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Topçu EG, Ubom AE, Roy P, Ruiloba F. A global study on knowledge and perception of HPV and HPV vaccination among young obstetricians and gynecologists. Turk J Obstet Gynecol 2024; 21:51-56. [PMID: 38440968 PMCID: PMC10920966 DOI: 10.4274/tjod.galenos.2024.31369] [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: 02/16/2024] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
Objective Our goal is to improve the understanding of human papillomavirus (HPV) and its vaccination among obstetrics and gynecology trainees and young specialists worldwide. Materials and Methods This cross-sectional study was conducted through an online survey consisting of 28 questions by the World Association of Trainees in Obstetrics and Gynecology between February and August 2023. The questionnaire collected demographic data of the study participants and assessed the respondents' knowledge and perception of HPV, HPV vaccines, and vaccine dosing schedule. Results Two hundred five Ob/Gyn trainees and young Ob/Gyns from 52 countries completed the survey. The majority of respondents were trainees (158, 77.1%). Most trainees and young Ob/Gyns learned about HPV for the first time during medical school (149, 72.6%). Almost all (204, 99.5%) Ob/Gyns responded that HPV was sexually transmitted. More than half of the respondents had not received HPV vaccination (110, 53.7%). The vaccine was recommended for respondents mostly by their Ob/Gyn senior colleagues (110, 53.7%). Most of the respondents knew how to manage HPV-positive patients (179, 87.3%). Conclusion This study suggests that even though knowledge on HPV and its vaccination is satisfactory among trainees and young Ob/Gyns, HPV vaccination remains deficient. There is a need to understand, educate, and address the potential problem that lies underneath.
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Affiliation(s)
- Elif Göknur Topçu
- Acıbadem Maslak Hospital, Assisted Reproductive Technologies Unit, İstanbul, Turkey
| | - Akaninyene Eseme Ubom
- Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Department of Obstetrics, Gynecology, and Perinatology, Osun State, Nigeria
| | - Priyankur Roy
- Roy’s Multispecialty Hospital, Clinic of Obstetrics and Gynecology, Siliguri, India
| | - Francisco Ruiloba
- Instituto Nacional de Perinatologia, Department of Obstetrics and Gynecology, Mexico, USA
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Kobayashi K, Yamamura M, Mikami B, Shiraishi A, Kumatani M, Satake H, Ono E, Umezawa T. Anthriscus sylvestris Deoxypodophyllotoxin Synthase Involved in the Podophyllotoxin Biosynthesis. PLANT & CELL PHYSIOLOGY 2023; 64:1436-1448. [PMID: 37948767 DOI: 10.1093/pcp/pcad103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 08/28/2023] [Accepted: 09/14/2023] [Indexed: 11/12/2023]
Abstract
Tetrahydrofuran ring formation from dibenzylbutyrolactone lignans is a key step in the biosynthesis of aryltetralin lignans including deoxypodophyllotoxin and podophyllotoxin. Previously, Fe(II)- and 2-oxoglutarate-dependent dioxygenase (2-ODD) from Podophyllum hexandrum (Himalayan mayapple, Berberidaceae) was found to catalyze the cyclization of a dibenzylbutyrolactone lignan, yatein, to give deoxypodophyllotoxin and designated as deoxypodophyllotoxin synthase (DPS). Recently, we reported that the biosynthesis of deoxypodophyllotoxin and podophyllotoxin evolved in a lineage-specific manner in phylogenetically unrelated plant species such as P. hexandrum and Anthriscus sylvestris (cow parsley, Apiaceae). Therefore, a comprehensive understanding of the characteristics of DPSs that catalyze the cyclization of yatein to deoxypodophyllotoxin in various plant species is important. However, for plant species other than P. hexandrum, the isolation of the DPS enzyme gene and the type of the enzyme, e.g. whether it is 2-ODD or another type of enzyme such as cytochrome P-450, have not been reported. In this study, we report the identification and characterization of A. sylvestris DPS (AsDPS). Phylogenetic analysis showed that AsDPS belonged to the 2-ODD superfamily and shared moderate amino acid sequence identity (40.8%) with P. hexandrum deoxypodophyllotoxin synthase (PhDPS). Recombinant protein assay indicated that AsDPS and PhDPS differ in terms of the selectivity of substrate enantiomers. Protein modeling using AlphaFold2 and site-directed mutagenesis indicated that the Tyr305 residue of AsDPS probably contributes to substrate recognition. This study advances our understanding of the podophyllotoxin biosynthetic pathway in A. sylvestris and provides new insight into 2-ODD involved in plant secondary (specialized) metabolism.
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Affiliation(s)
- Keisuke Kobayashi
- Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto, 611-0011 Japan
| | - Masaomi Yamamura
- Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto, 611-0011 Japan
- Faculty of Bioscience and Bioindustry, Tokushima University, 2-1, Minami-josanjima-cho, Tokushima, 770-8502 Japan
| | - Bunzo Mikami
- Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto, 611-0011 Japan
| | - Akira Shiraishi
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto, 619-0284 Japan
| | - Masato Kumatani
- Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto, 611-0011 Japan
| | - Honoo Satake
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto, 619-0284 Japan
| | - Eiichiro Ono
- Research Institute, Suntory Global Innovation Center Ltd., 8-1-1 Seikadai, Seika-cho, Soraku-gun, Kyoto, 619-0284 Japan
| | - Toshiaki Umezawa
- Research Institute for Sustainable Humanosphere, Kyoto University, Gokasho, Uji, Kyoto, 611-0011 Japan
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Redzic N, Pereira AR, Menon S, Bogers J, Coppens A, Kehoe K, Vanden Broeck D. Characterization of type-specific HPV prevalence in a population of persistent cutaneous warts in Flanders, Belgium. Sci Rep 2023; 13:17492. [PMID: 37840107 PMCID: PMC10577142 DOI: 10.1038/s41598-023-44154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023] Open
Abstract
Cutaneous warts are benign skin lesions caused by the human papillomavirus (HPV). Even though they are considered benign, they can have a considerable impact on the quality of life and cause serious illness in certain immunocompromised populations. Studies have shown that the efficacy of wart treatment is dependent on the causative HPV type. Therefore, in this article, we aim to determine the HPV genotype-specific prevalence in cutaneous warts of a Flemish population as part of the Omnivirol-Salycilic acid randomized controlled trial. Swab samples of cutaneous warts (n = 269) were collected during enrollment. The DNA extraction was performed on the automated NucliSENS® easyMAG® system (bioMérieux). The samples were analyzed with two separate in-house PCR assays capable of detecting the most prevalent cutaneous HPV types (i.e. wart-associated HPV qPCR) as well as the most relevant mucosal types (i.e. RIATOL qPCR assay). In total, the type-specific prevalence of 30 distinct HPV genotypes was determined. The beta-globin gene was used as a cellularity control and for viral load quantification. Data concerning wart persistence, previous treatment, wart type, and other relevant wart and patient characteristics was collected through a baseline questionnaire. The study population consisted mostly of persistent warts considering that 98% (n = 263) of the sampled skin lesions were older than six months and 92% (n = 247) had undergone previous treatment. The most prominent wart type was the mosaic verruca plantaris (42%, n = 113). The most prevalent HPV types were cutaneous HPV types 27 (73%, n = 195), 57 (63%, n = 169), and 2 (42%, n = 113). Only 2% (n = 6) of the lesions was HPV negative. The highest median viral loads were observed with HPV27 and 57 (i.e. 6.29E+04 and 7.47E+01 viral copies per cell respectively). The multivariate analysis found significant associations between wart persistence and certain wart types, the number of warts, and HPV genotypes. Based on these findings, persistent warts are more likely to: (1) be verruca vulgaris, verruca plantaris simple or mosaic, (2) to manifest as multiple warts, (3) and to be negative for HPV type 2 or 4. These characteristics can be useful in the clinical setting for future risk stratification when considering treatment triage and management. Trial registration: NCT05862441, 17/05/2023 (retrospectively registered).
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Affiliation(s)
- Nina Redzic
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium.
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium.
| | - A Rita Pereira
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
| | - Sonia Menon
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Johannes Bogers
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- National Reference Centre for HPV, Brussels, Belgium
- Department of Obstetrics and Gynecology, Women's Clinic, Ghent University Hospital, Ghent, Belgium
| | - Astrid Coppens
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
| | - Kaat Kehoe
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
- National Reference Centre for HPV, Brussels, Belgium
| | - Davy Vanden Broeck
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
- National Reference Centre for HPV, Brussels, Belgium
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Olguín‐García MG, Peralta‐Pedrero ML, Jurado‐Santa Cruz F, Vega‐Memije E, Morales‐Sánchez MA. Low-dose oral isotretinoin in the treatment of recalcitrant facial flat warts: A clinical case and review of literature. Health Sci Rep 2023; 6:e1633. [PMID: 37885463 PMCID: PMC10599275 DOI: 10.1002/hsr2.1633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/28/2023] Open
Abstract
Background and Aims The treatment of recalcitrant facial flat warts has always been challenging for dermatologists. The pain related to the application of the different treatments, side effects and costs are determining factors in the choice of therapy. To date, it is known that oral isotretinoin administered at a dose of 0.5 mg/kg/day is effective and safe; However, the different adverse effects reported have a dose-dependent behavior and they could limit their use. Our aim is to assess the effect of low-doses of oral isotretinoin to reducing side effects in the complete removal of recalcitrant facial flat warts and the current evidence in this regard. Methods An extensive literature review was conducted to identify articles relating to low doses of oral isotretinoin for recalcitrant flat warts treatment, regardless of design up to May 2023. Results The literature search yielded eight articles of 324 reviewed meeting criteria. Isotretinoin was administered in doses of 0.1-0.5 mg/kg/day. Complete elimination of the lesions occurred in 65.13% of the patients and a partial response in 19.26%. Four relapses were documented at the 4-month follow-up. The most frequent adverse effect was cheilitis. Conclusion We might consider low doses of oral isotretinoin for the treatment of recalcitrant facial flat warts in which side effects need to be reduced. However, current published works have several limitations, including small sample sizes, lack of control group and follow-up periods. Larger, randomized, controlled studies are needed to verify the efficacy and safety of different doses of isotretinoin.
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Affiliation(s)
- María Guadalupe Olguín‐García
- Universidad Nacional Autónoma de México “Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud”Mexico CityMexico
- Education and Research DepartmentCentro Dermatológico Dr. Ladislao de la Pascua (CDP) Secretaría de Salud de la Ciudad de MéxicoMexico CityMexico
- Internal Medicine DepartmentHospital General Dr. Darío Fernández Fierro, ISSSTEMexico CityMexico
| | - María Luisa Peralta‐Pedrero
- Universidad Nacional Autónoma de México “Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud”Mexico CityMexico
- Education and Research DepartmentCentro Dermatológico Dr. Ladislao de la Pascua (CDP) Secretaría de Salud de la Ciudad de MéxicoMexico CityMexico
| | - Fermín Jurado‐Santa Cruz
- Education and Research DepartmentCentro Dermatológico Dr. Ladislao de la Pascua (CDP) Secretaría de Salud de la Ciudad de MéxicoMexico CityMexico
| | - Elisa Vega‐Memije
- Dermatology DepartmentHospital General Dr. Manuel Gea González Secretaria de SaludMexico CityMexico
| | - Martha Alejandra Morales‐Sánchez
- Education and Research DepartmentCentro Dermatológico Dr. Ladislao de la Pascua (CDP) Secretaría de Salud de la Ciudad de MéxicoMexico CityMexico
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Lara-Vega I, Correa-Lara MVM, Vega-López A. Effectiveness of radiotherapy and targeted radionuclide therapy for melanoma in preclinical mouse models: A combination treatments overview. Bull Cancer 2023; 110:912-936. [PMID: 37277266 DOI: 10.1016/j.bulcan.2023.05.002] [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: 12/01/2022] [Revised: 03/29/2023] [Accepted: 05/04/2023] [Indexed: 06/07/2023]
Abstract
Cutaneous melanoma is an aggressive and highly metastatic skin cancer. In recent years, immunotherapy and targeted small-molecule inhibitors have improved the overall survival of patients. Unfortunately, most patients in advanced stages of disease exhibit either intrinsically resistant or rapidly acquire resistance to these approved treatments. However, combination treatments have emerged to overcome resistance, and novel treatments based on radiotherapy (RT) and targeted radionuclide therapy (TRT) have been developed to treat melanoma in the preclinical mouse model, raising the question of whether synergy in combination therapies may motivate and increase their use as primary treatments for melanoma. To help clarify this question, we reviewed the studies in preclinical mouse models where they evaluated RT and TRT in combination with other approved and unapproved therapies from 2016 onwards, focusing on the type of melanoma model used (primary tumor and or metastatic model). PubMed® was the database in which the search was performed using mesh search algorithms resulting in 41 studies that comply with the inclusion rules of screening. Studies reviewed showed that synergy with RT or TRT had strong antitumor effects, such as tumor growth inhibition and fewer metastases, also exhibiting systemic protection. In addition, most studies were carried out on antitumor response for the implanted primary tumor, demonstrating that more studies are needed to evaluate these combined treatments in metastatic models on long-term protocols.
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Affiliation(s)
- Israel Lara-Vega
- National School of Biological Sciences, National Polytechnic Institute, Environmental Toxicology Laboratory, Avenida Wilfrido Massieu s/n, Unidad Profesional Adolfo López Mateos, Mexico City CP 07738, Mexico
| | - Maximiliano V M Correa-Lara
- National School of Biological Sciences, National Polytechnic Institute, Environmental Toxicology Laboratory, Avenida Wilfrido Massieu s/n, Unidad Profesional Adolfo López Mateos, Mexico City CP 07738, Mexico
| | - Armando Vega-López
- National School of Biological Sciences, National Polytechnic Institute, Environmental Toxicology Laboratory, Avenida Wilfrido Massieu s/n, Unidad Profesional Adolfo López Mateos, Mexico City CP 07738, Mexico.
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Al‐Sabak H, Al‐Hattab M, Al‐Rammahi M, Al‐Dhalimi M. The efficacy of intralesional vitamin D3 injection in the treatment of cutaneous warts: A clinical therapeutic trial study. Skin Res Technol 2023; 29:e13442. [PMID: 37632174 PMCID: PMC10432866 DOI: 10.1111/srt.13442] [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: 07/19/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The human papillomavirus that causes warts is usually harmless, and it can infect any part of the skin or mucous membranes. Despite the availability of several treatments, warts often return, and scarring, pigmentation changes, and recurrence are all possible side effects. AIM Intralesional vitamin D3 was employed as an immunotherapy for cutaneous warts in the current investigation. MATERIALS AND METHODS In Al-Sadr Medical City in the city of Al-Najaf Al-Ashraf, a skin clinic conducted a therapeutic clinical experiment. A total of 204 cutaneous warts were examined in 40 patients (14 men and 26 females). Vitamin D3 solution of the dose (600 000 IU) was injected into the lesions' bases, with 0.2 mL per patient. Each session could only inject up to five warts. The injections were given every 2 weeks for a total of four times. Instructing patients to forego the use of any topical or oral medication was also a part of the protocol. Each patient was evaluated for recurrence risk before each therapy and then again 6 months later. RESULT AND DISCUSSION There was a wide range of patient ages in this study, from 20 months to 52 years. About 65% of the cases included females. When looking at the many kinds of warts, the most prevalent was the common wart (71.6%). After four treatments, a positive response was considered to have occurred when all lesions had disappeared, a partial response when more than half of the lesions had disappeared, and no reaction when less than half of the lesions had disappeared. The final tally was 81.9% for those who responded in whole, 11.3% for those who responded partially, and 6.9% for those who did not respond at all. Next-session complete response rates were 12.7%, 29.9%, 54.9%, and 81.9%, respectively. Thirteen people experienced adverse symptoms, most noticeably minor swelling and itching. Within 6 months of follow-up, warts had completely disappeared for all patients with a partial or modest response except one who had no reaction. CONCLUSION Vitamin D3 administered intralesional is an effective and low-cost treatment for cutaneous warts.
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Affiliation(s)
- Haider Al‐Sabak
- Head of Dermatology and Laser Department, College of MedicineUniversity of KufaNajafIraq
| | - Mohammed Al‐Hattab
- Department of DermatologyUniversity of Babylon College of MedicineBabylonIraq
| | | | - Muhsin Al‐Dhalimi
- Dermatology and Laser Department, College of MedicineUniversity of KufaNajafIraq
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Jindra C, Hainisch EK, Brandt S. Immunotherapy of Equine Sarcoids—From Early Approaches to Innovative Vaccines. Vaccines (Basel) 2023; 11:vaccines11040769. [PMID: 37112681 PMCID: PMC10145708 DOI: 10.3390/vaccines11040769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Horses and other equid species are frequently affected by bovine papillomavirus type 1 and/or 2 (BPV1, BPV2)-induced skin tumors termed sarcoids. Although sarcoids do not metastasize, they constitute a serious health problem due to their BPV1/2-mediated resistance to treatment and propensity to recrudesce in a more severe, multiple form following accidental or iatrogenic trauma. This review provides an overview on BPV1/2 infection and associated immune escape in the equid host and presents early and recent immunotherapeutic approaches in sarcoid management.
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8
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Wang J, Shen N, Shen H. Successful Treatment of Multiple Plantar and Periungual Warts by Local Hyperthermia Treatment: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:981-985. [PMID: 37056314 PMCID: PMC10089273 DOI: 10.2147/ccid.s408406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/31/2023] [Indexed: 04/15/2023]
Abstract
Local hyperthermia treatment, a common immunoadjuvant therapy, has been used in treating various human papillomavirus (HPV) infections. For multiple warts, it can clear off all warts of the body through targeted irradiation on one wart. We reported a case of a 22-year-old patient with multiple plantar warts combined with periungual warts, in which previous treatments were ineffective. Therefore, we utilized local hyperthermia treatment at 44°C using the largest fused-wart plaque on the right plantar as the treatment target for 30-minute irradiation each time. The hyperthermia induction therapy was performed on day 1, 2, 3, 12 and 13, followed by weekly maintenance therapy for 6 times. After 2 months of treatment, both irradiated and non-irradiated lesions disappeared, and no recurrence occurred during the follow-up period. This case indicates that local hyperthermia treatment may be a safe and effective approach for patients with multiple, recalcitrant, and site-specific viral warts due to the ineffectiveness of conventional treatment.
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Affiliation(s)
- Jian Wang
- Department of Dermatology, Zhejiang Provincial Institute for Dermatoses Prevention and Cure, Huzhou City, Zhejiang Province, 313200, People’s Republic of China
| | - Ningning Shen
- Department of Dermatology, Zhejiang Provincial Institute for Dermatoses Prevention and Cure, Huzhou City, Zhejiang Province, 313200, People’s Republic of China
| | - Huiliang Shen
- Department of Dermatology, Zhejiang Provincial Institute for Dermatoses Prevention and Cure, Huzhou City, Zhejiang Province, 313200, People’s Republic of China
- Correspondence: Huiliang Shen, Department of Dermatology, Zhejiang Provincial Institute for Dermatoses Prevention and Cure, No. 61, Wuyuan Street, Wukang Town, Deqing County, Huzhou City, Zhejiang Province, 313200, People’s Republic of China, Email
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Mohammed GF, Al-Dhubaibi MS, Bahaj SS, Elneam AIA. Systemic immunotherapy for the treatment of warts: A literature review. J Cosmet Dermatol 2022; 21:5532-5536. [PMID: 36017650 DOI: 10.1111/jocd.15330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/12/2022] [Accepted: 08/23/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Immunotherapy has emerged as a critical therapeutic tool for the treatment of warts. Immunotherapy for warts is currently restricted to recalcitrant lesions. A small number of regimens appear to be extremely effective. Furthermore, there is a scarcity of evidence-based research. OBJECTIVE Furthermore, in the majority of cases, their safety and effectiveness have not been evaluated in double-blind, controlled clinical trials, making the reproducibility of many of the listed treatments difficult to analyze and a possible placebo effect difficult to rule out. METHODS Analyzing and discussing different types of systemic immunotherapy. The different types of immunotherapy for warts are mentioned in this report. RESULTS Systemic immunotherapeutic modalities commonly used in the treatment Echinacea, propolis, oral retinoids, glycyrrhizinic acid, levamisole, cimetidine, and zinc sulfate have all been reported as effective treatment modalities for different types of warts. CONCLUSION Immunotherapy has emerged as one of the most important therapeutic modalities for warts. Such treatment is required not only for recalcitrant or multiple lesions, but also in the majority of treated cases.
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Affiliation(s)
- Ghada Farouk Mohammed
- Department of Dermatology, Venereology and Sexology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | - Saleh Salem Bahaj
- Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Ahmed Ibrahim Abd Elneam
- Department of Clinical Biochemistry, Department of Basic Medical Sciences, College of Medicine, Shaqra University, Dawadmi, Saudi Arabia.,Molecular Genetics and Enzymology Department, Human Genetics and Genome Research Institute, National Research Center, Cairo, Egypt
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10
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Zhu P, Qi R, Yang Y, Huo W, Zhang Y, He L, Wang G, Xu J, Zhang F, Yang R, Tu P, Ma L, Liu Q, Li Y, Gu H, Cheng B, Chen X, Chen A, Xiao S, Jin H, Zhang J, Li S, Yao Z, Pan W, Yang H, Shen Z, Cheng H, Song P, Fu L, Chen H, Geng S, Zeng K, Wang J, Tao J, Chen Y, Wang X, Gao X. Clinical guideline for the diagnosis and treatment of cutaneous warts (2022). J Evid Based Med 2022; 15:284-301. [PMID: 36117295 PMCID: PMC9825897 DOI: 10.1111/jebm.12494] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023]
Abstract
AIM Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidence-based guidelines to guide clinical practice are urgently needed. METHODS We collaborated with multidisciplinary experts to formulate this guideline based on evidences of already published literature, focusing on 13 clinical questions elected by a panel of experts. We adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to form classification of recommendations as well as the improved Delphi method to retain respective recommendations with a consensus degree of over 80%. RESULTS Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained. CONCLUSIONS It is a comprehensive and systematic evidence-based guideline and we hope this guideline could systematically and effectively guide the clinical practice of cutaneous warts and improve the overall levels of medical services.
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Affiliation(s)
- Peiyao Zhu
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Rui‐Qun Qi
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Yang Yang
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Wei Huo
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
| | - Yuqing Zhang
- Department of Clinical Epidemiology and Evidence‐Based MedicineThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
| | - Li He
- Department of DermatologyFirst Affiliated Hospital of Kunming Medical UniversityKunmingP.R. China
| | - Gang Wang
- Department of DermatologyXijing HospitalFourth Military Medical UniversityXi'an, ShaanxiP. R. China
| | - Jinhua Xu
- Department of DermatologyHuashan HospitalFudan UniversityShanghaiP.R. China
| | - Furen Zhang
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and VenereologyShandong First Medical University & Shandong Academy of Medical SciencesJinanP.R. China
| | - Rongya Yang
- Department of DermatologyGeneral Hospital of Beijing Military Command of PLADongcheng DistrictBeijingP.R. China
| | - Ping Tu
- Department of Dermatology and VenerologyPeking University First HospitalBeijingP.R. China
| | - Lin Ma
- Department of DermatologyBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingP.R. China
| | - Quanzhong Liu
- Department of DermatologyTianjin Medical University General HospitalTianjinP.R. China
| | - Yuzhen Li
- Department of DermatologySecond Affiliated Hospital of Harbin Medical UniversityHarbinP.R. China
| | - Heng Gu
- Institute of DermatologyChinese Academy of Medical Sciences and Peking Union Medical CollegeNanjingP.R. China
| | - Bo Cheng
- Department of DermatologyThe First Affiliated Hospital of Fujian Medical UniversityFuzhouP.R. China
| | - Xiang Chen
- Department of DermatologyXiangya HospitalCentral South UniversityChangshaP.R. China
| | - Aijun Chen
- Department of DermatologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingP.R. China
| | - Shengxiang Xiao
- Department of DermatologyThe Second Affiliated HospitalSchool of MedicineXi'an Jiaotong UniversityXi'anP.R. China
| | - Hongzhong Jin
- Department of DermatologyPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeDongcheng DistrictBeijingP.R. China
| | - Junling Zhang
- Department of DermatologyTianjin Academy of Traditional Chinese Medicine Affiliated HospitalTianjinP.R. China
| | - Shanshan Li
- Department of DermatologyThe First Hospital of Jilin UniversityChangchunJilin ProvinceP.R. China
| | - Zhirong Yao
- Department of DermatologyXinhua HospitalShanghai Jiao Tong University School of MedicineShanghaiP.R. China
| | - Weihua Pan
- Department of DermatologyShanghai Key Laboratory of Molecular Medical MycologySecond Affiliated Hospital of Naval Medical UniversityShanghaiP.R. China
| | - Huilan Yang
- Department of DermatologyGeneral Hospital of Southern Theatre Command of PLAGuangzhouP.R. China
| | - Zhu Shen
- Department of DermatologyInstitute of Dermatology and VenereologySichuan Academy of Medical Sciences and Sichuan Provincial People's HospitalChengduP.R. China
| | - Hao Cheng
- Department of Dermatology and VenereologySir Run Run Shaw HospitalSchool of MedicineZhejiang UniversityHangzhouP.R. China
| | - Ping Song
- Department of DermatologyGuang'anmen HospitalChina Academy of Chinese Medical SciencesBeijingP.R. China
| | - Lingyu Fu
- Department of Clinical Epidemiology and Evidence‐Based MedicineThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
| | - Hongxiang Chen
- Department of DermatologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanP.R. China
| | - Songmei Geng
- Department of DermatologyThe Second Affiliated Hospital of Xi'an Jiaotong UniversityXi'anShaanxiP.R. China
| | - Kang Zeng
- Department of DermatologyNanfang HospitalSouthern Medical UniversityGuangzhouP.R. China
| | - Jianjian Wang
- Evidence‐Based Medicine CenterSchool of Basic Medical SciencesLanzhou UniversityLanzhouP.R. China
| | - Juan Tao
- Department of DermatologyUnion HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanP.R. China
| | - Yaolong Chen
- Evidence‐Based Medicine CenterSchool of Basic Medical SciencesLanzhou UniversityLanzhouP.R. China
- World Health Organization Collaborating Center for Guideline Implementation and Knowledge TranslationLanzhouP.R. China
- GIN AsiaLanzhouP.R. China
| | - Xiuli Wang
- Institute of PhotomedicineShanghai Skin Disease HospitalSchool of MedicineTongji UniversityShanghaiP.R. China
| | - Xing‐Hua Gao
- Department of DermatologyThe First Hospital of China Medical UniversityHeping DistrictShenyangP.R. China
- NHC Key Laboratory of Immunodermatology, China Medical UniversityHeping DistrictShenyangP.R. China
- Key Laboratory of Immunodermatology, China Medical UniversityMinistry of EducationHeping DistrictShenyangP.R. China
- National and Local Joint Engineering Research Center of Immunodermatological TheranosticsHeping DistrictShenyangP.R. China
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11
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Shi RJ, Fan HY, Yu XH, Tang YL, Jiang J, Liang XH. Advances of podophyllotoxin and its derivatives: patterns and mechanisms. Biochem Pharmacol 2022; 200:115039. [DOI: 10.1016/j.bcp.2022.115039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/28/2022]
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12
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Jahromi BN, Razeghi M, Dastgheib L, Fazelzadeh A, Miri A, Vakili S, Foruhari S, Sabetian S. Formaldehyde 5% in Flexible Collodion Compared to Cryotherapy for Treatment of Female Genital Warts: A Randomized Clinical Trial. Indian J Dermatol 2022; 67:478. [PMID: 36578699 PMCID: PMC9792057 DOI: 10.4103/ijd.ijd_1035_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objectives Genital wart is a sexually transmitted disease caused by human papillomavirus (HPV) and is responsible for discomfort, and decreased quality of life and productivity in victims with a high recurrence rate after treatments. This study aimed to compare the efficacy and safety of formaldehyde 5% with cryotherapy for the treatment of female genital warts. Methods Eighty women with at least two similar genital warts who visited the outpatient dermatology clinic of Shahid Faghihi hospital, Shiraz, Iran, were enrolled in this study. One lesion of each patient was self-treated with formaldehyde 5% in flexible collodion gel once daily for 28 days and the other matched lesion was treated by weekly repeated cryotherapy courses. The number of eradicated lesions and the mean days needed to treat, pain scores, complications and patient satisfaction were compared between the treatment methods. Results Complete clearance of lesions was observed in 58.7% of formaldehyde-treated lesions compared to 88.7% for cryotherapy (P value = 0.000). With formaldehyde-treated lesions, 51% complained of pain, 36.3% had pruritus, 86.3% had skin dryness, 88.8% complained of burning sensation and 93.7% showed erythema. In the cryotherapy group, 92.5% complained of pain, 15% had burning sensation, 75% showed erythema, 5% had atrophy, 80% developed post-inflammatory hyper or hypopigmentation (PIH) and 92.5% suffered from ulceration. Seventy-five (93%) found it easy to apply and (47) 58% were satisfied with their treatment results. Conclusions Self-administration of formaldehyde 5% resulted in a lower clearance rate but had better cosmetic outcomes with lower pain scores compared to cryotherapy.
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Affiliation(s)
- Bahia Namavar Jahromi
- From the Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,Address for correspondence: Dr. Bahia Namavar Jahromi, Infertility and IVF, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. E-mail:
| | - Mahsa Razeghi
- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Dastgheib
- Department of Dermatology, Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Arezou Fazelzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Miri
- Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sina Vakili
- From the Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Foruhari
- From the Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soudabeh Sabetian
- From the Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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13
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Kuchta K, Cameron S. Tradition to Pathogenesis: A Novel Hypothesis for Elucidating the Pathogenesis of Diseases Based on the Traditional Use of Medicinal Plants. Front Pharmacol 2021; 12:705077. [PMID: 34759818 PMCID: PMC8572966 DOI: 10.3389/fphar.2021.705077] [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: 05/04/2021] [Accepted: 09/27/2021] [Indexed: 11/13/2022] Open
Abstract
Traditional medicines embody knowledge on medicinal plants that has been accumulated through cultural evolution over millennia. In the latter half of the 20th century, two approaches to medicinal plant research have been established: the "Bench to Bedside" and the "Bedside to Bench" approaches which serve primarily for the development of more efficient therapeutics. Here, we propose a third, novel approach: from "Tradition to Pathogenesis" which aims to understand the pathogenesis of diseases based on the cultural evolution of their respective empirical treatments. We analyse multiple examples of diseases where the acting mechanism of traditional treatments across multiple cultures points to the pathogenesis of the respective disease. E.g., many cultures traditionally treat rheumatism with anti-bacterial botanical drugs, which is at odds with our current understanding that rheumatism is an aseptic inflammation. Furthermore, gastric ailments have traditionally been treated with anti-infectious botanical drugs indicating local infections, as demonstrated by the discovery of Helicobacter pylori as a common cause of gastric ulcer. Understanding traditional treatments can thus help to elucidate the pathogenesis of the disease.
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Affiliation(s)
- Kenny Kuchta
- Forschungsstelle für Fernöstliche Medizin, Department of Vegetation Analysis and Phytodiversity, Albrecht von Haller Institute of Plant Sciences, Georg August University, Göttingen, Germany
| | - Silke Cameron
- Clinic for Gastroenterology and Gastrointestinal Oncology, University Medicine Göttingen, Göttingen, Germany.,Clinic, Hann. Münden, Germany
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14
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Abu El-Hamd M, Aboeldahab S. Possible clinical efficacy and tolerability of platelet-rich plasma in the treatment of patients with recalcitrant plane warts: The first clinical study. J Cosmet Dermatol 2021; 20:3623-3629. [PMID: 33599062 DOI: 10.1111/jocd.14008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/11/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Plane warts are prevalent cutaneous diseases, caused by different serotypes of human papillomavirus. AIMS This study aimed to assess the possible clinical efficacy and tolerability of platelet-rich plasma (PRP) in the treatment of patients with multiple recalcitrant plane warts. METHODS This prospective cohort clinical study was carried out on 25 patients with clinical and dermoscopic evident multiple recalcitrant plane warts. The patients were treated with autologous intralesional PRP injections every month until a complete clearance or for a maximum of two sessions. Then, patients were clinically evaluated one month after every session and after a six-month follow-up from the last injection. RESULTS Of the included patients, 20 (80%) patients had facial plane warts, 3 (12%) patients had plane warts in the dorsum of hands, and 2 (8%) patients had plane warts in the dorsal aspect of feet. 60% of the patients have more than 100 plane warts, and all the patients had plane warts than 1 cm in size. The complete improvement was observed in 20% and 100% of the patients after the first and second sessions, respectively. No recurrence was detected after a six-month follow-up. No side effects were recorded after the treatment sessions. CONCLUSION Intralesional injection of PRP could be potentially effective and well-tolerated immunotherapy for the treatment of multiple recalcitrant plane warts. Whatever, more studies are needed with a larger sample size and a longer period of follow-up. Also, randomized and controlled studies are required to evaluate its efficacy in treating different clinical types of warts.
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Affiliation(s)
- Mohammed Abu El-Hamd
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Egypt
| | - Soha Aboeldahab
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Egypt
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15
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Shaker ESE, Doghim NN, Hassan AM, Musafa SS, Fawzy MM. Immunotherapy in cutaneous warts: comparative clinical Study between MMR vaccine, tuberculin, and BCG Vaccine. J Cosmet Dermatol 2021; 20:2657-2666. [PMID: 33410249 DOI: 10.1111/jocd.13921] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/11/2020] [Accepted: 12/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Warts are common viral infection of the skin. Treating warts are still an ongoing challenge and no general agreement is reached, on the best treatment, despite different therapeutic approaches. Intralesional (IL) immunotherapy has recently been shown to be effective in treating various wart forms. AIMS To assess the efficacy and safety of IL tuberculin, IL MMR vaccine, and intradermal (ID) BCG vaccination in treating viral warts. PATIENTS AND METHODS Sixty patients with single or multiple warts were divided equally into three groups. Group A received IL MMR vaccine, and group B received IL tuberculin every 3 weeks (maximum 3 times). Group C received ID BCG vaccination in the arm with one month interval (maximum 3 times). Recurrence was followed up for 6 months. RESULTS In group A, complete response occurred in 30%, partial response in 5%, and no response in 65%. In group B, complete response occurred in 45%, partial response in 20%, minimal response in 10% and no response in 25%. In group C, complete response occurred in 70%, partial response in 5%, minimal response in 5%, and no response in 20%. No recurrence was observed in group A and B but occurred in one patient in group C with the same lesion. CONCLUSIONS Immunotherapy by IL tuberculin and ID BCG vaccination are safe, effective, and inexpensive techniques in treating all types of warts even if recalcitrant or multiple but immunotherapy by IL MMR vaccine has shown less effectiveness and less safety technique.
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Affiliation(s)
- Engi Seif E Shaker
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Noha N Doghim
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Arwa Mhammad Hassan
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Samia S Musafa
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed M Fawzy
- Dermatology and Venereology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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16
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Anggraini I, Hoemardani AS, Nilasari H, Indriatmi W. Randomised controlled trial of 1% and 5% 5-fluorouracil creams compared with 90% trichloroacetic acid solution for anogenital wart treatment. Int J STD AIDS 2020; 31:849-858. [PMID: 32605501 DOI: 10.1177/0956462420925250] [Citation(s) in RCA: 2] [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
To evaluate the efficacy and safety of 1% and 5% 5-fluorouracil (5-FU) creams compared with 90% trichloroacetic acid (TCA) for the treatment of anogenital warts. we conducted a randomised controlled study in 72 subjects allocated to three groups: 1% 5-FU, 90% TCA and 5% 5-FU; 90% TCA was administered once a week, whereas 5-FU cream was applied three times a week. Response to therapy and side-effects were evaluated weekly for seven weeks. Evaluation at week 7 demonstrated that there was no significant difference in the efficacy between 1% 5-FU cream and 90% TCA (p = 0.763) or between 5% 5-FU cream and 90% TCA (p = 0.274). Subjective side-effects with 1% 5-FU were significantly milder than 90% TCA; however, significantly milder objective side-effects were observed only at weeks 2, 6 and 7. The subjective side-effects with 5% 5-FU were also significantly milder than 90% TCA; however, significantly milder objective side-effects were observed only at week 2. 5-FU may become an alternative topical therapy as it offers the benefit of self-application; furthermore, a concentration of 1% 5-FU cream is recommended due to milder side-effects.
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Affiliation(s)
- Ika Anggraini
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Aida Sd Hoemardani
- Department of Dermatology and Venereology, Dharmais Cancer National Hospital, Jakarta, Indonesia
| | - Hanny Nilasari
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Wresti Indriatmi
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
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Fawzy MM, Nofal A, Alakad R. Intralesional antigen immunotherapy for the treatment of plane warts: A comparative study. Dermatol Ther 2020; 33:e13807. [PMID: 32530550 DOI: 10.1111/dth.13807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/31/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
Intralesional immunotherapy by different antigens has shown promising efficacy and safety in the treatment of warts. However, the use of these antigens for the treatment of plane warts has been investigated in two studies only. To evaluate the efficacy and safety of three antigens; Measles Mumps, Rubella vaccine (MMR), Candida antigen, and purified protein derivative (PPD) in the treatment of multiple plane warts. The study included 120 patients who were randomly assigned to three groups, 40 patients in each group. Each agent was injected intralesionally at a dose of 0.1 mL into the largest wart at 2-week intervals until complete clearance or for a maximum of five sessions. Complete clearance of warts was observed in 55% of the PPD group, in 70% of the Candida antigen group, and in 62.5% of the MMR group. No statistically significant difference in the therapeutic response was found between the three groups. Intralesional antigen immunotherapy seems to be a promising well-tolerated and effective therapeutic option for the treatment of multiple plane warts, with relatively higher efficacy of Candida antigen.
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Affiliation(s)
- Mohamed M Fawzy
- Faculty of Medicine, Department of Dermatology, Venereology, and Andrology, Tanta University, Tanta, Egypt
| | - Ahmad Nofal
- Faculty of Medicine, Department of Dermatology, Venereology, and Andrology, Zagazig University, Zagazig, Egypt
| | - Rania Alakad
- Faculty of Medicine, Department of Dermatology, Venereology, and Andrology, Zagazig University, Zagazig, Egypt
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18
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Miyoshi N, Tanabe H, Suzuki T, Saeki K, Hara Y. Applications of a Standardized Green Tea Catechin Preparation for Viral Warts and Human Papilloma Virus-Related and Unrelated Cancers. Molecules 2020; 25:molecules25112588. [PMID: 32498451 PMCID: PMC7321293 DOI: 10.3390/molecules25112588] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/21/2020] [Accepted: 05/28/2020] [Indexed: 12/16/2022] Open
Abstract
Most cell-based and animal experiments have shown that green tea catechins (GTC) exhibit various health benefits. In human experimental and epidemiological studies, there are conflicting results, and more precise investigations are required. One of the most effective ways to prove beneficial health effects in humans might be clinical intervention studies. Polyphenon®E was developed as a standardized GTC preparation, which was approved by Food and Drug Administration of US in 2006 as a medication to treat genital warts (Veregen® or sinecatechins). Positive efficacy of Polyphenon®E/sinecatechins/Veregen® (PSV) on anogenital warts has been demonstrated in several epidemiological studies and there have been several case reports to show the clinical effectiveness of PSV. In addition, several studies have provided evidence to suggest that PSV is effective in other human papillomavirus (HPV)-related diseases, although some studies failed to show such effects. Since (−)-epigallocatechin gallate (EGCG) is the major component of PSV, the mechanism of the action of PSV might be deduced from that of EGCG. The microarray analysis of the biopsy samples from the patients suggested that apoptosis induction and the downregulation of inflammation are involved in the mechanism of the action of PSV in the clearance of anogenital warts. Cell-based and animal experiments using PSV also demonstrated effects similar to those elicited by EGCG, explaining how PSV works to induce apoptosis and exert anti-inflammatory actions in HPV-related diseases. Future studies would clarify what kinds of diseases respond effectively to PSV, showing health benefits of GTC and EGCG in humans.
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Affiliation(s)
- Noriyuki Miyoshi
- Graduate School of Integrated Pharmaceutical and Nutritional Sciences, University of Shizuoka, Shizuoka 422-8526, Japan
- Correspondence: (N.M.); (Y.H.); Tel.: +81-54-264-5531 (N.M.); Tel.: +81-3-3209-0129 (Y.H.)
| | - Hiroki Tanabe
- Faculty of Health and Welfare Science, Nayoro City University, Nayoro, Hokkaido 096-8641, Japan;
| | - Takuji Suzuki
- Faculty of Agriculture, Yamagata University, Yamagata 990-8560, Japan;
| | - Koichi Saeki
- Regenerative Medicine iPS Gateway Center Co., Ltd., Tokyo 150-0012, Japan;
| | - Yukihiko Hara
- Tea Solutions, Hara Office Inc., Tokyo 130-0012, Japan
- Correspondence: (N.M.); (Y.H.); Tel.: +81-54-264-5531 (N.M.); Tel.: +81-3-3209-0129 (Y.H.)
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Tantawy EA, El-Beyali AA, Gohar MK, Ibrahim ZS, Nasr M, Marei A. Association of TLR2 and TLR4 gene polymorphism with susceptibility to wart infections and their response to candida antigen immunotherapy. J DERMATOL TREAT 2020; 33:166-172. [DOI: 10.1080/09546634.2020.1732285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Enas A. Tantawy
- Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Abdallah A. El-Beyali
- Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Maha K. Gohar
- Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Zynab S. Ibrahim
- Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Nasr
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ayman Marei
- Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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21
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Abd El-Magid WM, Nada EEA, Mossa RA. Intralesional injection of vitamin D3 versus zinc sulfate 2% in treatment of plantar warts: a comparative study. J DERMATOL TREAT 2019; 32:355-360. [DOI: 10.1080/09546634.2019.1656326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Wafaa M. Abd El-Magid
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Essam Eldein A. Nada
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Reem A. Mossa
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
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Hum M, Chow E, Schuurmans N, Dytoc M. Case of giant vulvar condyloma acuminata successfully treated with imiquimod 3.75% cream: A case report. SAGE Open Med Case Rep 2018; 6:2050313X18802143. [PMID: 30345054 PMCID: PMC6180360 DOI: 10.1177/2050313x18802143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Condyloma acuminata, also known as anogenital warts, represent a cutaneous infection caused by sexual transmission of the human papilloma virus. We present a case of overwhelming condyloma acuminata that was treated successfully without surgery using only topical imiquimod 3.75% cream. The patient, a 66-year-old female, was referred to Dermatology for large protruding verrucous plaques that covered the entire surface of her external vulva, perineum and perianal area. These lesions developed after being treated for genital warts with cantharidin. Four other cases treated with imiquimod were identified in the literature but either required surgery, higher doses or longer duration of treatment or involved pediatric populations. In patients who are not amenable to surgery, topical imiquimod may be a novel standalone or an adjunctive therapy for giant condyloma acuminata.
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Affiliation(s)
- Matthew Hum
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Eunice Chow
- Division of Dermatology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Nan Schuurmans
- Department of Obstetrics and Gynecology, University of Alberta, Edmonton, AB, Canada
| | - Marlene Dytoc
- Division of Dermatology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
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Clinical, histopathologic, and viral load study after treatment of plantar warts with 10% formaldehyde soaks versus liquid nitrogen cryotherapy. JOURNAL OF THE EGYPTIAN WOMEN’S DERMATOLOGIC SOCIETY 2018. [DOI: 10.1097/01.ewx.0000544113.64787.76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Barkat MT, Abdel-Aziz RTA, Mohamed MS. Evaluation of intralesional injection of bleomycin in the treatment of plantar warts: clinical and dermoscopic evaluation. Int J Dermatol 2018; 57:1533-1537. [DOI: 10.1111/ijd.14092] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 05/16/2018] [Accepted: 05/22/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Manal T. Barkat
- Department of Dermatology; Faculty of Medicine; Minia University; Al-Minya Egypt
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Radetskyy R, Daher A, Gatignol A. ADAR1 and PKR, interferon stimulated genes with clashing effects on HIV-1 replication. Cytokine Growth Factor Rev 2018; 40:48-58. [PMID: 29625900 DOI: 10.1016/j.cytogfr.2018.03.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 03/19/2018] [Accepted: 03/19/2018] [Indexed: 12/15/2022]
Abstract
The induction of hundreds of Interferon Stimulated Genes (ISGs) subsequent to virus infection generates an antiviral state that functions to restrict virus growth at multiple steps of their replication cycles. In the context of Human Immunodeficiency Virus-1 (HIV-1), ISGs also possess antiviral functions, but some ISGs show proapoptotic or proviral activity. One of the most studied ISGs, the RNA activated Protein Kinase (PKR), shuts down the viral protein synthesis upon activation. HIV-1 has evolved to evade its inhibition by PKR through viral and cellular mechanisms. One of the cellular mechanisms is the induction of another ISG, the Adenosine Deaminase acting on RNA 1 (ADAR1). ADAR1 promotes viral replication by acting as an RNA sensing inhibitor, by editing viral RNA and by inhibiting PKR. This review challenges the orthodox dogma of ISGs as antiviral proteins, by demonstrating that two ISGs have opposing and clashing effects on viral replication.
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Affiliation(s)
- Roman Radetskyy
- Laboratory of Virus-Cell Interactions, Lady Davis Institute for Medical Research, Canada; Department of Medicine, Division of Experimental Medicine, Canada
| | - Aïcha Daher
- Laboratory of Virus-Cell Interactions, Lady Davis Institute for Medical Research, Canada
| | - Anne Gatignol
- Laboratory of Virus-Cell Interactions, Lady Davis Institute for Medical Research, Canada; Department of Medicine, Division of Experimental Medicine, Canada; Department of Medicine, Division of Infectious Diseases, Canada; Department of Microbiology-Immunology, McGill University, Montréal, Québec, Canada.
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26
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Hood CR, Miller JR. The Ring Verruca Plantaris in Cantharidin Use A Case Report. J Am Podiatr Med Assoc 2018; 108:189-193. [PMID: 29634299 DOI: 10.7547/16-115] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Verrucae (warts) are the most common viral infections of the skin, affecting 7% to 10% of the general population. Typically caused by human papillomavirus type 1, plantar warts manifest as benign proliferation of the epithelial cells on the feet. It has been cited that up to one-third of nongenital warts become recalcitrant, and biopsy is often required to confirm diagnosis and direct appropriate treatment. These treatments can vary from various types of oral medications, acids, ablative modalities, and injections. In this article, we present a case of a recalcitrant plantar wart that appeared to circumferentially spread from the initial site after first-line treatment and presumed resolution with the product cantharidin. The development of ring warts is a known complication associated with cantharidin use, with little described rationale to the presentation.
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Affiliation(s)
- Christopher R. Hood
- Premier Orthopaedic and Sports Medicine, Foot and Ankle Surgery, Malvern, PA
| | - Jason R. Miller
- Premier Orthopaedic and Sports Medicine, Foot and Ankle Surgery, Malvern, PA
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Recanati MA, Kramer KJ, Maggio JJ, Chao CR. Cantharidin is Superior to Trichloroacetic Acid for the Treatment of Non-mucosal Genital Warts: A Pilot Randomized Controlled Trial. CLIN EXP OBSTET GYN 2018; 45:383-386. [PMID: 30078935 PMCID: PMC6075835 DOI: 10.12891/ceog4112.2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Condyloma Acuminatum is a sexually transmitted viral disease caused by the human papilloma virus (HPV). It is the most common viral sexually transmitted disease. In this randomized controlled trial, cantharidin was found to be more effective and better tolerated than trichloroacetic acid for the treatment of these lesions. Patients treated with cantharidin healed with less scarring than those treated with TCA (P<0.034), had less pain during treatment (P<0.01), and required fewer treatments to eradicate warts (P<0.01) when compared to Trichloroacetic acid.
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Affiliation(s)
- Maurice A Recanati
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit Medical Center
| | - Katherine J Kramer
- Department of Obstetrics and Gynecology, St. Vincent's Catholic Medical Centers, New York, NY
| | - John J Maggio
- Department of Obstetrics and Gynecology, St. Vincent's Catholic Medical Centers, New York, NY
| | - Conrad R Chao
- Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, NM
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28
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Pasquali P, Freites-Martinez A, Gonzalez S, Spugnini EP, Baldi A. Successful treatment of plantar warts with intralesional bleomycin and electroporation: pilot prospective study. Dermatol Pract Concept 2017; 7:21-26. [PMID: 29085716 PMCID: PMC5661162 DOI: 10.5826/dpc.0703a04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/27/2017] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Numerous studies have been performed to evaluate the efficacy of intralesional bleomycin for the treatment of warts with inconsistent result. Nevertheless, it is well known that the cytotoxicity of bleomycin can be enhanced in vivo by 300 to 700-fold by electroporation. OBJECTIVE AND METHODS In this article, we present an interventional, one-center, prospective case series, clinical trial of the effectiveness of intralesional bleomycin combined with electroporation for the treatment of plantar warts, in comparison to the use of intralesional bleomycin alone. RESULTS The study's cohort included 12 men and 10 women, with a mean age of 53.8 years. A total of 22 warts were treated. In dividing the patients in two groups (complete remission against all the others) and analyzing the different outcomes in the two arms of patients, a statistical significant difference was found (p=0.0015), proving a greater efficacy of the treatment with bleomycin combined with ECT as opposed to bleomycin alone. Electroporation was always well tolerated by the patients with no discomfort. CONCLUSIONS This study serves as a basis for the application of novel protocols in the treatment of different benign and locally malignant skin lesion by means of electroporation.
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Affiliation(s)
- Paola Pasquali
- Dermatology Service, Pius Hospital De Valls, Tarragona, Spain
| | | | - Salvador Gonzalez
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Medicine Department, Alcalá University, Madrid, Spain
| | | | - Alfonso Baldi
- Biopulse srl, Naples, Italy
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Caserta, Italy
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Curi DSC, Leite-Ribeiro PM, Torregrossa VR, Vieira VC, Sarmento VA. Efficacy of imidazolquinoline on treatment of condyloma acuminatum of the buccal mucosa. SPECIAL CARE IN DENTISTRY 2016; 37:51-54. [PMID: 27716987 DOI: 10.1111/scd.12199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The condylomata acuminata is a benign epithelial neoplasm induced by papillomavirus, and it is characterized by the proliferation of stratified squamous epithelial tissue that affects the anogenital and oral mucosa. It is considered to be a sexually transmitted disease and has a higher prevalence in individuals infected with human immunodeficiency virus. Various therapies have been used for the removal of lesions, such as cryotherapy, surgical laser and surgical excision, which are painful and scarring. These techniques, however, do not eliminate the virus and relapses are common shortly after treatment. The use of immunomodulators has been proposed to be an alternative treatment, as imidazolquinoline has been shown to be effective in the treatment of lesions in the anogenital region. However, its use in the oral cavity has been the subject of few reports in the literature. Thus, the objective of this study is to describe a case of warts in the labial mucosa of an HIV positive patient using imidazolquinoline 5%.
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Affiliation(s)
- Davi Silva Carvalho Curi
- Dentistry Department, Hospital Universitario Professor Edgard Santos, Federal University of Bahia (UFBA), Brazil
| | - Patrícia Miranda Leite-Ribeiro
- Professor at Dentistry Department, Hospital Universitario Professor Edgard Santos, Federal University of Bahia (UFBA), Brazil
| | | | - Vinicius Costa Vieira
- Dentistry Department, Hospital Universitario Professor Edgard Santos, Federal University of Bahia (UFBA), Brazil
| | - Viviane Almeida Sarmento
- Coordinator of Dentistry Department, Hospital Universitario Professor Edgard Santos, Federal University of Bahia (UFBA), Brazil
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30
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Blaizot R, Dutkiewicz AS, Guillet S, Pham-Ledard A, Beylot-Barry M. Intravenous cidofovir for diffuse genital warts in the setting of multifactorial immunosuppression. J Eur Acad Dermatol Venereol 2016; 31:e162-e163. [DOI: 10.1111/jdv.13880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Blaizot
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - A.-S. Dutkiewicz
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - S. Guillet
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - A. Pham-Ledard
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - M. Beylot-Barry
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
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31
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Aldahan AS, Mlacker S, Shah VV, Kamath P, Alsaidan M, Samarkandy S, Nouri K. Efficacy of intralesional immunotherapy for the treatment of warts: A review of the literature. Dermatol Ther 2016; 29:197-207. [PMID: 26991521 DOI: 10.1111/dth.12352] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Warts are common epidermal growths caused by human papillomavirus that often cause significant discomfort and embarrassment. Current treatment options include topical therapies, cryotherapy, laser vaporization, and surgical excision. Many of these options are destructive and may result in scarring, while less aggressive approaches can lead to lesion recurrence. Additionally, these local modalities are not practical for patients with a large number of warts. Systemic approaches such as immunotherapy have demonstrated success in treating multiple lesions by combining a targeted approach with upregulation of the host immune system. An extensive literature review was performed to evaluate the various vaccine antigens that have been used intralesionally to treat cutaneous and anogenital warts. The specific intralesional immunotherapies that have been studied include: Candida albicans; measles, mumps, and rubella; Trichophyton; and tuberculin antigens such as purified protein derivative, Mycobacterium w vaccine, and Bacillus Calmette-Guerin. Intralesional vaccine injection represents a safe, effective, and tolerable treatment for warts, including recalcitrant and anogenital warts. This approach has been somewhat overlooked in the past despite substantial evidence of high response rates with a low side effect profile. Large comparative trials are necessary to determine the most effective immunotherapy treatment option as well as the most appropriate dosing parameters.
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Affiliation(s)
- Adam Souhail Aldahan
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
| | - Stephanie Mlacker
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
| | - Vidhi V Shah
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
| | - Preetha Kamath
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
| | - Mohammed Alsaidan
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
| | - Sahal Samarkandy
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1475 NW 12th Ave., Suite 2175, Miami, Florida
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32
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Alikhan A, Griffin JR, Newman CC. Use ofCandidaantigen injections for the treatment of verruca vulgaris: A two-year mayo clinic experience. J DERMATOL TREAT 2015; 27:355-8. [DOI: 10.3109/09546634.2015.1106436] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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