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Bar-Ilan E, Bar J, Baniel A, Slodownik D, Artzi O, Samuelov L, Sprecher E, Mashiah J. Intralesional human papillomavirus vaccine for the treatment of recalcitrant cutaneous warts. J Dermatol 2023; 50:1373-1380. [PMID: 37501372 DOI: 10.1111/1346-8138.16905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/14/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023]
Abstract
Human papillomavirus (HPV) is ubiquitously distributed in the population worldwide and its most frequent clinical presentation is cutaneous warts. Despite various treatment options currently available, many patients experience persistent and refractory disease. We sought to evaluate the clinical effectiveness and safety profile of intralesional HPV 9-valent vaccine for the treatment of recalcitrant warts. A retrospective study was performed for all cases of cutaneous warts treated with intralesional 9-valent HPV vaccine between January 2017 and March 2021. Epidemiologic, clinical, and treatment data, including safety and effectiveness scores, were reviewed. Our cohort was composed of 20 patients: 13 adults and seven children. Twelve patients (60%) displayed a complete response whereas 8 patients (40%) showed a partial response. Older age was associated with a better response to treatment, while a history of laser therapy was associated with a worse prognosis. Adverse events were local, transient, and negligible. No systemic adverse effects were reported. Intralesional 9-valent HPV vaccine may be considered for the treatment of recalcitrant cutaneous warts. Controlled studies are required to confirm these results.
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Affiliation(s)
- Efrat Bar-Ilan
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jonathan Bar
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Avital Baniel
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dan Slodownik
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ofir Artzi
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liat Samuelov
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Dermatology Clinic, Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel Aviv, Israel
| | - Eli Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Dermatology Clinic, Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel Aviv, Israel
| | - Jacob Mashiah
- Division of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Dermatology Clinic, Sourasky Medical Center, Dana-Dwek Children's Hospital, Tel Aviv, Israel
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Burli A, Hancock S, Zhao YT, Paul D, Cordisco M. HPV Vaccination Status and Resolution of Warts in Pediatric Patients. Indian J Dermatol 2021; 66:604-608. [PMID: 35283520 PMCID: PMC8906332 DOI: 10.4103/ijd.ijd_30_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Warts are a common dermatologic complaint with an increased incidence within the pediatric population. Warts are caused by multiple strains of the human papillomavirus (HPV). There is little research on how a patient's HPV immunization status affects the response to treatment of warts in pediatric patients. Aims: The purpose of this study is to investigate the relationship between HPV vaccination status and wart resolution. Materials and Methods: This is a retrospective chart review that investigates the relationship between response to routine treatment of warts and a subject's HPV vaccination status. Results: There was no significant relationship found between HPV vaccination status and resolution of warts (p = 0.797). However, there was a significant positive correlation between having the HPV vaccine and number of visits for the treatment of warts (r = 0.180, P = 0.024). Conclusion: This study did not show a significant correlation between HPV vaccination status and wart resolution, although it demonstrated a significant positive relationship between those immunized with the HPV vaccine and an increased number of treatment visits. Possible explanations for this unexpected correlation include the variation in HPV vaccine formulation, vaccination status, and frequency of office visits, since vaccinated patients are more likely to be compliant with office visits.
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Affiliation(s)
- Anuk Burli
- Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Sarah Hancock
- Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Yu Tina Zhao
- Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Deborah Paul
- Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Maria Cordisco
- Department of Dermatology, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
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Management of Difficult-to-Treat Warts: Traditional and New Approaches. Am J Clin Dermatol 2021; 22:379-394. [PMID: 33432476 DOI: 10.1007/s40257-020-00582-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 10/24/2022]
Abstract
Warts are regularly treated by dermatologists, and while many respond readily to first-line treatments, others may represent a therapeutic challenge. Large, deep, numerous, and extensive warts; treatment-resistant lesions with higher risk for side effects, such as hypopigmentation; or patients unable to tolerate or comply with our treatment regimen, may need alternative treatment options. In this work we review the characteristics of select modalities that should be considered for difficult-to-treat warts. We discuss efficacy and tolerability data as well as practical features that can guide us to select the best treatment for every scenario. Novel approaches, still in an investigational phase, are also discussed to illustrate potential future directions of wart treatment.
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Couselo-Rodríguez C, Pérez-Feal P, Alarcón-Pérez CE, Bou-Boluda L, Baselga E. Clearance of genital warts in a pediatric patient following administration of the nonavalent human papillomavirus vaccine. Int J Dermatol 2021; 60:e377-e379. [PMID: 33825183 DOI: 10.1111/ijd.15569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 03/03/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Carmen Couselo-Rodríguez
- Department of Dermatology, Pontevedra University Hospital, Pontevedra, Spain.,DIPO Research Group, Galicia Sur Health Research Institute, SERGAS-UVIGO, Pontevedra, Spain
| | - Patricia Pérez-Feal
- Dermatology Department, University Hospital Complex, Santiago de Compostela, Spain
| | | | - Laia Bou-Boluda
- Dermatology Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - Eulalia Baselga
- Dermatology Department, Hospital Sant Joan de Déu, Barcelona, Spain
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Tyros G, Mastraftsi S, Gregoriou S, Nicolaidou E. Incidence of anogenital warts: epidemiological risk factors and real-life impact of human papillomavirus vaccination. Int J STD AIDS 2020; 32:4-13. [PMID: 33167803 DOI: 10.1177/0956462420958577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Anogenital warts (AGWs) rank among the most frequent sexually transmitted infections in young adults. They are benign lesions, but they pose a significant economic cost to health care systems and a substantial psychological burden on patients, who need evidence-based counselling. Human papillomavirus (HPV) vaccination has shown very high protection rates against AGWs in clinical trials and real-world settings but vaccination coverage remains low in many countries. The aim of this review is to summarize the current evidence on the risk factors for AGW development and to present the available real-life data on the impact of HPV vaccination on AGW incidence. An increased number of lifetime sexual partners, a new sexual partner in the last 12 months, smoking, and immunosuppression have been associated with increased risk for AGWs. HPV vaccination has led to a dramatic decline in AGW incidence in populations that have achieved high vaccination rates. These conclusions can contribute to primary prevention of AGWs and evidence-based counselling of AGW patients.
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Affiliation(s)
- Georgios Tyros
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Styliani Mastraftsi
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Stamatis Gregoriou
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Electra Nicolaidou
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
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Johnson NM, Pickard CM. Resolution of diffuse facial verruca plana following nonavalent human papillomavirus immunization. Pediatr Dermatol 2020; 38:292-293. [PMID: 33090480 DOI: 10.1111/pde.14384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/29/2020] [Indexed: 11/28/2022]
Abstract
Treatment of verruca plana is often challenging, and multiple treatment modalities, both pharmacologic and destructive, are frequently necessary to clear lesions. We report a case of a 16-year-old girl with a 2-year history of extensive verruca plana of the forehead, temples, and upper periorbital skin, recalcitrant to monotherapy with topical tretinoin cream, that completely resolved following first dose of nonavalent human papillomavirus (HPV) immunization.
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Affiliation(s)
- Nathan M Johnson
- Section of Dermatology, Department of Internal Medicine, Virginia Tech Carilion School of Medicine / Carilion Clinic, Roanoke, VA, USA
| | - Clay M Pickard
- Section of Dermatology, Department of Internal Medicine, Virginia Tech Carilion School of Medicine / Carilion Clinic, Roanoke, VA, USA
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