPV vaccine injection were 90% (complete and partial). Our results suggested that HPV vaccines could be effective in management of genital warts.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Condylomata Acuminata/prevention & control , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines/administration & dosage , Papillomaviridae , Condylomata Acuminata/surgery , Condylomata Acuminata/immunology , Prospective Studies , Follow-Up Studies , Treatment Outcome , Papillomavirus Infections/surgery , Papillomavirus Infections/virology , Papillomavirus Vaccines/immunology , Middle Aged
17.
DST j. bras. doenças sex. transm ; 31(1): 30-33, 31-03-2019.
Article in English | LILACS | ID: biblio-1119255

ABSTRACT

Introduction: Inflammatory linear verrucous epidermal nevus (ILVEN) is a variant of verrucous epidermal nevus. It has a psoriasiform or eczematous and itchy aspect, and has differential diagnosis compared to other more common dermatoses; thus, histological studies are often necessary. It mainly affects women of early age and must be differentiated from condyloma acuminatum. Interestingly, the lower left limb is often involved, but the genital region is rarely affected. Treatment is refractory and the best method is not yet established. Objective: We present a case of unusual vulvar involvement known as inflammatory linear verrucous epidermal nevus. Methods: This was a clinical case report of a child diagnosed with ILVEN in the vulvar region. Case report: An 11-year-old female presented to the gynecology department of the Universidade Federal de Alagoas complaining of pruritic lesions on the large left vulvar lip, perianal and anal regions, and vaginal introitus. The lesions were hypochromic, eroded, and covered by scabs along the Blaschko line with verrucous lesions in the abdomen and upper and lower limbs. These characteristics fit the clinical criteria of Altman and Mehregan, and the histological criteria of Dupre and Christol for diagnosis of ILVEN. The treatment was performed with Vitanol A® and Epidrat Ultra® with partial improvement of the lesions. We chose to excise the lesions to control the condition. Conclusion: These lesions are characterized by recurrent inflammatory phenomena including psoriasiform or eczematous aspects in the extremities with genital involvement being rare. Other common dermatoses are often confused with ILVEN and make anatomically pathological analysis extremely important for diagnosis. Despite details on several types of treatment for ILVEN, there are no studies on relative advantages because this lesion is very refractory to the treatment.


Introdução: Nevo epidérmico verrucoso inflamatório linear (NEVIL) é uma variante do nevo epidérmico verrucoso. Tem aspecto psoriasiforme ou eczematoso e pruriginoso, sendo o diagnóstico diferencial com outras dermatoses mais comuns e o estudo histológico é necessário para diferenciálas. Afeta, principalmente, mulheres em idade precoce e deve ser diferenciado do condiloma acuminado. Curiosamente, o membro inferior esquerdo está envolvido, sendo a região genital raramente afetada. O tratamento é refratário e ainda não está estabelecido qual o melhor método. Objetivo: Apresentar um caso de incomum acometimento vulvar conhecido como nevo epidérmico verrucoso inflamatório linear (NEVIL). Métodos: Realizada documentação de caso clínico de criança com diagnóstico de NEVIL em região vulvar. Relato de caso: Uma paciente do sexo feminino, 11 anos de idade, procurou o serviço de ginecologia da Universidade Federal de Alagoas queixando-se de lesões pruriginosas vegetantes em grande lábio vulvar esquerdo, regiões perianal e anal e introito vaginal. As lesões eram hipocrômicas, erosadas, recobertas por crostas ao longo da linha de Blaschko com lesões verrucosas no abdome e nos membros superiores e inferiores. Essas características se enquadram nos critérios clínicos de Altman e Mehregan e aos critérios histológicos de Dupre e Christol para diagnóstico de NEVIL. O tratamento foi realizado com Vitanol A® e complexo hidratante (Epidrat Ultra®) com melhora parcial das lesões. Optou-se pela exérese das lesões com controle do quadro. Conclusão: Essas lesões se caracterizam por fenômenos inflamatórios recorrentes, incluindo aspecto psoriasiforme ou eczematoso, normalmente em extremidades, sendo raro o acometimento genital. Outras variedades de dermatoses mais comuns são frequentemente confundidas com NEVIL, tornando a análise anatomopatológica de extrema importância para o diagnóstico. Apesar dos detalhes sobre diversos tipos de tratamento para NEVIL, não há estudos sobre vantagens relativas entre eles, uma vez que essa lesão é muito refratária ao tratamento.


Subject(s)
Humans , Vulva , Condylomata Acuminata , Nevus , Skin Diseases , Inflammation , Neoplasms
18.
Ciênc. cuid. saúde ; 18(1): e45523, 2019-02-13.
Article in Portuguese | LILACS | ID: biblio-1122211

ABSTRACT

Objective:to analyze the capacity of the bioaerosol retention filters with the use of a surgical smoke aspirator in procedures of cauterization of venereal warts. Method:field, descriptive, cross-sectional and quantitative research. The study was developedat a referral center for sexually transmitted infections in the northern state of Paraná, in the urology outpatient clinic. Data collection was collected from April to July 2016, with a sample obtained from 72 cauterization procedures. A descriptive statistical analysis was performed. Results:24 filters attached in two equipment, used to vacuum the smoke were analyzed. The conventional Polymerase Chain Reaction method was used to read the filters, using specific primers to search for Simple Herpes, HerpesZoster, Hepatitis C, Human Immunodeficiency Virus, Hepatitis B and Human Virus Papilloma. From the analyzed samples were found Viral Deoxyribonucleic Acid from Herpes Simplex, Hepatitis B and Human Virus Papilloma in the analyzed filters. Conclusion:the use of surgical vacuum aspiration equipment with Ultra-low Particulate Air filters during the cauterization of venereal warts was able to retain bioaerosols when the filter replacement time was respected.


Objetivo:analisar a capacidade dos filtros de retenção de bioaerossóis com o uso de aspirador de fumaça cirúrgica em procedimentos de cauterização de verrugas venéreas. Método: pesquisa de campo, descritiva, transversal e quantitativa. O estudo foi desenvolvido em um centro de referência para infecções sexualmente transmissíveis no Norte do estado do Paraná, no ambulatório de urologia. A coleta de dados foi realizada no período de abril a julho de 2016, com uma amostra obtida a partir de 72 procedimentosde cauterização. Realizou-se análise estatística descritiva. Resultados:foram analisados 24 filtros acoplados em dois equipamentos, utilizados para aspiração da fumaça. O método da Reação em Cadeia da Polimerase convencional foi utilizado para a leitura dos filtros, sendo utilizados primersespecíficos para a pesquisa de Herpes Simples, Herpes Zoster, Hepatite C, Vírus da Imunodeficiência Humana, Hepatite B e Papiloma Vírus Humano. A partir das amostras analisadas foram encontrados Ácido Desoxirribonucleico viral do Herpes Simples, Hepatite B e Papiloma Vírus Humano nos filtros analisados. Conclusão: O uso de um equipamento de aspiração de fumaça cirúrgica, com filtros Ultra-low Particulate Air, durante as cauterizações de verrugas venéreas mostrou-se capaz de reter bioaerossóis quando respeitado o tempo de troca dos filtros.


Subject(s)
Humans , Male , Female , Smoke , Condylomata Acuminata , Cautery , Outpatients , Papilloma , Referral and Consultation , Viruses , Biological Factors , Sexually Transmitted Diseases , Filters , Occupational Exposure , HIV , Health Personnel , Hepatitis C , Electrosurgery , Alphapapillomavirus , Air Filters , Hepatitis , Hepatitis B , Herpes Simplex , Herpes Zoster
19.
Annals of Dermatology ; : 434-437, 2019.
Article in English | WPRIM | ID: wpr-762354

ABSTRACT

Ingenol mebutate (IM) is approved for the treatment of actinic keratosis and induces cell death in precancerous lesions. The efficacy of IM in the treatment of genital warts was investigated in a therapy-refractory patient. The 74-year-old male was treated with IM gel for three consecutive days. Treatment course and efficacy were evaluated by clinical inspection and non-invasive diagnostics namely optical coherence tomography (OCT) and reflectance confocal microscopy (RCM). Within 24 to 48 hours IM induced a strong local inflammatory reaction. One week later a complete response was observed. OCT and RCM showed a strong reaction after treatment with erosions, swelling of cells, and a subepidermal dark band in representative lesions. IM has the advantage of a short treatment period in contrast to other topical treatments and shows a promising clinical outcome. Larger studies are needed to validate the data.


Subject(s)
Aged , Cell Death , Condylomata Acuminata , Humans , Keratosis, Actinic , Male , Microscopy , Microscopy, Confocal , Tomography, Optical Coherence
20.
INSPILIP ; 2(2): 1-13, jul.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-981892

ABSTRACT

Introducción: La condilomatosisgenital o verruga genital es una de las manifestaciones clínicas más común de infección del virus del papiloma humano (VPH), predominantemente causadas por los genotipos VPH-6 y -11. Durante el embarazo, el incremento en los niveles de las hormonas esteroides modifica el sistema inmune de la madre contribuyendo a la "tolerancia" del feto, pero disminuye la capacidad de eliminar infecciones, incluido el VPH. El presente estudio plantea determinar el comportamiento de la condilomatosis genital en gestantes atendidas en la Maternidad Mariana de Jesús desde 2016 a 2017. Materiales y métodos: Es un estudio longitudinal, observacional, retrospectivo, en 84 gestantes que fueron atendidas entre el 1 de enero de 2016 al 30 de septiembre de 2017. Resultados: En las 84 gestantes analizadas se pudo observar quela mayoría de las pacientes con condilomas tiene de 20 a 25 años de edad; su primera relación sexual fue entre los 17 a 19 años; existiendo mayor número de gestantes multíparas, y que han tenido más de 2 parejassexuales.


Introduction: Genital condylomatosisor genital wart is one of the most common clinical manifestations of human papilloma virus (HPV) infection, predominantly caused by HPV-6 and -11 genotypes. During pregnancy, increased levels of steroid hormones modify the mother's immune system contributing to the "tolerance" of the fetus, but decrease the ability to eliminate infections, including HPV. The present study proposes to determine the behavior of genital condilomatosis in pregnant women attended in the Mariana de Jesus Maternity from 2016 to 2017. Materials and Methods: It is a longitudinal, observational, retrospective study in 84 pregnant women who were attended between January 1, 2016 to September 30, 2017. Results: In the 84 pregnant women analyzed it was possible to observe that the majority of patients with condylomas are between 20 and 25 years of age; her first sexual relationship was between 17 and 19 years old; There is a greater number of multiparous pregnant women, and they have had more than 2 sexual partners. The condylomas were presented individually, preferably being accumulated, predominantly in the second trimester of pregnancy. Conclusion: Although the greatest effort of studies is carried out in high-risk HPV, it is important to carry out studies that show the reality of the condylomas caused by low-risk HPV, mainly focusing on avoiding maternal-neonatal transmission.


Subject(s)
Humans , Female , Pregnancy , Condylomata Acuminata , Sexually Transmitted Diseases , Immune System , Pregnant Women , Genotype , Hormones , Hospitals, Maternity
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