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Zhou S, Xu Z, Gu L, Zhai X, Zhao J, Gu L, Zhou B, Hua H. A nomogram to predict anal condyloma acuminatum recurrence in HIV-negative patients following photodynamic therapy: A decade-long retrospective clinical study at a single tertiary hospital. Photodiagnosis Photodyn Ther 2024; 48:104245. [PMID: 38871015 DOI: 10.1016/j.pdpdt.2024.104245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/26/2024] [Accepted: 06/10/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Anal condyloma acuminatum (CA) is marked by its thorny treatment and high recurrence rate. Although 5-aminolevulinic acid photodynamic therapy (ALA-PDT) demonstrates significant efficacy and safety in treating anal CA, it does not completely prevent recurrence. This study aimed to develop and validate a nomogram model in predicting the risk of relapse in HIV-negative patients with anal CA following treatment with ALA-PDT. METHODS A retrospective analysis was conducted on patients diagnosed with anal CA who received combined CO2 laser vaporization and ALA-PDT between January 2013 and May 2023. Patients were divided into recurrence and non-recurrence groups. A nomogram was developed based on factors showing statistical significance in multivariable logistic regression analysis. The discriminative ability and clinical utility of the nomogram were assessed via ROC curves and decision curve analysis, with internal validation performed through bootstrap resampling. RESULTS Among the 176 patients included, 33 (18.75 %) experienced recurrence, while 143 did not. Independent predictors for recurrence included HPV types, history of anal intercourse, and the number of CO2 laser treatments received. Incorporating these predictors, the nomogram demonstrated a superior diagnostic performance (area under the curve = 0.881, 95 % CI: 0.818-0.935) and a significant net benefit in decision curve analysis. CONCLUSIONS The nomogram accurately predicts the risk of recurrence in HIV-negative patients with anal CA following ALA-PDT. It offers a valuable tool for guiding preoperative clinical decision-making and establishing personalized treatment strategies to minimize the risk of relapse.
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Affiliation(s)
- Shu Zhou
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226001, China
| | - Zhiyi Xu
- Medical School, Nantong University, Nantong 226001, China
| | - Li Gu
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226001, China
| | - Xiaoyu Zhai
- Medical School, Nantong University, Nantong 226001, China
| | - Jing Zhao
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226001, China
| | - Liqun Gu
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226001, China
| | - Bingrong Zhou
- Department of Dermatology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Hui Hua
- Department of Dermatology, Nantong Third People's Hospital, Affiliated Nantong Hospital 3 of Nantong University, Nantong 226001, China.
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Górecka A, Majewski S, Szymańska E, Walecka I. Skin and mucosal manifestations of immune reconstitution inflammatory syndrome in people living with HIV: a review. Int J Dermatol 2024; 63:852-857. [PMID: 38426349 DOI: 10.1111/ijd.17082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 03/02/2024]
Abstract
Opportunistic infections have significantly decreased in individuals living with human immunodeficiency virus and receiving antiretroviral therapy. However, in approximately 10%-25% of patients, severe skin reactions during immune reconstruction are constantly increasing. This may manifest as either an exacerbation of a chronic disease or the development of a new disorder, referred to as immune reconstitution inflammatory syndrome. This review focuses on the current knowledge regarding the dermatological symptoms of immune reconstitution inflammatory syndrome observed in recent years. These symptoms encompass various pathogens, neoplasms, and certain autoimmune diseases. In addition to the most common skin reactions, attention is directed towards conditions not previously described in any review, such as psoriasis.
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Affiliation(s)
- Aleksandra Górecka
- Department of Dermatology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Sławomir Majewski
- Department of Dermatology and Venereology, Medical University of Warsaw, Warsaw, Poland
| | - Elżbieta Szymańska
- Department of Dermatology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
- Department of Dermatology and Pediatric Dermatology, Centre of Postgraduate Medical Education in Warsaw, Warsaw, Poland
| | - Irena Walecka
- Department of Dermatology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
- Department of Dermatology and Pediatric Dermatology, Centre of Postgraduate Medical Education in Warsaw, Warsaw, Poland
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Huang Z, Yao S, Zou L, Xie W, Xie D, Li W, Tan D, Shuai J. Evaluation of HPV infection and presence of licensed HPV vaccine genotypes among genital warts in Foshan, China. Front Microbiol 2024; 15:1376141. [PMID: 38699478 PMCID: PMC11064646 DOI: 10.3389/fmicb.2024.1376141] [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: 01/25/2024] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Objective This study aimed to evaluate the prevalence of human papillomavirus (HPV) infection and presence of licensed HPV vaccine genotypes among patients with genital warts in Foshan, China from 2015 to 2022, to provide useful references for the detection, prevention and control of genital warts in Foshan. Methods The present study retrospectively analyzed the HPV detection rates in patients with genital warts. A total of 1,625 patients were seen at the Second People's Hospital of Foshan, Guangdong Province, China, from 2015 to 2022. Samples were collected from various lesions and genotyped for 21 genotypes of HPV by infusion hybridization. The classification principle of HPV genotypes in this study: (1) Based on the relationship between HPV and carcinogenicity; (2) Based on the number of HPV genotypes infected; (3) Based on the HPV genotypes of licensed HPV vaccines. Results The detection rate of any HPV in patients with genital warts was 80.37% (1,306/1,625). The detection rates of HPV for low-risk infection, co-infection and high-risk infection were 49.48% (804/1,625), 24.92% (405/1,625) and 5.97% (97/1,625), respectively. Single infection was the predominant type (51.94%, 844/1625). HPV-6 and HPV-11 were the predominant types of single infection; HPV-6 and HPV-52 were the predominant types of paired combinations of multiple infection. 82.22% (1,336/1,625) of the cases had an age distribution of ≤ 24, 25-34, and 35-44. The distribution of some HPV genotypes had age specificity, annual specificity and gender specificity. The genotype detection rates of 2v, 4v and 9v showed a decreasing trend with ages (all P < 0.05). The genotype detection rates of 4v and 9v showed a decreasing trend over the 8-year period (both P < 0.05). The genotype detection rates of 4v and 9v in the male group were higher than those in the female group (both P < 0.05). The genotype detection rate of 9v was significantly higher than that of 2v and 4v in the female group (both P < 0.05). Conclusion Our study demonstrated that low-risk infection and single infection were the main types of HPV infection in patients with genital warts, mainly among young patients. Our study provides epidemiological data for the detection, prevention and control of genital warts in China.
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Affiliation(s)
- Zeqi Huang
- Department of Clinical Laboratory, The Second People’s Hospital of Foshan, Foshan, China
| | - Shaonuan Yao
- Department of Medical Records, The Second People’s Hospital of Foshan, Foshan, China
| | - Lin Zou
- Department of Clinical Laboratory, The Second People’s Hospital of Foshan, Foshan, China
| | - Weixian Xie
- Department of Clinical Laboratory, The Second People’s Hospital of Foshan, Foshan, China
| | - Dongde Xie
- Department of Clinical Laboratory, The Second People’s Hospital of Foshan, Foshan, China
| | - Weiwei Li
- Department of Clinical Laboratory, The Second People’s Hospital of Foshan, Foshan, China
| | - Deyou Tan
- Department of Dermatology, The Second People’s Hospital of Foshan, Foshan, China
| | - Jiangang Shuai
- Department of Gynaecology, The Second People’s Hospital of Foshan, Foshan, China
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Khorsandi K, Hosseinzadeh R, Esfahani H, Zandsalimi K, Shahidi FK, Abrahamse H. Accelerating skin regeneration and wound healing by controlled ROS from photodynamic treatment. Inflamm Regen 2022; 42:40. [PMID: 36192814 PMCID: PMC9529607 DOI: 10.1186/s41232-022-00226-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Cellular metabolisms produce reactive oxygen species (ROS) which are essential for cellular signaling pathways and physiological functions. Nevertheless, ROS act as “double-edged swords” that have an unstable redox balance between ROS production and removal. A little raise of ROS results in cell proliferation enhancement, survival, and soft immune responses, while a high level of ROS could lead to cellular damage consequently protein, nucleic acid, and lipid damages and finally cell death. ROS play an important role in various pathological circumstances. On the contrary, ROS can show selective toxicity which is used against cancer cells and pathogens. Photodynamic therapy (PDT) is based on three important components including a photosensitizer (PS), oxygen, and light. Upon excitation of the PS at a specific wavelength, the PDT process begins which leads to ROS generation. ROS produced during PDT could induce two different pathways. If PDT produces control and low ROS, it can lead to cell proliferation and differentiation. However, excess production of ROS by PDT causes cellular photo damage which is the main mechanism used in cancer treatment. This review summarizes the functions of ROS in living systems and describes role of PDT in production of controllable ROS and finally a special focus on current ROS-generating therapeutic protocols for regeneration and wound healing.
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Affiliation(s)
- Khatereh Khorsandi
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran. .,Department of Biochemistry and Molecular Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC, 20037, USA.
| | - Reza Hosseinzadeh
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran.,Academic center for education, culture and research, Urmia, Iran
| | - HomaSadat Esfahani
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran
| | - Kavosh Zandsalimi
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran
| | - Fedora Khatibi Shahidi
- Department of Photodynamic, Medical Laser Research Center, Yara Institute, ACECR, Tehran, Iran
| | - Heidi Abrahamse
- Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, P.O. Box 17011, Doornfontein, Johannesburg, 2028, South Africa
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Jomsky M, Summa CH, Zarraga MB, Demory Beckler M. Photodynamic Therapy Using Intense Pulse Light to Treat an HIV Patient With Perianal Squamous Cell Carcinoma: A Case Report. Cureus 2022; 14:e27679. [PMID: 36072171 PMCID: PMC9440736 DOI: 10.7759/cureus.27679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022] Open
Abstract
Anogenital warts are considered one of the most common sexually transmitted infections caused by the human papillomavirus (HPV). One of the primary considerations with HPV is the virus’s high rate to develop into squamous cell carcinoma (SCC). SCC is one of the leading causes of skin cancer with a variety of treatment options. The gold standard of treatment for SCC is surgical excision. Complications may arise for those that are considered immunocompromised, or lack of efficacy may be taken into consideration for nonsurgical approaches. Herein, we suggest prompt diagnosis and treatment with photodynamic therapy (PDT) of HPV lesions to prevent disease progression and reoccurrence. The patient is a 54-year-old male nonsmoker with a past medical history of squamous cell carcinoma and HIV and presented with a perianal rash. Additionally, he confirmed associated symptoms of itchiness, irritation, and pain. At the time of his appointment, his CD4 count was 121 cells/µL, and he stated he was compliant with his antiretroviral therapy. Based on history and physical examination, the patient was empirically treated with oral fluconazole and topical nystatin-triamcinolone for two weeks. At follow-up, symptomatology worsened, and a biopsy was performed. Squamous cell carcinoma in situ was confirmed histologically. A secondary bacterial skin infection developed at the biopsy site. At this point, PDT was recommended due to compromised tissue and further risk of infection. At present, a gold standard of care for HPV infection does not exist. Prompt diagnosis and treatment of these lesions are important to recognize due to the high risk of the development of squamous cell carcinoma. Complications of secondary bacterial infections can arise with current treatment for squamous cell carcinoma, particularly in the immunocompromised. Non-surgical approaches for HPV have been less than desirable with higher recurrence rates of HPV lesions. Herein, we suggest the consideration of PDT treatment for HPV and SCC.
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Abstract
The healing power of light has attracted interest for thousands of years. Scientific discoveries and technological advancements in the field have eventually led to the emergence of photodynamic therapy, which soon became a promising approach in treating a broad range of diseases. Based on the interaction between light, molecular oxygen, and various photosensitizers, photodynamic therapy represents a non-invasive, non-toxic, repeatable procedure for tumor treatment, wound healing, and pathogens inactivation. However, classic photosensitizing compounds impose limitations on their clinical applications. Aiming to overcome these drawbacks, nanotechnology came as a solution for improving targeting efficiency, release control, and solubility of traditional photosensitizers. This paper proposes a comprehensive path, starting with the photodynamic therapy mechanism, evolution over the years, integration of nanotechnology, and ending with a detailed review of the most important applications of this therapeutic approach.
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