Complications and dosing frequency of 5% imiquimod for genital warts in a young man

A clinical decision report using: Fife KH, Ferenczy A, Douglas JM Jr, et al. Treatment of external genital warts in men using 5% imiquimod cream applied three times a week, once daily, twice daily, or three times a day. Sex Transm Dis. 2001;28(4):226-231. https://doi.org/10.1097/00007435-200104000-00007 for a patient with genital warts and an unstable social support network.

MANAGEMENT OF PERINEAL AND PERIANAL WARTS THROUGH AYURVEDA: A CASE REPORT

Warts are the commonest benign, viral condition found in day to day practice and it is more common in young females. In Ayurveda warts may be compared with Charmakeel. As per Acharya Sushruta Agnikarma has been described as superior para-surgical procedures among all the measures used in Ayurveda, as the disease treated by it usually did not relapse. In present case report 33 years old female patient visited in Outpatient department (OPD) of Shalya Tantra having complaints of numerous growths in perineal and peri-anal region with itching and occasional pain since 6 months. The swelling was gradually increasing in size with local itching and discomfort. So the case was diagnosed as external genital warts and Chedana (excision) of the warts with cautery was planned. Orally two tablets (500mg each) Triphala Guggulu thrice in a day with luke warm water was advised for one month. Daily cleaning with Panchavalakal Kwath and dressing with Thumari Taila was performed till complete healing of the post-operative wound. Within 3 weeks wound was healed completely. Follow-up was done up to 10 months and patient had no any complaints or recurrence of warts. This case demonstrates that warts can be managed through Ayurveda without any complications, no recurrence and cost-effectively.

Effectiveness and Safety of Ablative Er:YAG Laser Treatment of External Genital Warts

Background: The aim of this study is to evaluate effectiveness and safety of the use of ablative Er:YAG laser for removal of external genital warts (EGW), also called condylomata acuminata (CA).Methods: This is a retrospective cohort study performed at Gynecology Clinic Juna in Ljubljana, Slovenia. All patients older than 18 years that were clinically diagnosed with EGW and were treated with ablative Er:YAG laser between January 2012 and December 2017 were included in the study.Results: A total of 133 female patients (mean age 39.6 ± 12.9 years, range: 19–80) with EGW were eligible to be included in this study. EGW have been present from one to seven months, with a mean presence of 2.1 ± 2.0 months. The majority of the warts were on the labia, major some also on the mons pubis. The size of the lesions was 2–8 mm. The majority of patients, who completed therapy (74 patients out of 116; 64 %) received only one treatment and 82 % of the patients (n = 95) showed complete clearance of the lesions, without recurrence observed to date of analysis. Complete clearance was achieved after an average of 1.33 treatment sessions. Recurrence was reported by 21 patients (18 %). Recorded adverse effects of laser treatment were mild and transient.Conclusion: Er:YAG laser removal of EGW is a simple, quick and safe procedure, particularly suitable for large volume EGW or those that are located in anatomical sites difficult to access by other techniques.

An analysis of infections incidence of multiple human papillomavirus (HPV) rising in cervical and genital samples

Background : Human papillomavirus (HPV) is associated with cervical cancer and genital condyloma, which is mainly transmitted through sexual contact.Cervical HPV infection in females and genital HPV infection in males can induce epithelial proliferation on both mucosal and cutaneous surfaces. HPV is divided into high-risk (HR) and low-risk (LR) types according to their oncogenic potential. The HR geneotypes are considered as etiological factors for invasive cervical cancer in females, and the LR geneotypes are correlated with hyperplastic lesions, including external genital warts, condyloma acuminata, and so on. The aim of this study was to investigate the prevalence of HPV infection and geneotype distribution among individuals in Xinjiang Province.Methods A total of 1094 patients the etiology and species with characteristic of cervical and genital warty surface which mainly come from CA in dermatology and STD outpatient service of People's Hospital of Xinjiang Uygur Autonomous Region.Using a method of real-time fluorescence quantitative PCR for the detection of human papilloma virus HPV 23 typing.Results The prevalence of HPV infection was 67.46%, the most common LR-HPV subtypes were HPV-6 (16.27%), HPV-11 (4.57%), HPV-42(1.19%) and HPV-43(1.19%), and HR-HPV subtypes were HPV-16 (1.65%) and HPV-58(0.91%). The prevalence of HPV infection with single subtype and multiple subtypes was 32.91% and 34.55%, respectively. Among the females infected with a single HPV subtype, 26.11% were infected with a HR-HPV subtype. Among the females infected with multiple HPV subtypes, 18.52% were infected with multiple HR-HR HPV subtypes. The prevalence and subtype distribution of HPV infection showedage differences ( P =0.012), and the prevalence peak of HPV infection was observed in females aged 20-29 years (292/404, 72.28%).Conclusion The prevalence of multiple infection was higher than singleinfection, and the prevalence varied significantly with age while had little association with race and gender.

Efficacy of sinecatechins 10% as proactive sequential therapy of external genital warts after laser CO2 ablative therapy: The PACT study (post-ablation immunomodulator treatment of condylomata with sinecatechins): a randomized, masked outcome assessment, multicenter trial

External genital warts (EGW) are the most common viral sexually transmitted infection. Ablative treatments like cryotherapy, curettage, and CO2 laser therapies offer rapid onset of effect, fast clearance, and reduction of virus load. However, these procedures are associated with high recurrence rates (RRs) ranging from 20% to 77% in the short and medium terms and do not provide sustained clearance. After laser therapy removal of EGW, an RR up to 77% has been reported. Topical sinecatechins (TS) 10% is a patient-applied regimen for the treatment of EGW with a low RR (<6.5%) at three months after completion of the therapy in the pivotal trials conducted so far. Sinecatechins can be considered a suitable proactive sequential therapy (PST) after ablative strategies to obtain a low RR. So far, no prospective data are available regarding the efficacy of sinecatechins 10% as PST. We evaluated the efficacy and tolerability of TS 10% ointment applied twice daily in subjects with “difficult to treat” EGW after CO2 laser ablative treatment in a prospective controlled trial. A total of 87 subjects (76 men and 11 women; mean age 42 years) were enrolled in this three-month masked outcome assessment parallel group trial with imbalanced randomization allocation (2:1). One week after a successful CO2 laser treatment, 60 subjects were randomized to TS 10% treatment and 27 subjects to no treatment (control group: ConTRol (CTR); no sequential therapy). All patients had a history of an average of 4.5 previous ablative treatments in the last 12 months due to recurrent EGW. Mean (standard deviation) baseline number of treated lesions was 6.5 (2.7). One subject in the TS arm dropped out due to burning sensation after the application of the product. Therefore, 86 subjects completed the study. After three months, in the TS group, three subjects presented new EGW lesions (RR: 5%) on treated sites. In the CTR group, eight subjects presented new EGW lesions (RR: 29%) on treated sites (p = 0.0024; odds ratio: 0.16; 95% confidence interval: 0.04–0.68). In the TS group, 34 subjects (56%) reported mild to moderate erythema or burning sensation at the application site. In this prospective multicenter trial, the use of TS 10% as PST after ablative treatment with CO2 laser was associated with a lower recurrence rate of new EGW lesions in the short term in comparison with the control group. Comparative larger trials are warranted to evaluate the role of this approach as PST (Trial Registration Number: ISRCTN44037479).