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Meena A, Sarkar R. Acitretin in dermatology. APOLLO MEDICINE 2023. [DOI: 10.4103/am.am_145_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Korecka K, Wiśniewska-Szymańska A, Mikiel D. The impact of systemic psoriasis treatments on human papillomavirus activation and propagation. Australas J Dermatol 2022; 63:293-302. [PMID: 35510323 DOI: 10.1111/ajd.13865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/20/2022] [Accepted: 04/21/2022] [Indexed: 11/27/2022]
Abstract
Psoriasis is one of the most prevalent diseases in the world and it affects up to 2% of the worldwide population. Its pathogenesis is complex and the lesions may be triggered by multiple factors. Human papillomavirus (HPV) is associated with anogenital cancers, cutaneous warts and is considered one of the most prevalent infections in the world. In this review, the available literature on the systemic treatment of patients with psoriasis and concomitant HPV infection was analysed.
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Affiliation(s)
- Katarzyna Korecka
- Department of Skin Diseases, Provincial Hospital in Poznan, Poznan, Poland
| | | | - Dominik Mikiel
- Department of Skin Diseases, Provincial Hospital in Poznan, Poznan, Poland
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Sindhuja T, Bhari N, Gupta S. Asian guidelines for condyloma acuminatum. J Infect Chemother 2022; 28:845-852. [PMID: 35341674 DOI: 10.1016/j.jiac.2022.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/16/2022] [Accepted: 03/08/2022] [Indexed: 11/18/2022]
Abstract
The present guidelines aim to provide comprehensive information on genital condyloma acuminata, including the epidemiology, clinical features, diagnosis and management. The guidelines provide evidence-based recommendations on the diagnosis, prevention and treatment of genital condyloma acuminata in adults in Asia, including patients with HIV co-infection. METHODOLOGY A PubMed search was performed, using the keywords "condyloma acuminata", "anal wart", "anogenital wart", "genital wart" and "genital HPV". A total of 3031 results were found in publications during last six years. A careful review of the titles and abstracts was done to find all the studies pertaining to epidemiology, clinical features, diagnosis, treatment and prevention of condyloma acuminata. DIAGNOSIS Various diagnostic procedures described are: 1. PCR (LE: 2b). 2. Serology (LE: 2b). 3. In-situ hybridization (LE: 3). PREVENTION 1. Vaccination (LE: 1a): Quadrivalent vaccine reduced the frequency of anogenital warts in both vaccinated and unvaccinated contacts. According to the update Advisory Committee on Immunization Practices (ACIP) recommendations, the following protocol is recommended: (a). HPV vaccination at age 11 or 12 years for both males and females. (b). Catch-up vaccination for all persons through age 26 years. (c). Shared clinical decision-making regarding potential HPV vaccination for persons aged 27-45 years, who are at risk of new HPV infection. 2. Male circumcision (LE: 2a): conflicting evidence. HIV AND CONDYLOMA ACUMINATA In HIV-affected individuals, the course of HPV is more aggressive, with a greater risk of treatment resistance, increased chances of intraepithelial neoplasia as well as cancers. TREATMENT Physician administered. 1. Photodynamic therapy (LE: 1a). 2. Laser (LE: 2b). 3. Surgery (LE: 1a). 4. Electrosurgery (LE: 2c). 5. Cryotherapy (LE: 1b). 6. Immunotherapy (LE: 1b). 7. Podophyllin (LE: 1b). Provider administered. 1. Imiquimod 5%(LE: 1a). 2. Podophyllotoxin (LE: 1b). 3. Sinecatechins (LE: 1a). 4. Cidofovir (LE: 3). 5. 5- Fluorouracil (LE: 1a). 6. Interferon (LE: 1a).
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Affiliation(s)
- Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
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Wang MF, Lin L, Li LF. Efficacy and Safety of Giant Condyloma Acuminatum with Monotherapy of Topical Traditional Chinese Medicine: Report of Eight Cases. Infect Drug Resist 2021; 14:1375-1379. [PMID: 33859483 PMCID: PMC8043789 DOI: 10.2147/idr.s302195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/13/2021] [Indexed: 11/23/2022] Open
Abstract
Background Giant condyloma acuminatum (GCA), also called Buschke-Löwenstein tumor, presents as a verrucous infiltrating lesion and is caused by sexual transmission of human papilloma virus. The optimal treatment is controversial and there are no standard guidelines because of its rarity and frequent recurrence. It has a relatively high local recurrence rate. Objective We here report eight patients (six men and two women) with GCA whose lesions were successfully treated topically with traditional Chinese medicine (TCM) preparations, paiteling. Methods and Materials We administered topical TCM preparations to eight patients diagnosed with GCA who had refused surgery. The treatment process included three stages, their durations depending on the speed of resolution of the lesions and the results of visual inspection with acetic acid. Results No significant complications occurred in any patient. The functional and esthetic outcomes were satisfactory. No recurrences were detected during follow-up. Conclusion Topical treatment with TCM preparations may be a good alternative to surgery or other traditional methods for the treatment of GCA. This treatment has the advantages of being non-invasive, painless, and having a low risk of recurrence, and may be a useful adjunct to mainstream medical treatments.
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Affiliation(s)
- Mei-Fang Wang
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Li Lin
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Lin-Feng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
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Nofal A, Elkot R, Nofal E, Mazen M. Combination therapy versus monotherapy in the treatment of recalcitrant warts: A clinical and immunological study. J Cosmet Dermatol 2019; 18:1448-1455. [PMID: 30597693 DOI: 10.1111/jocd.12848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 10/11/2018] [Accepted: 10/25/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Treatment of recalcitrant warts represents a continuing therapeutic challenge. Combination therapies can help improve treatment response, decrease adverse effects, and reduce recurrence. OBJECTIVE To compare the efficacy, safety and immunological effects of a combined acitretin-intralesional Candida antigen against acitretin alone and Candida antigen alone for intractable warts. METHODS Sixty adult patients with intractable warts were included in this study. Patients were subdivided into three groups, each containing 20 patients. Acitretin alone was taken by patients of group I, Candida antigen alone was injected in patients of group II, and group III received a combination of intralesional Candida antigen and acitretin. Serum cytokine levels of IL-10 and IFN-γ were measured before and after therapy in the studied groups. RESULTS Total resolution of warts was achieved in 8 patients (40%) of the acitretin alone group, 9 patients (45%) of the Candida antigen alone group and 15 patients (75%) of the combination therapy group. The therapeutic response was statistically higher in the combined acitretin-Candida antigen group as compared with either agent alone. Adverse effects were non-significant in the three groups. There were no statistically significant differences in the serum levels of IFN-γ and IL-10 between responders and non-responders after therapy in the three studied groups. CONCLUSION The combination therapy of acitretin + Candida antigen is superior to either agent alone. Serum cytokine levels of IL-10 and IFN-γ were not associated with clearance or persistence of warts in any of the studied groups.
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Affiliation(s)
- Ahmad Nofal
- Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Reham Elkot
- Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Eman Nofal
- Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mai Mazen
- Dermatology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Lalošević J, Lekić B, Gajić-Veljić M, Škiljević D, Đukić K, Medenica L. Verrucous Carcinoma of the Foot - Report of Two Cases. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2017. [DOI: 10.1515/sjdv-2016-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Verrucous carcinoma (VC) is a rare variant of a well-differentiated squamous cell carcinoma (SCC) with a low grade of malignancy. Epithelioma cuniculatum (EC) is a subtype of VC, usually found on the sole of the foot.
Two patients, a 55-year-old female, and a 77-year-old male, with VC were treated at the Clinic of Dermatology and Venereology, Clinical Center of Serbia, from 2002 to 2011. Both patients presented with a tumor on the foot. Incisional biopsies showed a well differentiated squamous cell carcinoma. Foot x-rays showed bone involvement in one case. One patient underwent surgical amputation of the lower extremity, while the other had a partial amputation of the affected foot.
In the initial stage of the disease, it is difficult to distinguish pseudoepitheliomatous hyperplasia from verrucous carcinoma. The superficial biopsy of EC lesion may mislead to a histopathological diagnosis of warts or condylomas. Multiple deep biopsies are necessary for accurate and timely diagnosis of verrucous carcinoma.
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Affiliation(s)
- Jovan Lalošević
- Clinic of Dermatology and Venereology, Clinical Center of Serbia, Belgrade, Serbia
| | - Branislav Lekić
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mirjana Gajić-Veljić
- Clinic of Dermatology and Venereology, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dušan Škiljević
- Clinic of Dermatology and Venereology, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Katarina Đukić
- Clinic of Dermatology and Venereology, Clinical Center of Serbia, Belgrade, Serbia
| | - Ljiljana Medenica
- Clinic of Dermatology and Venereology, Clinical Center of Serbia, Belgrade, Serbia
- School of Medicine, University of Belgrade, Belgrade, Serbia
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Luo S, Wang Y, Zhao M, Lu Q. The important roles of type I interferon and interferon-inducible genes in systemic lupus erythematosus. Int Immunopharmacol 2016; 40:542-549. [PMID: 27769023 DOI: 10.1016/j.intimp.2016.10.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 09/30/2016] [Accepted: 10/14/2016] [Indexed: 12/23/2022]
Abstract
Systemic lupus erythematosus (SLE) is a severe autoimmune disease that causes multiple-organ dysfunction mainly affecting women in their childbearing years. Type I IFN synthesis is usually triggered by viruses, and its production is tightly regulated and limited in time in health individuals. However, many patients with systemic autoimmune diseases including SLE have signs of aberrant production of type I interferon (IFN) and display an increased expression of IFN-inducible genes. Continuous type I IFNs derived from activated plasmacytoid dendritic cells (pDCs) by interferogenic immune complexes (ICs) and migration of these cells to tissues both break immune tolerance and promote an on-going autoimmune reaction in human body. By the means of detecting type I IFNs and IFN-inducible genes, it can help with diagnosis and evaluation of SLE in early stage and more efficiently. Anti-IFN-α monoclonal antibodies in SLE patients were recently reported and is now being investigated in phase II clinical trails. In this review, we focus on recent research progress in type I IFN and IFN-inducible genes. Possible mechanisms behind the dysregulated type I IFN system in SLE and how they contribute to the development of an autoimmune process, and act as a biomarker and therapeutic target will be reviewed.
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Affiliation(s)
- Shuaihantian Luo
- Department of Dermatology, Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Medical Epigenetics, Changsha, Hunan, China
| | - Yunuo Wang
- Department of Endocrinology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ming Zhao
- Department of Dermatology, Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Medical Epigenetics, Changsha, Hunan, China
| | - Qianjin Lu
- Department of Dermatology, Second Xiangya Hospital of Central South University, Hunan Key Laboratory of Medical Epigenetics, Changsha, Hunan, China.
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Sir E, Gungor M, Ucer O, Kebat T. Invasive squamous cell carcinoma originating from a giant penile condyloma. Int J STD AIDS 2016; 28:619-622. [PMID: 26912164 DOI: 10.1177/0956462416635361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this case study, we present an unusual case with squamous cell carcinoma originating from a giant condyloma acuminata completely surrounding the penis. A 57-year-old circumcised heterosexual male patient presented with a penile lesion existing for 20 years. Incisional biopsy revealed acanthosis of the squamous epithelium. The patient was operated on under spinal anaesthesia. The lesion was resected circumferentially with macroscopic clearance, resulting in complete degloving of the penile shaft. Neurovascular bundles were preserved. The penile skin was constructed with a split thickness skin graft. Histopathological analysis of the lesion revealed an invasive and well-differentiated squamous cell carcinoma arising on a condyloma, and the surgical margins were free from tumour. The patient was staged as G2 T1 N0 M0 and was followed for one year. He did not have any erectile dysfunction and could engage in intercourse. Pelvic tomographic and physical examination findings did not reveal any episode of recurrence or metastasis. When encountering patients with giant condyloma acuminata, it should not be forgotten that it may be accompanied by squamous cell carcinoma. In addition, tissue excision should be as extensive as possible while keeping in mind the importance of the function. This is the first case of a penile-degloving surgery for giant penile condyloma, supporting conservative and preserving penile surgery for such tumours.
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Affiliation(s)
- Emin Sir
- 1 Department of Plastic and Reconstructive Surgery, Izmir Training and Research Hospital, Izmir, Turkey
| | - Melike Gungor
- 1 Department of Plastic and Reconstructive Surgery, Izmir Training and Research Hospital, Izmir, Turkey
| | - Oktay Ucer
- 2 Department of Urology, Celal Bayar University, Faculty of Medicine, Manisa, Turkey
| | - Tulu Kebat
- 3 Department of Pathology, Izmir Training and Research Hospital, Izmir, Turkey
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Shi H, Zhang X, Ma C, Yu N, Wang J, Xia L, Ge X, Liu M, Duan A. Clinical analysis of five methods used to treat condylomata acuminata. Dermatology 2013; 227:338-45. [PMID: 24216675 DOI: 10.1159/000355351] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 08/23/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Treatments for condylomata acuminata (CA) include pharmacotherapy and surgical therapies, but each treatment has its limitations. The aim of this study was to investigate the virus clearance rate, wart cure rate and safety of 5 methods on CA. METHODS 361 patients diagnosed with CA were divided into groups A (<0.5 cm), B (0.5-2.0 cm) and C (>2.0-4.0 cm) according to the maximum diameter of their lesion. Five treatments were compared in each group, and the clinical outcomes were evaluated during follow-ups. RESULTS A 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is preferred if the maximum lesion diameter is <0.5 cm and an ALA-PDT plus cryotherapy treatment is preferred for lesions 0.5-2.0 cm. For lesions >2.0- 4.0 cm, an ALA-PDT retreatment (after cryotherapy or CO2 laser treatment) should be the first choice. CONCLUSIONS The treatments for CA should be chosen according to the maximum diameter of each patient's lesion.
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Affiliation(s)
- Huijuan Shi
- Department of Dermatovenereology, Ningxia Medical University General Hospital, Yinchuan, China
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Nofal A, Yosef A, Salah E. Treatment of recalcitrant warts with Bacillus Calmette-Guérin: a promising new approach. Dermatol Ther 2013; 26:481-5. [DOI: 10.1111/dth.12019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ahmad Nofal
- Dermatology Department, Faculty of Medicine; Zagazig University; Zagazig Egypt
| | - Ayman Yosef
- Dermatology Department, Faculty of Medicine; Zagazig University; Zagazig Egypt
| | - Eman Salah
- Dermatology Department, Faculty of Medicine; Zagazig University; Zagazig Egypt
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