Polymeric Nanoparticles and Chitosan Gel Loading Ketorolac Tromethamine to Alleviate Pain Associated with Condyloma Acuminata during the Pre- and Post-Ablation

This study describes the preparation and evaluation of two formulations, a hydrogel and a nanostructured system, containing ketorolac tromethamine as an anti-inflammatory agent for the local therapy against the inflammatory process derived from the surgical excision of Condyloma acuminata. Both formulations were physicochemically characterized.In vitrorelease profiles show that the nanoparticles release 92%±2.3 of the total ketorolac tromethamine encapsulated, while the chitosan gel releases 18.6%±0.2. Theex vivo permeation and distribution through human skin were also assayed and was observed how the main amount of ketorolac tromethamine is retained in the epidermis. In vivo studies were accomplished to evaluate the anti-inflammatory efficacy in mice which also involved the histological analysis to confirm thein vivoresults. The nanoparticles present a significantly higher anti-inflammatory efficacy than chitosan gel. The tolerability of developedformulations was assessed by monitoring the biomechanical properties of the skin before and after application of both formulations. No statistical differences in trans-epidermal water loss and skin hydration with respect to the basal values were observed and the formulations exhibited higher anti-inflammatory activity compared to a reference ketotorlac tromethamine solution. Therefore, it can be concluded that both formulations can be proposed as outstanding candidates for offering a local anti-inflammatory therapeutical toolwith potential clinical application.

Successful ablation of giant condyloma acuminata in an adolescent

Condyloma acuminata are usually associated with persistent and recurrent infections and early surgical intervention is often required to prevent recurrences. The Buschke–Löwenstein tumor, a locally invasive, slow-growing, cauliflower-like growth, is an example of a giant condyloma acuminatum. Herein, we report a case of sexually-acquired perianal giant condyloma acuminata in a fourteen-year-old male successfully treated by electrofulguration with radiofrequency cautery under general anesthesia in a single session with no evidence of recurrence over a follow-up period of six months.

Expression Pattern of Genes in Condyloma Acuminata Treated with Clinacanthus nutans Lindau Cream versus Podophyllin

Clinacanthus nutans Lindua (C. nutans), a strong antiviral traditional medicine, can be used to treat condyloma acuminata (CA) caused by the human papillomavirus (HPV). However, its molecular mechanism for CA elimination is unknown. Herein, we conducted a randomized clinical trial to evaluate the effectiveness of C. nutans and its molecular mechanism compared with podophyllin, the gold standard treatment. Using a randomized block design, six patients were treated with C. nutans and podophyllin for four weeks. Efficacy of drugs was assessed by size reduction of the warts and HPV viral load quantification using droplet digital PCR. The gene expression profiling of CA was analyzed using NanoString Technology. After the podophyllin and C. nutans treatments, CA lesion sizes were reduced to 97.0% and 84.4% clearance, and the HPV viral loads were reduced by 74.0% and 46.6%, respectively. The gene expression pattern of immune profiling showed that 23 genes (i.e., HLA-DPB, CCL3, CXCL2, CXCR2, and OSM) were significantly differentially expressed by podophyllin, whereas 2 genes (IFNL1 and IRF2) were remarkably expressed by C. nutans. In inflammatory profiling, 108 genes (i.e., CXCL2, IL8, and STAT3) were highly expressed by podophyllin, but none of genes were observed to change expression by C. nutans. These results suggested that podophyllin may reduce the HPV infection through a mechanism related to proinflammatory response. In addition, C. nutans was found to suppress the HPV infection through mechanism related to the activation of immune response. This study shows novel therapeutic mechanisms of podophyllin and C. nutans. It is suggested that C. nutans might be used as an alternative treatment for CA treatment.

Profil Penderita Kondiloma Akuminata Di Poliklinik Kulit Dan Kelamin Rumah Sakit Pertamina Bintang Amin Periode Januari 2016 Sampai Desember 2019

ABSTRACT: PROFILE OF CONDYLOMA AKUMINATA PATIENTS IN THE SKIN AND SEX POLYCLINIC OF PERTAMINA BINTANG AMIN HOSPITAL FOR THE PERIOD OF JANUARY 2016 TO DECEMBER 2019. Introduction: Sexually transmitted infection (STI) is one of the diseases and causes of health, social and economic problems in many countries. According to WHO, more than 1 million sexually transmitted infections are acquired every day in various parts of the world and more than 290 million women have human papillomavirus infection. In America, data from the CDC shows new cases with more than 19.7 million sexually transmitted infections each year, and about 14.1 million cases are human papillomavirus infections. Objective: This study aims to find out information about the profile of condyloma acuminata sufferers at the Dermatology and Venereology Polyclinic at Pertamina Bintang Amin Hospital for the period January 2016 to December 2019.Methods: This study used quantitative descriptive analysis with the aim of knowing the profile of patients with condyloma acuminata. Sampling was done by using the total sampling method. The sample in this study were patients with condyloma acuminata who were treated at the Dermatology and Venereology Polyclinic at Pertamina Bintang Amin Hospital for the period January 2016 to December 2019 totaling 22 patient medical records. Results: It was found that patients with condyloma acuminata were more commonly found in the age group of 26 to 35 years (early adulthood), as many as 9 patients (40.9) in the female sex, namely 17 patients (77.3%) with married status. as many as 17 patients (77.3) while based on the management of patients more were given treatment using electric surgery, namely as many as 8 patients (36.4%).Conclusion: Patients with condyloma acuminata in order to maintain their health condition, and avoid risk factors that can increase the occurrence of condyloma acuminata, it is hoped that health workers can hold health promotion activities about the prevention of sexually transmitted diseases, especially condyloma acuminata and this research can be used as additional information to develop further research regarding the factors that have not been studied in this study Keywords: Condyloma acuminata, sexually transmitted infection, HPV

Giant Condyloma Accuminata in Pregnancy, Use of Trichloroacetic Acid combined with electrocauterization and excision Procedure: A Case Report

Condyloma acuminata is a sexually transmitted disease caused by the Human Papilloma Virus (HPV). During pregnancy, condyloma acuminata can proliferate rapidly due to changes in immunity and increased blood supply. One of the safest therapeutic modalities is trichloroacetic acid (TCA). Electrocautery is another modality in pregnant patients. A 16-year-old woman, 6-months pregnant, complained of a wart-like lump in the pubic area getting more prominent since the last two weeks and covering the vagina surface. The lump is not itchy and painless. From history-taking it was found that patient often changes partners. On physical examination, the lesions were multiple papules with a verrucous surface. The results of the work-up showed a positive acetowhite test. Patients are then treated with a TCA of 80-90% during pregnancy and followed by electrocautery and excision during cesarean section. The results of 80-90% TCA treatment followed by electrocautery and excision were satisfactory, and there were no recurrences when the patient went for a follow-up. TCA is a substance that is caustic and can erode skin and mucous membranes. TCA works by coagulation of proteins which causes dryness of cells and tissues. TCA is safe for pregnant women. Combination of TCA 80-90% with electrocautery and excision, in this case, proved to be effective with no sign of recurrence. The combination of TCA therapy with electrocautery and excision has proven effective and safe for pregnant patients.

Prenatal Attachment pada Kehamilan Remaja dengan Gangguan Penyesuaian dan Retardasi Mental Berat

Prenatal attachment is an abstract and unidirectional bond between parents and the fetus that develops during pregnancy. It is closely associated with how the mother utilizes her abilities and knowledge to organize and perform the duties related to her maternal role attainment. We report a case of 15 years old girl admitted to the emergency room with an official request of visum et repertum in January 2018 due to becoming suspected sexual violence victim. The history of present illness revealed a 15 y.o. girl G1P0A0, singleton, at 34-36W Estimated Gestational Age with condyloma acuminata. During her pregnancy, she described relatively negative feelings about her pregnancy including shame, anxiety, and anger. She felt lack of energy and motivation since she became aware of her pregnancy, therefore spent her most of her time on the bed. Her IQ-test showed a profound intelligence rate followed by a total score of Strength and Difficulty Questionnaire (SDQ) 16, and scored low in Prenatal Attachment Inventory (PAI) at 31. We concluded that PA scoring can be utilized as a predictor of mother-infant bonding quality after birth, thus the instrument will be beneficial as initial screening before choosing appropriate management for vulnerable population mother.