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PubMedDate not supplied

Podophyllotoxin in serum: absorption subsequent to three-day repeated applications of a 0.5% ethanolic preparation on condylomata acuminata.

High-performance liquid chromatography was used for quantitative determination of podophyllotoxin in serum subsequent to repeated applications of a 0.5% ethanolic preparation on condylomata acuminata. The drug was not detectable in the serum of ten men treated with < or = 50 microliters. In serum of seven patients receiving 100-1,500 microliters on extraordinarily large en-plaque lesions, peak levels of 1-17 ng/ml were measured within 1-2 hr. The drug did not accumulate in serum. Dispersion of 100 microliters gave rise to peak levels of < or = 5.0 ng/ml and to subsequent levels of < or = 3.0 ng/ml for 4 hr. Larger doses gave rise to traceable amounts in serum for < or = 12 hr. Investigations with 52 patients indicated that volumes of > 100 microliters are rarely required for topical treatment of condylomata. It is concluded that application of volumes of < or = 250 microliters twice daily for three days would satisfy the most stringent safety precautions and avoid any danger of systemic toxicity. Potential hazards associated with use of the nonstandardized 20% podophyllin preparations are emphasized.

Absorption↗

PubMed1984

Perianal condylomata acuminata in a male child.

A one year old male child presented with a perianal growth of two months' duration. Clinical and histopathological findings confirmed the diagnosis of condylomata acuminata, which regressed completely following topical treatment with podophyllin.

Anus Neoplasms↗

PubMed1985

Increased risk of cervical neoplasia in consorts of men with penile condylomata acuminata.

19 (76%) of 25 women who had been the sole sexual consorts, for at least 1 year, of men with pre-existing penile condylomata acuminata had similar lesions of the lower genital tract. 9 (36%) of the women had an abnormal cervix as judged by cytology, colposcopy, and histology, and 7 (77%) of these 9 had associated human papillomavirus (HPV) infection detected by DNA/DNA hybridisation. None of 20 women in an age-matched control group had cytological or colposcopic evidence of cervical epithelial atypia. It is suggested that penile HPV infection in a male partner places a woman at risk of cervical neoplasia.

Adult↗

PubMed1993

[Monstrous Buschke-Loewenstein tumor (condylomata acuminata gigantea) with transition to invasive squamous epithelial cancer].

The case of a 34-year-old female is reported, who has suffered from recurring condylomata acuminata of the anogenital region since she was 16. In the further course of the disease multiple Buschke-Loewenstein tumors developed, and finally an invasively growing, highly differentiated, keratinizing squamous cell carcinoma. The course of the disease was complicated by severe septicemia. In the framework of multimodal therapy, laser resection was the preferred method of surgical intervention. A systemic or local interferon treatment has only a prophylactic character in this stage of the disease.

Adult↗

PubMed1988

Simultaneously occurring condylomata acuminata, carcinoma in situ and verrucous carcinoma of the vulva and carcinoma in situ of the cervix in a young woman. A case report.

A case of simultaneously occurring condylomata acuminata, carcinoma in situ and verrucous carcinoma of the vulva and carcinoma in situ of the cervix was seen in a 26-year-old woman. In situ DNA hybridization on sections of the condyloma acuminata and verrucous carcinoma yielded DNA sequences for human papillomavirus 6.

Adult↗

PubMed1987

Genital condylomata acuminata in pregnancy: effectiveness, safety and pregnancy outcome following cryotherapy.

Fifty-one patients, 16 in the second trimester and 35 in the third, were treated by cryotherapy for genital condylomata acuminata; 19 of them had cervical cryotherapy in the second and third trimesters for cervical involvement. Cryosurgical treatment was performed on an out-patient basis, with no general anaesthesia or analgesia, and repeated every 2 weeks until resolution of the condylomata. Male partners were treated as necessary. Patients were followed every 2 weeks before and after delivery until 6 weeks postpartum. The newborn infants were examined for the presence of genital or laryngeal condylomata. Most women required two cryosurgical treatment sessions before complete resolution of condylomata; all resolved in pregnancy and no patient had residual disease at 6 weeks postpartum. There was no case of preterm premature rupture of membranes or premature delivery following cryotherapy, and no case of fetal injury. Labour and delivery were unaffected even by cervical cryotherapy.

Adult↗

PubMed2006

Treatment of condylomata acuminata with pegylated interferon alfa-2b in HIV-infected patients.

BACKGROUND: Interferon in a variety of topical, interlesional, and parenteral preparations has been used for condylomata acuminata (CA) in HIV negative patients. - STUDY GOALS: This open trial was initiated to determine the safety and efficacy of a new formulation of interferon, pegylated interferon-alpha2b (PEG-IFN, PegIntron in the treatment of recalcitrant CA in patients with HIV infection. - STUDY DESIGN: 22 HIV-1 infected patients in virologic steady state with clinically demonstrable anogenital CA were enrolled in this study (treatment group, n=12; control group, n=10). Patients in the treatment group received 80 microg PEG-IFN s.c. once a week for 24 weeks. Follow-up period was 6 month. The effects were assessed by a clinical scoring system (complete response; major response; minor response; stable disease; progression of disease). - RESULTS: 2 patients did not finish the study because of side effects. PEG-IFN was well accepted and completed by ten patients. Four patients revealed complete response, four patients had major response and two had minor response after PEG-IFN. In the control group, all patients showed progression of CA during the 24 weeks of this study (p < 0.001). 7/10 patients of the treatment group and 8/10 patients of the control received HAART. - While the differences of CD4 cell counts between treatment group and control group were not significant (increase of the mean CD4 cell count in the treatment group was 31.5 (75.33 without patient 1 with leucopenia under ribavirine), in the control group 69.75 CD4 cells), the HIV RNA decline in the PEG-IFN group was impressive (0.74 log subset10). Biological side effects of PEG-IFN treatment included flu-like symptoms, fatigue, local reaction, leucopenia, and increase of AST. This result makes an educated guess that PEG-IFN enhances the benefit of HAART. - CONCLUSION: PEG-IFN is an effective and safe therapy option in HIV infected individuals with CA with concomitant positive effects on the suppression of HIV-1 replication and CD4 cell count. It might be considered as an alternative in patients that have failed to standard therapies of CA and - at the same time -could improve the benefit of HAART to a great extent. This last hypothesis needs further research.

Adult↗

PubMedDate not supplied

Severe anal condylomata acuminata following high-dose chemotherapy and autologous hematopoietic stem cell transplantation: a case report.

We report the case of a 37 years old male patient who developed severe anal condylomata acuminata after high-dose chemotherapy and autologous hematopoietic stem cell transplantation for follicular non-Hodgkin's lymphoma. Anal warts were particularly disabling, refractory to the treatment and finally imposed diversion colostomy. The role of cellular immunodeficiency observed after high-dose chemotherapy and autologous hematopoietic stem cell transplantation as etiology of anal condylomata is discussed.

Adult↗

PubMed1992

Children with condylomata acuminata.

BACKGROUND: The modes of transmission of genital human papillomavirus (HPV) infection in children are controversial. Studies have varied in reporting suspicion of sexual abuse in children with condylomata acuminata from zero to 90.9%. Possible modes of transmission include sexual, from mother to infant in utero, passage through an infected birth canal, infection of a nongenital type virus to the genital area, and nonsexual acquisition from a fomite. METHODS: Seven children, ranging in age from 2 to 12 years, who had genital HPV infections were assessed for sexual abuse. An interview with each child was conducted and an examination with a colposcope of the external genitalia was performed. A shave biopsy of a representative genital lesion was obtained. The tissue was sent for HPV typing. RESULTS: Six of the children had perianal warts; the seventh had a labial lesion. Five of the children (71%) had been sexually abused as determined by the history, physical examination, or an investigation by Child Protective Services. Five had HPV type 6 or 11, one had HPV type 16 or 18, and one had a novel HPV type. CONCLUSIONS: Genital types of HPV (6 or 11, 16 or 18, and others) should alert the family physician to proceed with a careful assessment for sexual abuse. This study supports the findings of other reports that genital HPV infection can be the result of sexual abuse and points out the usefulness of HPV typing.

Anus Neoplasms↗

PubMed1997

[Anogenital condylomata acuminata, mucocutaneous candidiasis, vitiligo, keratopathy and primary hypoparathyroidism in an autoimmune polyglandular syndrome type 1].

HISTORY: 6 months before admission a 21-year-old woman had developed anogenital condylomata acuminata (CA). Since early childhood she had been treated for primary hypoparathyroidism (PHPT) and recurrent mucocutaneous candidiasis. 5 years before admission corneal clouding had caused visual impairment. Recently, mainly truncal vitiligo with occipital poliosis had developed. INVESTIGATIONS: PHPT was confirmed (parathormone level 7.7 mg/l). In addition, liver transaminases were raised (GOT 105.8 U/l, GPT 145.6 U/l, gamma-GT 56.8 U/l), pointing to noninfectious hepatitis. An ACTH stress test could not exclude manifest adrenocortical insufficiency, and thyroid function was also normal. The Merieux Multitest indicated an anergy. DIAGNOSIS, TREATMENT AND COURSE: The constellation of test results suggested autoimmune polyglandular syndrome type I. The condylomata were treated by electrocautery and the intestinal candidiasis with amphotericin B suspension. Calcitriol capsules, 0.5 microgram, and calcium gluconate or lactate, 500 and 300 mg respectively, 3 times daily each, were given for the PHPT. CONCLUSION: This case demonstrates a complex syndrome which can be recognized early by simple clinical tests. Early diagnosis prevents possible life-threatening complications.

Adult↗

PubMed1991

Detection of human papillomaviruses in paraffin-embedded condylomata acuminata--comparison of immunohistochemistry, in situ hybridization, and polymerase chain reaction.

The polymerase chain reaction (PCR) is used for detection of human papillomavirus (HPV) DNA in paraffin-embedded tissue sections of condylomata acuminata. Incorporation of biotinylated nucleotides during the amplification process allows a highly sensitive, fast, and non-isotopic detection of viral DNA in a subsequent Southern dot blot. In 100% (13 of 13) of histologically confirmed condylomata, HPV-6 or -11 could be detected by polymerase chain reaction. By in situ hybridization 77% (10 of 13) and by immunohistochemistry (IHC) 69% (nine of 13) positive results were obtained. Because HPV genital infection is linked to penile and cervical dysplasia, polymerase chain reaction provides a powerful and highly sensitive tool for epidemiologic studies on sexual transmission of HPV.

Adult↗

PubMed1995

Detection with the polymerase chain reaction of human papillomavirus DNA in condylomata acuminata treated with CO2 laser and microwave.

BACKGROUND: The recurrence rates of condyloma acuminata are high. The reasons for the relatively high relapse rates with different treatments are unknown. METHODS: Twelve specimens of condylomata acuminata of the vulva were excised from 12 patients and divided into three parts. One part was untreated, the second and the third parts were treated with CO2 laser and microwave, respectively. DNA was then extracted from tissue by proteolytic digestion and amplified by the polymerase chain reaction. Dot blots were performed with the use of radiolabeled consensus and human papilloma virus (HPV) type-specific probes. RESULTS: HPV DNA was amplified in 100% of untreated specimens (6-HPV 6; 6-HPV 11), and in 83.3% and 50% of specimens treated with CO2 laser and microwave, respectively. There was a significant difference in detection between untreated and microwave-treated specimens (chi 2 = 4.18, P < 0.05). CONCLUSION: Microwave damages HPV DNA more effectively than CO2 laser.

Carbon Dioxide↗

PubMedDate not supplied

Morphological transformation in vivo of human uterine cervix with papillomavirus from condylomata acuminata.

Carcinoma of the human uterine cervix has been associated with several infectious agents including papillomavirus. Papillomavirus group-specific antigen (GSA) and viral particles have been demonstrated in human condylomata acuminata (CA) and flat warts of the uterine cervix. Cell alterations consisting of nuclear enlargement, hyperchromasia, irregularity, binucleation and cytoplasmic clearing (koilocytosis) are often interpreted as mild to moderate dysplasia. Present evidence that human papillomavirus (HPV) is responsible for the development of these lesions relies on the association of GSA and virus particles in the affected tissue, fulfilling the first two of Koch's postulates. Direct proof of an aetiological relationship, however, requires induction of the CA change in normal, human uterine cervix after exposure to papillomavirus. Infecting human subjects with HPV is ethically unacceptable and no satisfactory alternative systems have been defined. Also, human cell cultures do not support growth or transformation by HPV. Here we report the first demonstration of the morphological transformation of human tissues with a human papillomavirus under controlled, experimental conditions. 'Transformation' is used here in its literal sense to refer to a heritable morphological alteration in the appearance of the cells. The use of this term does not indicate that the changes described are neoplastic, but they are identical to the dysplastic changes found in biopsies of uterine cervical CA. Our results demonstrate the direct involvement of CA virus in dysplastic change of human cervical tissue and indicate that the experimental system described may be useful in elucidating the contribution of human papillomaviruses to the pathogenesis of human cervical cancer.

Cell Transformation, Neoplastic↗

PubMed1978

Topical treatment of penile condylomata acuminata with podophyllin, podophyllotoxin and colchicine. A comparative study.

The effect of alcoholic solutions with 20% podophyllin from Podophyllum peltatum and Podophyllum emodi, 8% podophyllotoxin, and 8% colchicine, when applied to penile condylomata acuminata in 227 men, were statistically alike. Of the patients initially judged to be cured after 1-2 applications, 13% showed recurrence, thus bringing down the permanent cure frequency to only 43%. Local side effects were absent after only half the series of colchicine applications, whereas as much as about 3/4 of the treatment course with podophyllin and pure podophyllotoxin could be completed without provoking discomfort. Warts in the urinary meatus healed significantly less well than warts on the other genital mucous membranes. Eighty-nine per cent of patients who had previously been cured of concylomata became wart-free after 1-2 treatments, as opposed to only 40% of those who had never had this wart type previously. The use of the commercially available colchicine offers an opportunity to establish a standardized therapy; following application of an 8% solution, rinsing off should be performed after 6-8 hours.

Administration, Topical↗

PubMed1994

Molluscum contagiosum mimicking sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata in HIV-infected patients.

We report on three HIV-infected homosexual male patients with atypical manifestations of mollusca contagiosa (MC). Their clinical presentation mimicked sebaceous nevus of Jadassohn, ecthyma and giant condylomata acuminata. HIV-infected patients feature MC with atypical morphology in about two thirds of the cases. The atypical aspects of MC concern the localization, morphology, growth pattern and size of the lesions. MC is a late manifestation of HIV infection and mirrors marked cellular immune deficiency. We conclude that in HIV-infected patients all tumorous lesions should be biopsied because the clinical characteristics are often not specific enough for a definite diagnosis.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Clinical study with recombinant interferon gamma versus interferon alpha-2c in patients with condylomata acuminata.

A multi-centre, randomized, open-label trial was conducted to evaluate the safety and efficacy of recombinant interferon (rIFN) alpha-2c versus rIFN gamma in patients with recurrent or persistent condylomata acuminata (CA). Thirty-three such patients were treated either with 6 micrograms rIFN alpha-2c or with 0.1 mg rIFN gamma (both equivalent to 2 x 10E6 IU), single dose, subcutaneously 3 times a week for 6 weeks. In case of no complete clearance at week 10, a second course of treatment with the other type of rIFN was given. There was no significant difference in the complete clearance proportions at week 10 between the two treatment groups (3/16 vs 6/17). No relapses occurred in these patients during the 16 weeks' follow-up. Further clearances during the follow-up resulted in a total complete clearance proportion of 14/33 at the end of study. The treatment was well tolerated. Repeated interferon therapy has its place in treating persistent or recurrent condylomas.

Adolescent↗

PubMed1998

A randomized, controlled, molecular study of condylomata acuminata clearance during treatment with imiquimod.

Imiquimod, an immune response modifier, has been demonstrated to be safe and effective in the treatment of external genital and perianal warts caused by human papillomavirus (HPV). To identify the molecular mechanism(s) by which condylomata acuminata clear during topical treatment with imiquimod, wart skin biopsies were taken from patients before treatment, at treatment week 6, and at the end of treatment. Tissues were analyzed for HPV DNA and for mRNA of several cytokines and HPV gene products. Wart clearance was associated with evidence of tissue production of interferon-alpha, -beta, and -gamma and tumor necrosis factor-alpha. Regression of warts was strongly associated with a decrease in HPV DNA and in mRNA expression for both early and late viral proteins. Thus, topical imiquimod treatment of anogenital warts led to significant increases in local production of multiple interferon mRNAs and a significant reduction in virus load as measured by decreases in HPV DNA and mRNA for early HPV proteins.

Administration, Topical↗

PubMedDate not supplied

Expression of metallopanstimulin in condylomata acuminata of the female anogenital region induced by papilloma virus.

We have identified by cDNA cloning a gene, denoted MPS-1, that is activated in cultured human transformed cells by growth factors. The MPS-1 gene contains one zinc finger domain similar to those present in the C4 family of DNA binding proteins. In this study, the expression of MPS-1 mRNA and protein were examined in HPV-induced human condylomata acuminata. Initially, we detected the presence of MPS-1 mRNA by message amplification phenotyping in all condylomata tissues examined. Subsequently, the cellular distribution and abundance of MPS-1 mRNA was studied by in situ hybridization with specific MPS-1 DNA and RNA probes. We found that MPS-1 mRNA is expressed at high levels in the cytoplasm of condylomata cells. In contrast, the MPS-1 mRNA is expressed at low levels in nonneoplastic tissues. Moreover, antibodies were raised against the predicted N-terminal sequence of the MPS-1 protein and used to detect MPS-1 in condylomata cells. MPS-1 immunoreactivity was detected in the cytoplasm and/or the perinuclear regions of condylomata cells, with marked staining in areas of active proliferation. In distinction, MPS-1 immunoreactivity was very weak in normal epithelial cells. The results support the contention that the MPS-1 protein may be a potentially important mediator of proliferative responses induced by HPV.

Adult↗