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Usami T, Ohsawa I, Suga Y, Mitsuishi T. Human papillomavirus type 94-associated flat warts and review of reported cases. J Dermatol 2024; 51:95-97. [PMID: 37698040 DOI: 10.1111/1346-8138.16962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 08/10/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
To date, 10 types of human papillomavirus have been identified that cause flat warts, including human papillomavirus type 3, which belongs to species group 2 of the genus alpha papillomavirus. Among these 10 types, human papillomavirus type 94 is most closely related to human papillomavirus type 10, sharing 86% homology. In this study, we conducted polymerase chain reaction analysis with sequencing on samples obtained from cutaneous lesions located on the face and lower legs of an individual, revealing the presence of human papillomavirus type 94. Dermatoscopic findings revealed numerous dotted vessels within one group of macular brown lesions located on the lower leg, which contributed to the diagnosis of flat warts. An online search revealed that human papillomavirus type 94 has previously been detected in various skin diseases, and we provide a review of prior reports.
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Affiliation(s)
- Tamae Usami
- Department of Dermatology, Juntendo University Urayasu, Hospital, Chiba, Japan
- Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan
| | - Ikuroh Ohsawa
- Department of Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yasushi Suga
- Department of Dermatology, Juntendo University Urayasu, Hospital, Chiba, Japan
| | - Tsuyoshi Mitsuishi
- Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan
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Jiryis B, Avitan-Hersh E, Mirmovich O, Judith Nevet M, Khamaysi Z. Evaluation of combined treatment with Er:YAG laser and long-pulsed Nd:YAG laser for the treatment of recalcitrant warts: A prospective randomized controlled trial. J Eur Acad Dermatol Venereol 2023; 37:2569-2574. [PMID: 37528476 DOI: 10.1111/jdv.19388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Viral warts are common infectious skin disease induced by human papillomavirus (HPV). Lasers have been used for warts treatment in recent years with variable success rates. OBJECTIVE This study aimed to prospectively evaluate combined treatment with Er:YAG laser and long-pulsed Nd:YAG laser compared to Er:YAG laser for the treatment of recalcitrant warts after one session. MATERIALS AND METHODS This study included 240 lesions from 24 patients. All the lesions were diagnosed clinically as recalcitrant warts after failure of topical treatment and cryotherapy. About 120 lesions underwent a combined therapy of Er:YAG and long-pulsed (LP) Nd:YAG lasers, and the remaining 120 lesions underwent Er:YAG laser therapy only. The clearance rate was evaluated 5 weeks after and classified by three-graded evaluation: complete response, partial response and poor response. RESULTS The clearance rate in the combined Er:YAG + LP Nd:YAG lasers group was, statistically significant, higher than that of the Er:YAG laser group (p = 0.008). The complete response rate was 48% (58 of 120 warts) for the Er:YAG +LP Nd:YAG lasers group and only 29% (35 of 120 warts) for the Er:YAG laser group. CONCLUSION The combination of Er:YAG and long-pulsed Nd:YAG lasers is more effective than Er:YAG laser alone in treating recalcitrant warts after single session.
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Affiliation(s)
- B Jiryis
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - E Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - O Mirmovich
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - M Judith Nevet
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Z Khamaysi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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3
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Brazão C, Filipe P. sQUIZ your Knowledge! Hyperkeratotic verrucous plaques and nodules and hyperpigmented warts in the setting of Hodgkin lymphoma. Eur J Dermatol 2023; 33:66-67. [PMID: 37178044 DOI: 10.1684/ejd.2023.4439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- Cláudia Brazão
- Dermatology and Venereology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE. Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal
| | - Paulo Filipe
- Dermatology and Venereology Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE. Av. Prof. Egas Moniz, 1649-035, Lisbon, Portugal, Dermatology and Venereology University Clinic, Faculty of Medicine, University of Lisbon, Av. Prof. Egas Moniz, 1649-035 Lisbon, Portugal, Dermatology Research Unit, iMM João Lobo Antunes, University of Lisbon, Av. Prof. Egas Moniz, 1649-028 Lisbon, Portugal
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Lofty AR, Elbakry AM, Omar GAB, Hamdino M. Intralesional combined furosemide and digoxin in cutaneous warts treatment: A randomized controlled clinical trial. Dermatol Ther 2022; 35:e15935. [PMID: 36226802 DOI: 10.1111/dth.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/30/2022]
Abstract
Although being a benign lesion, Warts can affect the quality of life by causing discomfort, disfigurement, and social embarrassment besides the tendency to spread. Cutaneous wart treatment faces many challenges as the development of an antiviral drug that can eradicate the human papilloma virus (HPV) is difficult. This clinical study aimed to assess the efficacy and safety of intralesional combined furosemide and digoxin in the treatment of multiple cutaneous warts. This double blinded randomized clinical trial included 80 adult patients with multiple cutaneous warts (≥2 warts) who were randomized into two groups, Group I (40 patients) treated with intralesional combined furosemide and digoxin and Group II (40 patients) who were treated with intralesional normal saline solution as a control group, weekly till improvement or for maximum five sessions. Clinical and dermoscopic evaluation at baseline, every session, and monthly for 6 months after the last session to detect any recurrence was performed. Complete wart clearance was observed in 92.5% of patients in the intralesional combined furosemide and digoxin group (Group I) compared with 10.0% in saline group (Group II), with highly statistically significant difference (P-value = 0.000). Pain during injection in 95.0% and 45.0% of patients in Group I and Group II respectively, treatment group was superior compared to control group. Intralesional injection of combined furosemide and digoxin can be a safe and effective treatment option in multiple cutaneous warts with minimal side effects in this study.
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Affiliation(s)
- Amira Reda Lofty
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Asmaa Mohamed Elbakry
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy for Girls, Al-Azhar University, Cairo, Egypt
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Heliopolis University, Cairo, Egypt
| | - Ghada Abdel Badea Omar
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Mervat Hamdino
- Dermatology and Venereology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
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Navarro-Pérez D, García-Oreja S, Álvaro-Afonso FJ, López-Moral M, García-Madrid M, Lázaro-Martínez JL. Cantharidin-Podophyllin-Salicylic Acid Formulation as a First-Line Treatment for Plantar Warts? A Case Report with Multiple Plantar Warts of Human Papillomavirus Biotype 27 and Previous Failed Treatments. Am J Case Rep 2022; 23:e937867. [PMID: 36348614 PMCID: PMC9662077 DOI: 10.12659/ajcr.937867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 10/04/2022] [Accepted: 09/13/2022] [Indexed: 11/07/2023]
Abstract
BACKGROUND Plantar warts are benign skin tumors caused by the human papillomavirus (HPV). There are multiple treatments, but none ensure absolute success. Successful treatment depends on several factors, such as the location, number of lesions, HPV biotype, and the patient's health condition. This report presents a 53-year-old woman who had multiple recalcitrant plantar warts with HPV biotype 27 that were treated using a cantharidin-podophyllin-salicylic acid (CPS) formulation after 2 failed treatments. CASE REPORT A 53-year-old woman was seen on October 25, 2021. She had 6 plantar warts due to HPV biotype 27, which was confirmed by polymerase chain reaction using a sample of hyperkeratosis scales obtained from the wart after debridement. Five cryotherapy sessions were applied, without clinical improvement. Two sessions of nitric-acid-zinc complex were then applied, from which the patient reported severe pain, without clinical improvement. Finally, 3 sessions of CPS formulation were applied, and the HPV remitted in all warts. CONCLUSIONS Conservative treatments, such as cryotherapy, have not been effective in a case of multiple recalcitrant plantar warts. The combined action of the 3 compounds of CPS formulation was key in the resolution of this case. Plantar wart treatment should be easy to apply, effective, fast, and efficient. In cases of recalcitrant or numerous warts, treatment should be more aggressive from the beginning if the patient's lifestyle allows it. It would be interesting to conduct randomized clinical trials to find out which patients could be indicated for the CPS formulation as a first line of treatment.
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Youssefian L, Saeidian AH, Tavasoli AR, Kalamati E, Naghipoor K, Hozhabrpour A, Mesdaghi M, Saffarian Z, Mahmoudi H, Nabavi M, Shokri S, Zeinali S, Béziat V, Casanova JL, Jouanguy E, Uitto J, Vahidnezhad H. Recalcitrant Cutaneous Warts in a Family with Inherited ICOS Deficiency. J Invest Dermatol 2022; 142:2435-2445. [PMID: 35276224 PMCID: PMC9391267 DOI: 10.1016/j.jid.2022.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/16/2022] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
Abstract
Recalcitrant warts, caused by human papillomaviruses (HPVs), can be a cutaneous manifestation of inborn error of immunity. This study investigated the clinical manifestations, immunodeficiency, single-gene susceptibility, and HPV repertoire in a consanguineous family with severe sinopulmonary infections and recalcitrant warts. Clinical and immunologic evaluations, including FACS and lymphocyte transformation test, provided evidence for immunodeficiency. Combined whole-exome sequencing and genome-wide homozygosity mapping were utilized to disclose candidate sequence variants. Whole-transcriptome sequencing was used to concomitantly investigate the HPV genotypes and the consequences of detected sequence variants in the host. The proband, a male aged 41 years, was found to be homozygous for the c.6delG, p.Lys2Asnfs∗17 variant in ICOS, encoding the inducible T-cell costimulator. This variant was located inside the 5 megabase of runs of homozygosity on 2q33.2. RNA sequencing confirmed the deleteriousness of the ICOS variant in three skin biopsies revealing significant downregulation of ICOS and its ligand, ICOSLG. Reads unaligned to the human genome were applied to 926 different viruses, and α-HPV57, β-HPV107, β-HPV14, and β-HPV17 were detected. Collectively, we describe a previously unrecognized inborn error of T-cell immunity to HPVs, indicating that autosomal recessive ICOS deficiency can underlie recalcitrant warts, emphasizing the immunologic underpinnings of recalcitrant warts at the nexus of human and viral genomic variation.
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Affiliation(s)
- Leila Youssefian
- Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Amir Hossein Saeidian
- Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Genetics, Genomics & Cancer Biology PhD Program, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ali Reza Tavasoli
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Pediatric Neurology Division, Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Elnaz Kalamati
- Department of Obstetrics and Gynecology, Imam Zaman Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Karim Naghipoor
- Student Research Committee, Golestan University of Medical Sciences, Gorgan, Iran
| | - Amir Hozhabrpour
- Department of Medical Genetics and Molecular Biology, Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mehrnaz Mesdaghi
- Department of Allergy and Clinical Immunology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Saffarian
- Imam Khomeini Hospital, Tehran University of Medical Science, Tehran, Iran; Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Mahmoudi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Nabavi
- Department of Allergy and Clinical Immunology, Rasool-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sima Shokri
- Department of Allergy and Clinical Immunology, Rasool-E-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Sirous Zeinali
- Kawsar Human Genetics Research Center, Tehran, Iran; Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Vivien Béziat
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France; Imagine Institute, Paris University, France
| | - Jean-Laurent Casanova
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France; Imagine Institute, Paris University, France; Pediatric Hematology and Immunology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France; Howard Hughes Medical Institute, New York, New York, USA
| | - Emmanuelle Jouanguy
- St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, New York, USA; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Inserm U1163, Necker Hospital for Sick Children, Paris, France; Imagine Institute, Paris University, France
| | - Jouni Uitto
- Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Hassan Vahidnezhad
- Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
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8
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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9
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Fejfarová V, Bieliková J, Voska L, Diamantová D, Dubský M, Wosková V, Bém R, Husáková J, Vrátná E, Jirkovská A. Verrucous Skin Lesions on the Feet in Diabetic Neuropathy in the Context of Podiatric Practice - Our Pilot Experiences. Acta Dermatovenerol Croat 2022; 30:49-53. [PMID: 36153719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Skin changes in patients with diabetic foot (DF) are relatively common. The most frequent lesions feature papillae or cilia of various forms. The condition known as "verrucous skin lesions on the feet in diabetic neuropathy" (VSLDN) occurs in patients with distal diabetic sensorimotor neuropathy and is commonly located in places of high mechanical pressure. However, there is a scarcity of published data on the diagnosis and treatment of VSLDN. Our paper describes various types of VSLDN skin pathology, summarizes the diagnostic procedure options available, and documents the experience of our diabetic foot clinic in applying short-term VSLDN therapies as part of routine podiatric practice.
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Affiliation(s)
- Vladimira Fejfarová
- Vladimíra Fejfarová, MD, PhD, Diabetes Centre, Institute for Clinical and Experimental Medicine, Vídeňská 1958, Prague 4;
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10
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Kneiber D, Cassarino DS. Combined Poroma and Verruca Plantaris. Am J Dermatopathol 2022; 44:e51-e53. [PMID: 35120031 DOI: 10.1097/dad.0000000000002123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 76-year-old female patient presented with a peculiar new exophytic-appearing, flesh-colored skin lesion on her left hallux. Owing to its atypical appearance, the neoplasm was biopsied. Histologic sections demonstrated numerous thickened, anastomosing cord-like structures composed of bland appearing adnexal keratinocytes attached to the epidermis and extending into the superficial dermis. Nearby areas exhibited papillomatosis, epidermal acanthosis, dense hyperparakeratosis, hypergranulosis, and superficial koilocytes, findings consistent with a verruca plantaris. A p16 stain was positive in many of the superficial epidermal keratinocytes. Human papillomavirus typing by in situ hybridization for the most common low-risk and high-risk types was also performed and was negative for these. We herein present an unusual case of a skin lesion which combines features of a poroma with a verruca plantaris. We further review what is known of the relationship between human papillomavirus and poroid neoplasms.
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Affiliation(s)
- Diana Kneiber
- Departments of Dermatology and Pathology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA
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11
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Merati N, Sivachandran S, Jfri A, Ben-Shoshan M, Vinh DC, Popradi G, Litvinov IV. Plerixafor on a WHIM - Promise or Fantasy of a New CXCR4 Inhibitor for This Rare, but Important Syndrome? Skin Therapy Lett 2022; 27:1-5. [PMID: 35385630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Warts, Hypogammaglobulinemia, Infections and Myelokathexis (WHIM) is a primary immunodeficiency syndrome. Patients with WHIM syndrome are more susceptible to human papillomavirus (HPV) infections and commonly present to a dermatologist with recalcitrant to treatment warts. Other cardinal features of WHIM syndrome include recurrent sinopulmonary bacterial infections, neutropenia/lymphopenia, low levels of immunoglobulins (IgG, IgA, IgM) and myelokathexis. Research demonstrated that truncating gain-of-function mutations of the C-X-C chemokine receptor type 4 gene (CXCR4) are responsible for this disease. Plerixafor, a specific small molecule antagonist of CXCR4, is currently used for peripheral blood hematopoietic stem cell (HSC) mobilization in stem cell transplant recipients. It has recently shown promise for the treatment of WHIM syndrome in phase I/II clinical trials. In this paper we review the emerging patient clinical data for this medication and highlight the role of CXCR4 in other important skin diseases including keratinocyte carcinomas, psoriasis and cutaneous T-cell lymphoma.
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Affiliation(s)
- Nickoo Merati
- Division of Dermatology, McGill University Health Centre, Montréal, QC, Canada
| | | | - Abdulhadi Jfri
- Division of Dermatology, McGill University Health Centre, Montréal, QC, Canada
| | - Moshe Ben-Shoshan
- Division of Allergy and Immunology, McGill University Health Centre, Montréal, QC, Canada
| | - Donald C Vinh
- Division of Allergy and Immunology, McGill University Health Centre, Montréal, QC, Canada
- Division of Infectious Diseases, McGill University Health Centre, Montréal, QC, Canada
| | - Gizelle Popradi
- Division of Hematology, McGill University Health Centre, Montréal, QC, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University Health Centre, Montréal, QC, Canada
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12
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Cui X, Sun J, Minkove SJ, Li Y, Cooper D, Couse Z, Eichacker PQ, Torabi‐Parizi P. Effects of chloroquine or hydroxychloroquine treatment on non-SARS-CoV2 viral infections: A systematic review of clinical studies. Rev Med Virol 2021; 31:e2228. [PMID: 33694220 PMCID: PMC8209942 DOI: 10.1002/rmv.2228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/05/2021] [Accepted: 02/08/2021] [Indexed: 12/15/2022]
Abstract
Chloroquine (CQ) and hydroxychloroquine (HCQ) have been used as antiviral agents for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. We performed a systematic review to examine whether prior clinical studies that compared the effects of CQ and HCQ to a control for the treatment of non-SARS-CoV2 infection supported the use of these agents in the present SARS-CoV2 outbreak. PubMed, EMBASE, Scopus and Web of Science (PROSPERO CRD42020183429) were searched from inception through 2 April 2020 without language restrictions. Of 1766 retrieved reports, 18 studies met our inclusion criteria, including 17 prospective controlled studies and one retrospective study. CQ or HCQ were compared to control for the treatment of infectious mononucleosis (EBV, n = 4), warts (human papillomavirus, n = 2), chronic HIV infection (n = 6), acute chikungunya infection (n = 1), acute dengue virus infection (n = 2), chronic HCV (n = 2), and as preventive measures for influenza infection (n = 1). Survival was not evaluated in any study. For HIV, the virus that was most investigated, while two early studies suggested HCQ reduced viral levels, four subsequent ones did not, and in two of these CQ or HCQ increased viral levels and reduced CD4 counts. Overall, three studies concluded CQ or HCQ were effective; four concluded further research was needed to assess the treatments' effectiveness; and 11 concluded that treatment was ineffective or potentially harmful. Prior controlled clinical trials with CQ and HCQ for non-SARS-CoV2 viral infections do not support these agents' use for the SARS-CoV2 outbreak.
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Affiliation(s)
- Xizhong Cui
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Junfeng Sun
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Samuel J. Minkove
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Yan Li
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Diane Cooper
- NIH LibraryClinical CenterNational Institutes of HealthBethesdaMarylandUSA
| | - Zoe Couse
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
| | - Peter Q. Eichacker
- Critical Care Medicine DepartmentNational Institutes of HealthBethesdaMarylandUSA
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13
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Singh RK. Diffuse Non-Genital Cutaneous Warts. Am J Trop Med Hyg 2021; 106:378-379. [PMID: 34695802 PMCID: PMC8832905 DOI: 10.4269/ajtmh.21-0807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/13/2021] [Indexed: 12/04/2022] Open
Affiliation(s)
- Ranjan Kumar Singh
- Address correspondence to Ranjan Kumar Singh, Antiretroviral Therapy Centre, District Hospital, Nr Vishal Bajarangbali Mandir, Mainpura, G.P.O., Patna, India, 800 001. E-mail:
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14
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Affiliation(s)
- Fang-Gu Li
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Guangdong, China
| | - Yi-Ming Fan
- Department of Dermatology, Affiliated Hospital of Guangdong Medical University, Guangdong, China
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15
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Affiliation(s)
- Fei Han
- Department of Dermatology, Suqian First Hospital, Suqian City, Jiangsu Province, China
| | - Bo Guo
- Department of Dermatology, Tongxiang Dermatology Hospital, Tongxiang City, Zhejiang Province, China
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16
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Abstract
RATIONALE Tattooing is a procedure where ink is inserted typically in the intraepidermal space of the skin. Multiple incidences of viral infections following tattooing which lead to warts have been reported in recent years. The aim of this report was to show a relatively rare adverse effect after tattooing - verruca plana. PATIENT CONCERNS A 27-year-old female presented to our department with complains of multiple verrucous papules over her 2-year-old tattoo without itch. DIAGNOSES Pathological investigation confirmed the diagnosis as verruca plana. INTERVENTIONS The patient was treated with 3 cycles of liquid nitrogen cryotherapy and 5% imiquimod cream for 5 months. OUTCOMES A significant improvement in her lesions was observed after the combined treatment. LESSONS Clinically, verruca plana post-tattooing is relatively less reported. We need to combine clinical manifestations with pathological results to arrive at a definitive diagnosis. Besides, there are a large numbers of post-tattoo complications and various routes of virus inoculation. Therefore, it is important for medical professionals to caution people before considering to have a tattoo.
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17
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Hao S, Wang C, Liu S, He J, Jiang Y. HPV genotypic spectrum in Jilin province, China, where non-vaccine-covered HPV53 and 51 are prevalent, exhibits a bimodal age-specific pattern. PLoS One 2020; 15:e0230640. [PMID: 32208459 PMCID: PMC7313545 DOI: 10.1371/journal.pone.0230640] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/04/2020] [Indexed: 01/10/2023] Open
Abstract
Background Human papillomavirus (HPV), the most common sexually transmitted disease, is
involved in a series of other diseases. The persistent infection of
high-risk HPVs (HR-HPVs) is considered to be the causative agent of cervical
cancer, and it is related to noncervical cancers. The present study aims to
estimate the HPV prevalence and genotype distribution in Jilin province,
China, to guide HPV-related cervical cancer screening and HPV
vaccination. Methods From October 2017 to September 2019, 21,282 samples (634 male and 20,648
female) were collected for HPV infection detection using an HPV genotyping
panel. The age-related HPV prevalence and morbidity of HPV-based disease and
HPV prevalence associated with specific diseases were analyzed. Results A total of 7095 (34.4%) positive for HPV infection of 20648 women, and 164
(25.8%) positive of 634 men. The HPV prevalence among women exhibited a
bimodal pattern, with a peak in young group and a second peak in old group,
with increased severity of cervical lesions. HPV16 (7.8%), HPV52 (5.8%),
HPV58 (5.0%), HPV53 (3.4%), and HPV51 (3.0%) were the most prevalent
genotypes among women, and HPV6 (6.0%), HPV11 (5.7%), HPV16 (3.6%), HPV18
(2.7%), and HPV51 (3.0%) were prevalent among men. Non-vaccine-covered HPV53
and 51 were found in 6.3% of HPV infection and 8.9% of cervical cancer in
Jilin province. Furthermore, 45.5% of females and 28.6% of males with
genital warts were infected with HR-HPV genotypes. Conclusion The HPV genotypic spectrum in Jilin province, where non-vaccine-covered HPV53
and 51 were prevalent, exhibited an age- and cervical lesion-specific
pattern, which provides guidance for HPV vaccination and cervical cancer
screening. HPV infection in men and benign hyper-proliferative lesions
should not be neglected.
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Affiliation(s)
- Sijia Hao
- Key Laboratory of Organ Regeneration & Transplantation
of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of
Jilin University, Changchun, China
| | - Chunyan Wang
- Key Laboratory of Organ Regeneration & Transplantation
of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of
Jilin University, Changchun, China
| | - Siwen Liu
- Key Laboratory of Organ Regeneration & Transplantation
of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of
Jilin University, Changchun, China
| | - Jiaxue He
- Key Laboratory of Organ Regeneration & Transplantation
of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of
Jilin University, Changchun, China
| | - Yanfang Jiang
- Key Laboratory of Organ Regeneration & Transplantation
of the Ministry of Education, Genetic Diagnosis Center, The First Hospital of
Jilin University, Changchun, China
- * E-mail:
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18
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Amorrortu RP, Fenske NA, Cherpelis BS, Vijayan L, Zhao Y, Balliu J, Messina JL, Sondak VK, Giuliano AR, Waterboer T, Pawlita M, Gheit T, Tommasino M, Rollison DE. Viruses in Skin Cancer (VIRUSCAN): Study Design and Baseline Characteristics of a Prospective Clinic-Based Cohort Study. Cancer Epidemiol Biomarkers Prev 2020; 29:39-48. [PMID: 31427307 PMCID: PMC6954275 DOI: 10.1158/1055-9965.epi-19-0446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/26/2019] [Accepted: 08/13/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that cutaneous viral infections are risk factors for the development of keratinocyte carcinomas. The Viruses in Skin Cancer (VIRUSCAN) Study, a prospective cohort study, was established in 2014 to investigate the risk of keratinocyte carcinoma associated with cutaneous human papillomavirus and polyomavirus infection and the possible interaction with ultraviolet radiation exposure (UVR). METHODS/RESULTS VIRUSCAN incorporates repeated measures of viral infection using multiple markers of infection and quantitative measures of UVR using a spectrophotometer. Participants were recruited between July 14, 2014 and August 31, 2017 at the University of South Florida Dermatology Clinic in Tampa, FL. After excluding 124 individuals with prevalent keratinocyte carcinomas at baseline, 1,179 participants (53.2% women, 46.8% men, all ages 60 years and older) were followed for up to 4 years with routine skin exams occurring every 6 to 12 months. Here, we present the VIRUSCAN Study design, methods, and baseline characteristics, including demographics, sun exposure behavior, quantitative UVR exposure measurements, and cutaneous viral prevalence, for the full study cohort. CONCLUSIONS The VIRUSCAN Study will provide critical temporal evidence needed to assess the causality of the role cutaneous viral infections play in the development of keratinocyte carcinomas, as well as the potential interaction between cutaneous viral infections and UVR exposure. IMPACT Study findings will be valuable in future development of novel keratinocyte carcinoma prevention strategies.
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MESH Headings
- Aged
- Carcinoma, Basal Cell/epidemiology
- Carcinoma, Basal Cell/etiology
- Carcinoma, Basal Cell/pathology
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/epidemiology
- Carcinoma, Merkel Cell/pathology
- Carcinoma, Merkel Cell/virology
- Carcinoma, Squamous Cell/epidemiology
- Carcinoma, Squamous Cell/etiology
- Carcinoma, Squamous Cell/pathology
- Female
- Follow-Up Studies
- Humans
- Keratinocytes/pathology
- Keratinocytes/radiation effects
- Keratinocytes/virology
- Male
- Middle Aged
- Prevalence
- Prospective Studies
- Research Design
- Risk Factors
- Skin/cytology
- Skin/pathology
- Skin/radiation effects
- Skin/virology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/epidemiology
- Skin Neoplasms/etiology
- Skin Neoplasms/pathology
- Spectrophotometry, Ultraviolet
- Ultraviolet Rays/adverse effects
- Warts/diagnosis
- Warts/epidemiology
- Warts/pathology
- Warts/virology
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Affiliation(s)
| | - Neil A Fenske
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Basil S Cherpelis
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
| | - Laxmi Vijayan
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Juliana Balliu
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida
| | - Jane L Messina
- Department of Dermatology and Cutaneous Surgery, University of South Florida College of Medicine, Tampa, Florida
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, Florida
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida
| | - Anna R Giuliano
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
| | - Tim Waterboer
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Pawlita
- Infections and Cancer Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tarik Gheit
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Massimo Tommasino
- Infections and Cancer Biology Group, International Agency for Research on Cancer-World Health Organization, Lyon, France
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
- Center for Immunization and Infection Research in Cancer, Moffitt Cancer Center, Tampa, Florida
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19
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Veasey JV, Erthal ALN, Lellis RF. In vivo and ex vivo dermoscopy of lesions from implantation of human papillomavirus in tattoos: report of two cases. An Bras Dermatol 2019; 95:78-81. [PMID: 31889590 PMCID: PMC7058879 DOI: 10.1016/j.abd.2019.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/12/2019] [Indexed: 11/29/2022] Open
Abstract
The number of individuals with tattoos has been increasing worldwide, alongside with reports of complications varying from reactions to the injected pigments to infections caused by agents inoculated in the pigmentation process. The diagnosis of such unwanted events can be obtained through complementary non-invasive methods, preserving the maximum of the tattoo design. The authors present two cases of patients with warts on tattooing, and correlate their clinical aspects to in vivo and ex vivo dermoscopy, and to the findings in the histopathological examination, aiming to determine patterns that aid the diagnosis of these lesions without performing biopsy.
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Affiliation(s)
- John Verrinder Veasey
- Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.
| | - Ana Luisa Nasser Erthal
- Dermatology Clinic, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Rute Facchini Lellis
- Pathology Laboratory, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
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20
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Priya A, Adil M, Amin SS, Mohtashim M, Bansal R, Alam M. Intralesional Vitamin D3 in Recalcitrant Palmoplantar and Periungual Warts: A Prospective, Observational Study. Acta Dermatovenerol Croat 2019; 27:215-224. [PMID: 31969233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cutaneous warts are particularly difficult to treat with conventional treatment on sites such as the palms, soles, and periungual region. Immunotherapy boosts the host immune response and helps clear warts with less chance of recurrence. Vitamin D plays an important role in proliferation and differentiation of keratinocytes. The aim of this observational study was to study the efficacy and safety of intralesional vitamin D immunotherapy in the treatment of recalcitrant palmoplantar and periungual warts. Patients who had palmoplantar and periungual warts for more than 6 months and were non-responsive to at least two conventional treatment modalities were selected for the study. A maximum of four warts were injected with 0.2 mL of lignocaine (20 mg/mL), followed by intralesional injection of 0.2-0.5 mL of vitamin D3 (15 mg/mL), every 2 weeks for a maximum of four sessions. Response was assessed based on the reduction in the number of warts. A total of 63 patients were included in the study. The mean number of intralesional vitamin D3 injections required for complete clearance was 3.05±0.83 (mean ± Standard Deviation). Complete response was observed in 56 (88.9%) patients. Maximum clearance was observed in periungual warts (92.9%), followed by palmar warts (90.0%) and plantar warts (86.2%). The most common adverse effect was pain during injection (100.0%) and local swelling (25.4%). Two patients developed recurrence during follow-up. Immunotherapy with vitamin D3 appears to be an effective, inexpensive, and safe treatment in recalcitrant palmoplantar and periungual warts.
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Affiliation(s)
| | - Mohammad Adil
- Assist. Prof. Mohammad Adil, MD, Department of Dermatology, Jawaharlal Nehru Medical College , Aligarh Muslim University, Aligarh, India;
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21
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Nussbaum D, Schwartz J, Friedman A. A Giant Cutaneous Horn: One of the Largest Recorded. J Drugs Dermatol 2019; 18:697-698. [PMID: 31334930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We present a case of one of the largest cutaneous horns recorded in the known literature as an opportunity to explore diagnostic considerations and treatment options. Cutaneous horns are common exophytic neoplasms composed of dense keratin that are always secondary to primary lesions, which can be benign or malignant. Due to the variance of the primary lesion, diagnostic biopsies are necessary to rule out a malignant origin. Several case reports of giant cutaneous horns may suggest that a larger size indicates a verrucous origin, although a biopsy is necessary as this association has only been noted in very few cases. If the primary lesion is found to be malignant and extending to the biopsy margins, further treatment is required, whereas a benign origin usually requires no further treatment. J Drugs Dermatol. 2019;18(7):697-698.
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22
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Antaya RJ, del Carmen M, Alonso F, Sukumar N, Yong F, Dvoretzky I. An Open Label Study of an Occlusive Heat Patch in the Treatment of Warts. J Drugs Dermatol 2019; 18:368-373. [PMID: 31012566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background: Local hyperthermia has been demonstrated to be a safe and efficacious treatment for warts. Objective: We aimed to evaluate the safety and efficacy of an epicutaneous heat patch to induce local hyperthermia for the treatment of warts. Methods: We performed an uncontrolled, proof of concept study by applying a novel, reproducible, epicutaneous heat patch to a target wart for 2 hours per day for 12 weeks. There were 15 evaluable participants. An untreated wart was also observed and measured. Wart measurements included the diameter in two dimensions, an investigator global assessment (IGA) score, wart clearance, and monitoring for adverse events as endpoints at week 12 (end of treatment) and week 24 (end of study). Results: No major adverse events were observed. 6.7% of participants reported minor cutaneous events. At week 24, 46.7% of participants achieved complete clearance of both warts. Limitations: The small sample size and lack of independent control in each participant were the main limiting factors. Conclusion: Local hyperthermia delivered by epicutaneous heat patches was well-tolerated, safe, and achieved complete clearance in both treated as well untreated warts in 46.7% of participants at week 24 after 12 weeks of daily use. Clinicaltrials.gov: NCT01746056 J Drugs Dermatol. 2019;18(4):368-373.
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23
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Steinweg SA, Groleau PF, Choi E, Snider J, Amin P, Vujaskovic Z, Gaspari AA. Radiation and Hyperthermia Combination Therapy for Recalcitrant Verruca Vulgaris. Skinmed 2019; 17:68-71. [PMID: 30888954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 47-year-old white woman presented to our clinic complaining of recalcitrant warts on her trunk and extremities. She had an extensive past medical history including immunodeficiency of unknown origin, pulmonary hypertension, rheumatoid arthritis, and systemic lupus erythematosus, for which she was being treated with chronic immunosuppressive therapy with methylprednisolone and belimumab. The patient had previously failed treatments at an outside facility with liquid nitrogen, trichloroacetic acid, topical cidofovir, imiquimod, topical 5-fluorouracil, intralesional candida antigen, pulsed-dye laser (Vbeam Perfecta), surgical excision, and photodynamic therapy. (SKINmed. 2019;17:68-71).
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Affiliation(s)
- Stephanie A Steinweg
- University of Maryland School of Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Patricia F Groleau
- Department of Dermatology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Enid Choi
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - James Snider
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Pradip Amin
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Zeljko Vujaskovic
- Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
| | - Anthony A Gaspari
- University of Maryland Medical Center, Baltimore, MD, Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA
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24
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Albuquerque A, Medeiros R. New Insights into the Role of Human Papillomavirus in Anal Cancer and Anal Wart Development. Acta Cytol 2019; 63:118-123. [PMID: 30861525 DOI: 10.1159/000491815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 07/05/2018] [Indexed: 01/18/2023]
Abstract
Human papillomavirus is associated with several anogenital and oropharyngeal lesions, including warts, premalignant lesions, and cancer. There are specific groups that were identified as high-risk groups for anal squamous cell carcinoma and anal human papillomavirus infection, namely HIV-positive patients, men who have sex with men, women with genital tract neoplasia, and solid organ transplant recipients. Condylomas have classically been considered to be a benign lesion, with an exception made for the Buschke-Loewenstein tumor, but several publications have shown that a high percentage of condylomas harbor high-grade lesions. Due to the similarities between anal and cervical carcinogenesis, anal cancer screening based on anal cytology and referral to high-resolution anoscopy, in case of abnormalities, have been advocated. Testing for anal human papillomavirus is not routinely done in anal cancer screening, because of the very high prevalence in high-risk populations. The large majority of anal cancers are squamous cell carcinomas (SCC), and around 90% are attributed to human papillomavirus. Human papillomavirus positivity in anal SCC seems to have a prognostic value, with better survival in those patients with positive tumors. Prophylactic vaccination has been shown to be important for prevention of anal human papillomavirus-related lesions.
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Affiliation(s)
| | - Rui Medeiros
- Faculty of Medicine of the University of Porto, Porto, Portugal,
- Molecular Oncology and Viral Pathology Group, IPO Research Center, Portuguese Oncology Institute, Porto, Portugal,
- FP-ENAS Research Unit, UFP Energy, Environment and Health Research Unit, CEBIMED, Biomedical Research Centre, University Fernando Pessoa, Porto, Portugal,
- LPCC, Research Department - Portuguese League Against Cancer (LPPC-NRN), Porto, Portugal,
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Shi L, Luo M, Zhang F, Zhang L, Wang B, Liu P, Zhang Y, Zhang H, Yang D, Zhang G, Zhou F, Stepp H, Sroka R, Chen WR, Wang X. Photothermal therapy enhanced the effectiveness of imiquimod against refractory cutaneous warts through boosting immune responses. J Biophotonics 2019; 12:e201800149. [PMID: 29952075 DOI: 10.1002/jbio.201800149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/21/2018] [Accepted: 06/26/2018] [Indexed: 06/08/2023]
Abstract
Refractory cutaneous warts are difficult to eliminate. In situ photo-immunotherapy (ISPI) is an innovative treatment concept combining local photothermal therapy (PTT) and topical immunotherapy using imiquimod. To compare the efficacy of ISPI vs topical imiquimod alone, a prospective randomized controlled trial was performed with patients suffering from refractory cutaneous warts. In both groups, approximately 50% of the skin surface containing warts was treated for 6 weeks. On the basis of topical imiquimod, ISPI includes an additional 808 nm laser irradiation. Treatment response, temperatures during irradiation and histopathologic examination were evaluated. The complete response rate in the ISPI-group (22/36, 61.1%) was significantly higher than in the imiquimod alone group (11/34, 32.4%). In the ISPI-group, the mean maximum temperature was 44.5 ± 5.1°C, and obvious lymphocytic infiltration was found in the perivasculature of the dermis. There was no recurrence or worsening in both groups during the 12-month follow-up. No obvious adverse reaction was observed. This study demonstrates that ISPI can be used as an effective and safe treatment modality for refractory cutaneous warts.
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Affiliation(s)
- Lei Shi
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Min Luo
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Fuhe Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Linglin Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bo Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Pei Liu
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yunfeng Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Haiyan Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Degang Yang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Guolong Zhang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Feifan Zhou
- Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research, College of Mathematics and Science, University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Herbert Stepp
- Laser-Forschungslabor, LIFE Center, University Hospital of Munich, Munich, Germany
- Department of Urology, University Hospital of Munich, Munich, Germany
| | - Ronald Sroka
- Laser-Forschungslabor, LIFE Center, University Hospital of Munich, Munich, Germany
- Department of Urology, University Hospital of Munich, Munich, Germany
| | - Wei R Chen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
- Biophotonics Research Laboratory, Center for Interdisciplinary Biomedical Education and Research, College of Mathematics and Science, University of Central Oklahoma, Edmond, Oklahoma, USA
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
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McDermott DH, Pastrana DV, Calvo KR, Pittaluga S, Velez D, Cho E, Liu Q, Trout HH, Neves JF, Gardner PJ, Bianchi DA, Blair EA, Landon EM, Silva SL, Buck CB, Murphy PM. Plerixafor for the Treatment of WHIM Syndrome. N Engl J Med 2019; 380:163-170. [PMID: 30625055 PMCID: PMC6425947 DOI: 10.1056/nejmoa1808575] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
WHIM syndrome (warts, hypogammaglobulinemia, infections, and myelokathexis), a primary immunodeficiency disorder involving panleukopenia, is caused by autosomal dominant gain-of-function mutations in CXC chemokine receptor 4 (CXCR4). Myelokathexis is neutropenia caused by neutrophil retention in bone marrow. Patients with WHIM syndrome are often treated with granulocyte colony-stimulating factor (G-CSF), which can increase neutrophil counts but does not affect cytopenias other than neutropenia. In this investigator-initiated, open-label study, three severely affected patients with WHIM syndrome who could not receive G-CSF were treated with low-dose plerixafor, a CXCR4 antagonist, for 19 to 52 months. Myelofibrosis, panleukopenia, anemia, and thrombocytopenia were ameliorated, the wart burden and frequency of infection declined, human papillomavirus-associated oropharyngeal squamous-cell carcinoma stabilized, and quality of life improved markedly. Adverse events were mainly infections attributable to the underlying immunodeficiency. One patient died from complications of elective reconstructive surgery. (Funded by the National Institutes of Health.).
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Affiliation(s)
- David H McDermott
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Diana V Pastrana
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Katherine R Calvo
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Stefania Pittaluga
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Daniel Velez
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Elena Cho
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Qian Liu
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Hugh H Trout
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - João F Neves
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Pamela J Gardner
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - David A Bianchi
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Elizabeth A Blair
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Emily M Landon
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Susana L Silva
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Christopher B Buck
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
| | - Philip M Murphy
- From the Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases (D.H.M., D.V., E.C., Q.L., P.M.M.), the Laboratories of Cellular Oncology (D.V.P., C.B.B.) and Pathology (S.P.), National Cancer Institute, the Department of Laboratory Medicine, Clinical Center (K.R.C.), the National Institute of Dental and Craniofacial Research (P.J.G.), and the National Institute on Deafness and Other Communication Disorders (D.A.B.), National Institutes of Health, and Kozloff and Trout MDs (H.H.T.), Bethesda, MD; the Infectious Diseases Unit and Primary Immunodeficiencies Unit, Hospital Dona Estefânia, Pediatric University Hospital (J.F.N.), and Centro de Imunodeficiências Primárias, Academic Medical Center of Lisbon (S.L.S.), Lisbon, Portugal; and the University of Chicago Medical Center, Chicago (E.A.B., E.M.L.)
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Abstract
We report a case of amelanotic acral melanoma in a 42-year-old Chinese woman. Ten months previously the patient found a 2-cm asymmetric erythematous macular plaque on her left sole. The lesion was diagnosed as verruca plantaris by every physician the patient consulted. One month ago, an enlarged lymph node was detected in the left groin, which biopsy reported as metastatic melanoma. Dermoscopy suggested verruca plantaris, and positron emission tomography (PET) revealed increased glucose metabolism in the macular plaque. Finally, biopsy of the plaque revealed amelanotic melanoma. Misdiagnosis and diagnostic delay are usually associated with poorer patient outcomes. Awareness of atypical presentations of acral melanoma is thus important for decreasing misdiagnosis rates and improving patient outcomes.
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Affiliation(s)
- Wei Deng
- Department of Dermatology and Venereology, China-Japan
Friendship Hospital, Beijing, China
| | - Ruixing Yu
- Department of Dermatology and Venereology, China-Japan
Friendship Hospital, Beijing, China
| | - Yong Cui
- Department of Dermatology and Venereology, China-Japan
Friendship Hospital, Beijing, China
| | - Zhancai Zheng
- Department of Dermatology and Venereology, China-Japan
Friendship Hospital, Beijing, China
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Oppermann K, Cocco AR, Heck R, Bonamigo RR. PLECT or PPLECT? Granulomatous pyoderma gangrenosum in the differential diagnosis of the verrucous syndrome. An Bras Dermatol 2018; 93:605-607. [PMID: 30066779 PMCID: PMC6063102 DOI: 10.1590/abd1806-4841.20187329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Accepted: 10/13/2017] [Indexed: 11/30/2022] Open
Abstract
Pyoderma gangrenosum (PG) is an uncommon neutrophilic dermatosis, with variable clinical features, nonspecific histopathology and multifactorial pathogenesis, posing a challenging diagnosis for the dermatologist. Pyoderma gangrenosum is a diagnosis of exclusion and should be included in the differential diagnoses of the verrucous syndrome. We report a granulomatous variant affecting the face.
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Affiliation(s)
- Kenselyn Oppermann
- Ambulatório de Dermatologia Sanitária de Porto
Alegre, Porto Alegre (RS), Brazil
| | - Ariane Rubin Cocco
- Ambulatório de Dermatologia Sanitária de Porto
Alegre, Porto Alegre (RS), Brazil
| | - Renata Heck
- Ambulatório de Dermatologia Sanitária de Porto
Alegre, Porto Alegre (RS), Brazil
| | - Renan Rangel Bonamigo
- Ambulatório de Dermatologia Sanitária de Porto
Alegre, Porto Alegre (RS), Brazil
- Service of Dermatology, Hospital de Clínicas de Porto
Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre (RS), Brazil
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Gao JL, Yim E, Siwicki M, Yang A, Liu Q, Azani A, Owusu-Ansah A, McDermott DH, Murphy PM. Cxcr4-haploinsufficient bone marrow transplantation corrects leukopenia in an unconditioned WHIM syndrome model. J Clin Invest 2018; 128:3312-3318. [PMID: 29715199 DOI: 10.1172/jci120375] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/27/2018] [Indexed: 02/06/2023] Open
Abstract
For gene therapy of gain-of-function autosomal dominant diseases, either correcting or deleting the disease allele is potentially curative. To test whether there may be an advantage of one approach over the other for WHIM (warts, hypogammaglobulinemia, infections, and myelokathexis) syndrome - a primary immunodeficiency disorder caused by gain-of-function autosomal dominant mutations in chemokine receptor CXCR4 - we performed competitive transplantation experiments using both lethally irradiated WT (Cxcr4+/+) and unconditioned WHIM (Cxcr4+/w) recipient mice. In both models, hematopoietic reconstitution was markedly superior using BM cells from donors hemizygous for Cxcr4 (Cxcr4+/o) compared with BM cells from Cxcr4+/+ donors. Remarkably, only approximately 6% Cxcr4+/o hematopoietic stem cell (HSC) chimerism after transplantation in unconditioned Cxcr4+/w recipient BM supported more than 70% long-term donor myeloid chimerism in blood and corrected myeloid cell deficiency in blood. Donor Cxcr4+/o HSCs differentiated normally and did not undergo exhaustion as late as 465 days after transplantation. Thus, disease allele deletion resulting in Cxcr4 haploinsufficiency was superior to disease allele repair in a mouse model of gene therapy for WHIM syndrome, allowing correction of leukopenia without recipient conditioning.
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Han SS, Kim MS, Lim W, Park GH, Park I, Chang SE. Classification of the Clinical Images for Benign and Malignant Cutaneous Tumors Using a Deep Learning Algorithm. J Invest Dermatol 2018; 138:1529-1538. [PMID: 29428356 DOI: 10.1016/j.jid.2018.01.028] [Citation(s) in RCA: 262] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/21/2018] [Accepted: 01/26/2018] [Indexed: 01/04/2023]
Abstract
We tested the use of a deep learning algorithm to classify the clinical images of 12 skin diseases-basal cell carcinoma, squamous cell carcinoma, intraepithelial carcinoma, actinic keratosis, seborrheic keratosis, malignant melanoma, melanocytic nevus, lentigo, pyogenic granuloma, hemangioma, dermatofibroma, and wart. The convolutional neural network (Microsoft ResNet-152 model; Microsoft Research Asia, Beijing, China) was fine-tuned with images from the training portion of the Asan dataset, MED-NODE dataset, and atlas site images (19,398 images in total). The trained model was validated with the testing portion of the Asan, Hallym and Edinburgh datasets. With the Asan dataset, the area under the curve for the diagnosis of basal cell carcinoma, squamous cell carcinoma, intraepithelial carcinoma, and melanoma was 0.96 ± 0.01, 0.83 ± 0.01, 0.82 ± 0.02, and 0.96 ± 0.00, respectively. With the Edinburgh dataset, the area under the curve for the corresponding diseases was 0.90 ± 0.01, 0.91 ± 0.01, 0.83 ± 0.01, and 0.88 ± 0.01, respectively. With the Hallym dataset, the sensitivity for basal cell carcinoma diagnosis was 87.1% ± 6.0%. The tested algorithm performance with 480 Asan and Edinburgh images was comparable to that of 16 dermatologists. To improve the performance of convolutional neural network, additional images with a broader range of ages and ethnicities should be collected.
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Affiliation(s)
| | - Myoung Shin Kim
- Department of Dermatology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Woohyung Lim
- SK Telecom, Human Machine Interface Technology Laboratory, Seoul, Korea
| | - Gyeong Hun Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Dongtan, Korea
| | - Ilwoo Park
- Department of Radiology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
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Quast DR, Nauck MA, Bechara FG, Meier JJ. A case series of verrucae vulgares mimicking hyperkeratosis in individuals with diabetic foot ulcers. Diabet Med 2017; 34:1165-1168. [PMID: 28523836 DOI: 10.1111/dme.13387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Diabetic foot ulcers are a common complication in the advanced stages of diabetes mellitus. Certain lesions may be refractory to usual treatments with prolonged healing. In these cases, differential diagnoses to classical ulcers should be considered. Although plantar warts are a common and easy-to-diagnose finding in the general population, diagnosis can be challenging in people with diabetic foot ulcers, as they mimic hyperkeratosis in these people. CASE REPORT We report seven cases of people with diabetic foot ulcers and verrucae vulgares mimicking treatment-refractory hyperkeratosis, presenting to our centre between 2014 and 2016. Diagnosis was aided by the clinical presentation, followed by dermoscopy and punch biopsy. Treatment included topical application of 5-fluoruracil and salicylic acid (four people), cryotherapy (three people) and surgical excision (three people), all in combination with local pressure offloading. In five people, the verrucae were completely removed after a mean treatment period of 9.4 months; two individuals were lost to follow-up. CONCLUSION Verrucae may be more common in people with diabetic foot lesions and polyneuropathy than generally assumed. Typical findings include small, pinhead-sized bleedings within and surrounding hyperkeratous lesions. These findings should alert the clinician for the potential presence of a verruca. In such cases, biopsy should be performed to enable specific diagnosis and treatment.
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Affiliation(s)
- D R Quast
- Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany
| | - M A Nauck
- Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany
| | - F G Bechara
- Department of Dermatology, St. Josef-Hospital, Ruhr-University Bochum, Germany
| | - J J Meier
- Diabetes Division, Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany
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Affiliation(s)
- X Li
- Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - J Yu
- Department of Dermatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - S Thomas
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Qld, Australia
| | - K Lee
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Qld, Australia
| | - H P Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Qld, Australia
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Nelson EO, Kozin AF, Ruiz G, Lasku A, Langland JO. Treatment of Athlete's Plantar Warts Using a Botanical Blend: A Case Report. Altern Ther Health Med 2017; 23:51-54. [PMID: 28236614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Context • Viral plantar warts, or verruca plantaris, are a benign epithelial tumor caused by various strains of the human papilloma virus (HPV). Current treatments have had mixed degrees of success, are moderately invasive, and are often incompatible with participation in sports. Objective • The study intended to examine the benefits of treating plantar warts with a topical, botanical blend that has had clinical success treating herpes simplex virus cold sores. Methods • A synergistic botanical blend was applied topically. Setting • The case report was completed at the Southwest College of Naturopathic Medicine (Tempe, Arizona, USA). Participant • The participant was a 24-y-old male soccer player, 177.8 cm tall, and weighing 69 kg with previously diagnosed, viral mosaic warts. Intervention • The patient used a pumice stone during bathing for the first week to remove dead tissue and ensure sufficient contact and entry of the botanical gel into infected tissue. After drying the area, the patient applied the botanical gel blend 1 to 2 times daily postshower, spreading it evenly across the surface of the entire lesion. The patient discontinued the exfoliation technique after the first week. Results • Within the first week of treatment, the patient noted changes to the infected area of the hallux epidermal tissue. The combination of exfoliation and application of the gel caused marked, visible differences in presentation by the fifth day of treatment. At 1-mo postintervention, or day 90, the epidermal tissue was asymptomatic and devoid of petechiae, malformations, or visible infection. Conclusions • The results of the current case study directly contrast with the drawbacks of commonly accepted, first-line interventions in the treatment of viral plantar warts and, in many respects, demonstrate better efficacy and fewer side effects than the standard of care. The positive results also highlight the necessity for additional study in the fields of sports medicine and podiatry to further establish the botanical blend when treating viral plantar in athletes, an overall at-risk population for the condition.
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Abstract
Human Papillomavirus (HPV) research has been dominated by the study of a subset of Alpha papillomaviruses that together cause almost 5% of human cancers worldwide, with the focus being on the two most prominent of these (HPV16 and 18). These viruses are referred to as 'high-risk' (hrHPV), to distinguish them from the over 200 prevalent HPV types that more commonly cause only benign epithelial lesions. The 'low-risk' (lrHPV) term used to describe this group belies their cumulative morbidity. Persistent laryngeal papillomas, which occur rarely in children and adults, require regular surgical de-bulking to allow breathing. Such infections are not curable, and despite being caused by HPV11 (a lrHPV) are associated with 1-3% risk of cancer progression if not resolved. Similarly, the ubiquitous Beta HPV types, which commonly cause asymptomatic infections at cutaneous sites, can sometimes cause debilitating papillomatosis with associated cancer risk. Recalcitrant genital warts, which affect 1 in 200 young adults in the general population, and even the ubiquitous common warts and verrucas that most of us at some time experience, cannot be reliably eradicated, with treatment strategies advancing little over the last 100 years. The review highlights molecular similarities between high and low-risk HPV types, and focuses on the different pathways that the two groups use to ensure persistent infection and adequate virus shedding from the epithelial surface. Understanding the normal patterns of viral gene expression that underlie lesion formation, and which also prevent loss of the infected basal cells in established lesions, are particularly important when considering new treatment options. Finally, the common requirement for deregulated viral gene expression and genome persistence in development of cancers, unites both high and low-risk HPV types, and when considered alongside viral protein functions, provides us with a working understanding of the mechanisms that underlie HPV-associated pathology.
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Affiliation(s)
- Nagayasu Egawa
- Department of Pathology, Tennis Court Road, University of Cambridge, Cambridge, UK
| | - John Doorbar
- Department of Pathology, Tennis Court Road, University of Cambridge, Cambridge, UK.
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Zaiac MN, Mlacker S, Shah VV, Simmons BJ. Clinical pearl: the squeeze maneuver. Cutis 2016; 97:202-204. [PMID: 27023088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Plantar warts can be distinguished from calluses using the squeeze maneuver, a quick and easy method to diagnose plantar warts. This technique negates the need for an expensive diagnostic tool.
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Affiliation(s)
- Martin N Zaiac
- Department of Dermatology, Herbert Wertheim College of Medicine, Florida International University, Miami Beach, USA
| | - Stephanie Mlacker
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, USA
| | - Vidhi V Shah
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, USA
| | - Brian J Simmons
- Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, USA
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Viac J, Chardonnet Y, Euvrard S, Chignol MC, Thivolet J. Langerhans Cells, Inflammation Markers and Human Papillomavirus Infections in Benign and Malignant Epithelial Tumors from Transplant Recipients. J Dermatol 2015; 19:67-77. [PMID: 1352312 DOI: 10.1111/j.1346-8138.1992.tb03183.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Organ transplant recipients frequently develop warts which progress toward premalignant or malignant lesions after a rather long grafting period. The local immune responses of such lesions (warts, condyloma acuminata, actinic keratoses, Bowen, basal and squamous cell carcinomas) was studied in 32 frozen skin specimens taken from 15 male transplant recipients and compared to similar lesions from the normal population. We studied the expression of T cell subsets, Langerhans cell phenotype, HLA class 1 (beta 2-microglobulin), HLA class 2 (DR antigen), and intercellular adhesion molecule 1 (ICAM 1). The presence of HPV infection was also considered, using in situ hybridization with biotinylated probes in order to examine the correlation with immunological markers. In the dermis, the lesions from grafted patients showed a moderate to intense inflammatory reaction of HLA-DR-positive cells. Most of these cells were CD4+ and CD8+ without any predominance of a single T cell subset. In the epidermis, most lesions were characterized by a reduced number of CD1-positive cells; this was concomitant with a decrease or a loss of beta 2-microglobulin expression by epithelial cells. HLA-DR antigen was not expressed by keratinocytes or tumoral cells in any specimen; ICAM 1 antigen was observed in a few cases. The expression of these markers was similarly modified with or without the presence of HPV DNA. Conversely, most lesions from non-immunocompromised patients, except warts, showed intense inflammatory reactions, with a predominance of CD4-positive cells and large foci of ICAM 1-positive cells. Expression of activation markers by keratinocytes occurred mainly in condylomas and squamous cell carcinomas. In the normal population, HPV infection was only detected in papilloma lesions. These data indicate, in lesions from grafted patients, a lack of effective immune response with partial inhibition of activation markers expressed by keratinocytes. It is conceivable that immunosuppressive treatment with solar exposure may also be responsible for the local immune deficiency and thus for the conversion of benign warts toward malignant lesions in grafted patients.
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Affiliation(s)
- J Viac
- INSERM U209, Affiliée CNRS, Hôpital E. Herriot, Lyon, France
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López-López D, Agrasar-Cruz C, Bautista-Casasnovas A, Álvarez-Castro CJ. [Application of cantharidin, podophyllotoxin, and salicylic acid in recalcitrant plantar warts. A preliminary study]. GAC MED MEX 2015; 151:14-19. [PMID: 25739479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Plantar warts often are refractory to any treatment and can last for decades in adults. Recalcitrant warts are defined as those that have persisted for more than two years, or after at least two treatment modalities. METHODS A total of 15 consecutive patients with recalcitrant plantar warts were included in this preliminary study. The treatment consisted of applying one to two sessions that comprised compounding 1% cantharidin, 5% of podophyllotoxin, and 30% salicylic acid (CPS), with an interval between applications of four weeks. RESULTS With treatment and subsequent follow-up for six months, there was complete eradication of lesions in 15 patients, eight (53.3%) required a single application of the solution, and seven (46.7%) two applications, with no side effects. Patient satisfaction related to treatment was measured by a visual analog scale (VAS) of 10 cm in length, with an average score 9.73 ± 0.46, and all said they would proceed with the treatment again if necessary. CONCLUSIONS Topical treatment by compounding is safe, effective, and a promising therapeutic modality when applied in recalcitrant plantar warts.
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Affiliation(s)
- Daniel López-López
- Departamento de Ciencias de la Salud, Facultad de Enfermería y Podología, Universidade da Coruña, España
| | - Carlos Agrasar-Cruz
- Departamento de Medicina, Facultad de Ciencias de la Salud, Universidade da Coruña, España
| | - Adolfo Bautista-Casasnovas
- Departamento de Pediatría, Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, España
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Bloom BS, Kamino H, Hale CS, Pomeranz MK. Collision tumor of eccrine poroma, seborrheic keratosis, and a viral wart. Dermatol Online J 2014; 20:13030/qt8tm0r9b9. [PMID: 25526344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 06/04/2023] Open
Abstract
A 68-year-old woman presented for evaluation of a large, red-brown plaque on her left buttock with irregular borders and prominent overlying verrucous changes. The plaque had been present since childhood but over a three-year period had been enlarging with increasing nodularity and easy bleeding with trauma. Histopathologic examination demonstrated an enlarged papillated and polypoid heterogeneous lesion. In part of the specimen, there are bulbous aggregates of small squamous cells with foci of eccrine ductal differentiation. There are other areas with horn pseudocysts, hypergranulosis, and compact orthokeratosis with parakeratosis. There are scattered enlarged heavily pigmented melanocytes, some of which have long and thick dendrites. This collision tumor consisted of an eccrine poroma, a seborrheic keratosis, and a viral wart. The clinical and histopathologic features of collision tumors and poromas are reviewed.
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Forcey DS, Walker SM, Vodstrcil LA, Fairley CK, Bilardi JE, Law M, Hocking JS, Fethers KA, Petersen S, Bellhouse C, Chen MY, Bradshaw CS. Factors associated with participation and attrition in a longitudinal study of bacterial vaginosis in Australian women who have sex with women. PLoS One 2014; 9:e113452. [PMID: 25412421 PMCID: PMC4239064 DOI: 10.1371/journal.pone.0113452] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 10/24/2014] [Indexed: 11/24/2022] Open
Abstract
Objective A number of social and sexual risk factors for bacterial vaginosis (BV) have been described. It is important to understand whether these factors are associated with non-participation or attrition of participants from longitudinal studies in order to examine potential for recruitment or attrition bias. We describe factors associated with participation and attrition in a 24-month prospective cohort study, investigating incident BV among Australian women who have sex with women. Study Design and Setting Participants negative for prevalent BV were offered enrolment in a longitudinal cohort study. Participants self-collected vaginal samples and completed questionnaires 3-monthly to endpoint (BV-positive/BV-negative by 24 months). Factors associated with participation in the cohort study were examined by logistic regression and factors associated with attrition from the cohort were examined by Cox regression. Results The cross-sectional study recruited 457 women. 334 BV-negative women were eligible for the cohort and 298 (89%, 95%CI 85, 92) enrolled. Lower educational levels (aOR 2.72, 95%CI 1.09, 6.83), smoking (aOR 2.44, 95%CI 1.13, 5.27), past BV symptoms (aOR 3.42, 95%CI 1.16, 10.10) and prior genital warts (aOR 2.71, 95%CI 1.14, 6.46) were associated with non-participation; a partner co-enrolling increased participation (aOR 3.73, 95%CI 1.43, 9.70). 248 participants (83%, 95%CI 78, 87) were retained to study endpoint (BV-negative at 24 months or BV-positive at any stage). Attrition was associated being <30 yrs (aHR 2.15, 95%CI 1.13, 4.10) and a male partner at enrolment (aHR 6.12, 95%CI 1.99, 18.82). Conclusion We achieved high participation and retention levels in a prospective cohort study and report factors influencing participation and retention of participants over a 24-month study period, which will assist in the design and implementation of future cohort studies in sexual health and disease.
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Affiliation(s)
- Dana S. Forcey
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- * E-mail: (DSF); (CSB)
| | - Sandra M. Walker
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Lenka A. Vodstrcil
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Christopher K. Fairley
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Jade E. Bilardi
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Matthew Law
- The Kirby Institute, The University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Jane S. Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | | | - Susan Petersen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Clare Bellhouse
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Marcus Y. Chen
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
| | - Catriona S. Bradshaw
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Central Clinical School, Monash University, The Alfred Centre, Melbourne, Victoria, Australia
- * E-mail: (DSF); (CSB)
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Abstract
Lipoid proteinosis (LP) is a very rare, autosomally recessive, inherited disease. It is also known as Urbach Wiethe disease or Hyalinosis cutis et mucosa. LP usually runs a benign, stable, and slowly progressing course. We present one LP case with additional unusual dermatologic involvement; verruca vulgaris was superimposed on papular lesions of LP. To our knowledge, this case is the first and only one described in the literature. In this presentation, we discuss the possibility of predisposition to Human Papilloma Virus (HPV) infections in LP.
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Affiliation(s)
- Ali Haydar Parlak
- Department of Dermatology, Abant Izzet Baysal University, Izzet Baysal Medical Faculty, Turkey
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Acipayam C, Kupeli S, Sezgin G, Acikalin A, Ozkan A, Inan DA, Bayram I, Tanyeli A. Dermatopathic lymphadenitis associated with human papilloma virus infection and verruca vulgaris. J Pediatr Hematol Oncol 2014; 36:e231-3. [PMID: 23669728 DOI: 10.1097/mph.0b013e3182913e44] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Here we present a pediatric case of human papilloma virus associated with dermatopathic lymphadenitis (DL). A 5-year-old boy presented to the pediatric oncology clinic with swelling of the neck and warts on his lower jaw. His blood chemistry and complete blood count were normal, as was chest x-ray. HIV, EBV, CMV, and parvovirus serologies were negative. The patient was investigated for malignancy and lymphoma but no association was found. Histopathologic examination of the lymph node and the lesion revealed DL and verruca vulgaris, respectively. DL represents a benign form of reactive lymph node hyperplasia and described in patients with HIV and EBV infections. It is a rare entity described in patients with human papilloma virus infection. To our knowledge, this is the first report of DL in a patient with human papilloma virus infection.
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Affiliation(s)
- Can Acipayam
- *Division of Pediatric Oncology/BMT Unit †Department of Pathology, Cukurova University Medical School, Adana, Turkey
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Hung CY, Sun PL, Chiang SJ, Jaw FS. In vitro differential diagnosis of clavus and verruca by a predictive model generated from electrical impedance. PLoS One 2014; 9:e93647. [PMID: 24705282 PMCID: PMC3976310 DOI: 10.1371/journal.pone.0093647] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Accepted: 03/08/2014] [Indexed: 11/18/2022] Open
Abstract
Background Similar clinical appearances prevent accurate diagnosis of two common skin diseases, clavus and verruca. In this study, electrical impedance is employed as a novel tool to generate a predictive model for differentiating these two diseases. Materials and Methods We used 29 clavus and 28 verruca lesions. To obtain impedance parameters, a LCR-meter system was applied to measure capacitance (C), resistance (Re), impedance magnitude (Z), and phase angle (θ). These values were combined with lesion thickness (d) to characterize the tissue specimens. The results from clavus and verruca were then fitted to a univariate logistic regression model with the generalized estimating equations (GEE) method. In model generation, log ZSD and θSD were formulated as predictors by fitting a multiple logistic regression model with the same GEE method. The potential nonlinear effects of covariates were detected by fitting generalized additive models (GAM). Moreover, the model was validated by the goodness-of-fit (GOF) assessments. Results Significant mean differences of the index d, Re, Z, and θ are found between clavus and verruca (p<0.001). A final predictive model is established with Z and θ indices. The model fits the observed data quite well. In GOF evaluation, the area under the receiver operating characteristics (ROC) curve is 0.875 (>0.7), the adjusted generalized R2 is 0.512 (>0.3), and the p value of the Hosmer-Lemeshow GOF test is 0.350 (>0.05). Conclusions This technique promises to provide an approved model for differential diagnosis of clavus and verruca. It could provide a rapid, relatively low-cost, safe and non-invasive screening tool in clinic use.
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Affiliation(s)
- Chien-Ya Hung
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Pei-Lun Sun
- Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Shu-Jen Chiang
- Institute of Zoology, National Taiwan University, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
- * E-mail:
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Kim SJ, Byun SW, Lee SS. Various tumors in the nasal vestibule. Int J Clin Exp Pathol 2013; 6:2713-2718. [PMID: 24294358 PMCID: PMC3843252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 10/21/2013] [Indexed: 06/02/2023]
Abstract
Various types of diseases can involve the nasal vestibule. Diagnosis and treatment of a nasal vestibular mass is often challenging due to the anatomical features of the nasal vestibule. Here, we present four cases with nasal vestibular masses. Two cases were diagnosed as squamous papillomas. The others were a trichofolliculoma and pseudoepitheliomatous hyperplasia with hyperkeratosis. Our aim was to discuss the characteristics of each disease and the considerations thought to be necessary for diagnosis and treatment of nasal vestibular tumors from these cases and the related literature.
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Affiliation(s)
- So Jeong Kim
- Department of Otolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine Seoul, Korea
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Mitsuishi T, Ohsawa I, Kato T, Egawa N, Kiyono T. Molecular cloning and characterisation of a novel type of human papillomavirus 160 isolated from a flat wart of an immunocompetent patient. PLoS One 2013; 8:e79592. [PMID: 24282509 PMCID: PMC3835941 DOI: 10.1371/journal.pone.0079592] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/03/2013] [Indexed: 11/25/2022] Open
Abstract
More than 150 types of Human papillomaviruses (HPVs) have been isolated from numerous cutaneous and/or mucosal lesions. Flat wart samples on the face from 36 immunocompetent patients were collected and screened for HPV. From one sample, we cloned a putative novel genotype. The novel type consisted of 7779 bp in length with a GC content of 47.1%, containing open reading frames for putative early proteins (E1, E2, E4, E6, and E7) and two late proteins (L1 and L2). Homology searches and phylogenetic analyses indicated that it belonged to Alphapapillomavirus (Alpha-PV) species 2 and most closely resembled HPV 3. The virus fulfilled the definition of a novel type, and was named HPV 160 by the Reference Center for Papillomaviruses. The putative E7 protein of HPV 160 as well as HPV 29, 77, and 78 contained the Leu-X-Cys-X-Glu pRB-binding motif but other Alpha-PV species 2 (HPV 3, 10, 28, 94, 117, and 125) did not have this conserved motif.
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Affiliation(s)
- Tsuyoshi Mitsuishi
- Department of Dermatology, Tokyo Women’s Medical University Yachiyo Medical Center, Ohwada Shinden, Yachiyo City, Chiba, Japan
- * E-mail: (TK); (TM)
| | - Ikuroh Ohsawa
- Department of Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Toshihiko Kato
- Research Institute of Vaccine Therapy for Tumours and Infectious Diseases, Nippon Medical school, Tokyo, Japan
| | - Nagayasu Egawa
- Division of Virology, National Cancer Center Research Institute, Tokyo, Japan
| | - Tohru Kiyono
- Division of Virology, National Cancer Center Research Institute, Tokyo, Japan
- * E-mail: (TK); (TM)
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Ko CJ, McNiff JM, Iftner A, Iftner T, Choi JN. Vemurafenib (PLX-4032)-induced keratoses: verrucous but not verrucae. J Am Acad Dermatol 2013; 69:e95-6. [PMID: 23866896 DOI: 10.1016/j.jaad.2012.03.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 03/24/2012] [Accepted: 03/27/2012] [Indexed: 11/19/2022]
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Abstract
The epidemiology of human papillomaviruses (HPVs) genotype distribution of cutaneous warts in Jordanian patients were studied. A total of 200 samples were collected using skin swabs from patients with warts attending the dermatology clinic at the Jordan University Hospital over the period of June 2010 to October 2010. Another 100 control samples were taken from healthy Jordanian individuals with no current or previous history of warts. DNA extraction and sequencing was carried out using PCR with the FAP primer pair to detect HPV DNA, followed by multiple-type-specific (Multiplex) PCR combined with DNA sequencing. The prevalence of HPV among Jordanian patients tested with warts diagnosed clinically was 82% (157/192); of these 45% (87/192) were detected by FAP PCR method, and 37% (70/192) were detected by multiplex PCR method. Sequencing of the FAP positive samples shows that HPV 2 was associated with the highest prevalence (36%), followed by HPV 27 (28%) and HPV 57 (21%). A total of 6% of healthy persons were positive for HPV DNA. In conclusion, this study demonstrates that alpha HPV types (HPV 2, HPV 27, and HPV 57) are associated with the most prevalent cutaneous warts in Jordanian patients.
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Affiliation(s)
- Suzan Al Bdour
- Faculty of Medicine, Pathology, Microbiology, and Forensic Medicine, University of Jordan, Amman, Jordan
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Kaçar N, Demirkan N. Plantar wart with parallel ridge pattern in a patient with a previous history of melanoma: a diagnostic challenge. Australas J Dermatol 2013; 54:e78-9. [PMID: 23905982 DOI: 10.1111/ajd.12083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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