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PubMed1997

Cervical intraepithelial neoplasia, anogenital cancer, and other cancer types in women after hospitalization for condylomata acuminata.

To investigate the possible association between condylomata acuminata and anogenital neoplasia, a cohort of 9552 women recorded as having condylomata acuminata in the Danish Hospital Discharge Register during 1977-1989 was followed through 1991 for the occurrence of cancer and cervical intraepithelial neoplasia grade III (CIN III) by linkage to the Danish Cancer Registry. Eleven cases of vulvar cancer were identified, with 0.3 expected (standardized incidence ratio [SIR], 40.1; 95% confidence interval [CI], 20.0-71.7), and there were increased risks for cervical cancer (SIR, 2.0; 95% CI, 1.3-3.0), anal cancer (SIR, 8.5; 95% CI, 0.9-30.5), and CIN III (SIR, 2.6; 95% CI, 2.3-2.9). Risks were also elevated for non-anogenital cancers, notably lung cancer (SIR, 3.8; 95% CI, 2.2-6.0). Although confounding by smoking and other factors may exist, these results support the view that condylomata acuminata are associated with an increased risk of anogenital neoplasias, particularly vulvar cancer, and emphasize that women hospitalized with these lesions should undergo thorough anal and gynecologic examinations at regular intervals.

Adolescent↗

PubMed1994

"Seborrheic keratoses" that contain human papillomavirus are condylomata acuminata.

Seborrheic keratoses situated in the anogenital region often resemble condylomata acuminata, clinically and histopathologically, yet they are benign neoplasms of unknown cause, in contrast to condylomata acuminata, which are hyperplasias induced by human papillomavirus (HPV). In the past few years, some authors claimed to have demonstrated HPV in some anogenital seborrheic keratoses, but they failed to set forth precise histopathologic criteria for diagnosis of seborrheic keratoses. Standards by which to diagnose condylomata acuminata histopathologically also are wanting in many textbooks of dermatology, general pathology, and dermatopathology. In fact, in some of those books, findings proffered for histopathologic diagnosis of condyloma acuminata are very similar to those for diagnosis of seborrheic keratoses. All of this, as well as our own observations about condylomata acuminata and seborrheic keratoses on genital skin, prompt us to a different conclusion about the matter, namely, lesions said to be seborrheic keratoses replete with HPV are really condylomata acuminata. This essay gives reasons for our conclusion.

Condylomata Acuminata↗

PubMed1983

Intraoral condylomata acuminata. A case report.

Condylomata acuminata occurred intraorally in a 6 year old Nigerian girl. Since she had no skin or genital lesions and no history of sexual contact, the virus was probably acquired from environmental sources. Non-sexual modes of transmission should, therefore, be considered, particularly when the lesions are extragenital.

Child↗

PubMedDate not supplied

Perianal condylomata acuminata.

Anal and perianal condylomata acuminata are warts caused by infection with the human papillomavirus (HPV). The annual incidence of genital warts seems to have increased during the past few decades. Approximately 1.5 million consultations per year take place in the United States with this condition (1). Papillomavirus is a sexually transmitted disease, and is associated with several other venereal infections as well as with intraepithelial neoplasia and invasive squamous carcinoma. Only certain genotypes of HPV are carcinogenic, and can be precisely identified by in situ hybridisation techniques. There are many therapeutic alternatives, possibly reflecting the wide variability in treatment response.

Adult↗

PubMed1986

Interferon therapy for condylomata acuminata.

Current therapy for condylomata acuminata (genital warts) is not consistently effective. Therefore, we conducted a randomized, double-blind trial to compare interferon alpha-2b with placebo in the treatment of this disorder. Our rationale was that interferon has both antiproliferative and antiviral properties. The placebo or interferon (1 X 10(6) IU) was injected directly into one to three warts three times weekly for three weeks. The injections were well tolerated by both groups of patients. The side effects of fever, chills, myalgia, headache, fatigue, and leukopenia occurred more commonly in the interferon group than in the placebo group, but such effects rarely disrupted daily routines. Only 13 of 296 patients (4 percent) discontinued therapy because of side effects (11 in the interferon group and 2 in the placebo group). Twenty-six other patients were excluded from analysis because of a loss to follow-up or other deviations from protocol, thus leaving 257 patients in the final evaluation. At one week after the completion of therapy, interferon had produced a large and significantly greater reduction in mean wart area (a 62.4 percent decrease), as compared with placebo (a 1.2 percent increase in mean area) (P less than 0.001). At the conclusion of the study (13 weeks after the completion of therapy), the mean wart area was still decreased 39.9 percent below the initial size in the interferon group, whereas it had increased by 46 percent over base-line measurements in the placebo group (P less than 0.001). At the same time, all treated warts had completely cleared in 36 percent of the interferon recipients and in 17 percent of the placebo recipients (P less than 0.001), whereas treated warts progressed in 13 percent of the interferon recipients and in 50 percent of the placebo recipients (P less than 0.001). We conclude that injection of interferon alpha-2b directly into genital warts appears to be an effective and fairly well-tolerated form of therapy.

Adolescent↗

PubMed1997

Recombinant human interferon-beta in the treatment of condylomata acuminata.

The number of clinic consultations for condylomata acuminata (genital warts) has increased substantially during the last 30 years. Most infections produce benign lesions but a few types may be associated with cervical and penile cancers. Interferons (IFN) have shown antiviral properties to these infections and IFN-beta in particular has demonstrated a specific cytopathic effect in humans. A total of 124 patients with condylomata acuminata, the majority of whom had failed previous therapy, were treated intralesionally with either recombinant human interferon-beta la (r-hIFN-beta-1a) or placebo. Up to 6 lesions were treated in each patient, and injections were made 3 times per week for a total of 9 injections. The patients were then followed up for 3 months. Efficacy assessments at all time points (day 19, week 6 and month 3) showed a clear advantage for the r-hIFN-beta-1a interferon-beta treatment. Patients receiving r-hIFN-beta-1a showed a greater proportion of treatment success in terms of the complete or partial reduction (at least 50%) of the total area of the treated lesions. The treatment was also well tolerated. Headache, flu-like symptoms and asthenia were more common in patients receiving r-hIFN-beta-1a, but these adverse events were generally mild in severity and rarely led to patient withdrawal. It was concluded that r-hIFN-beta-1a has good efficacy in condylomata acuminata, and therefore presents a useful therapeutic alternative in this hard-to-treat condition.

Adult↗

PubMed1992

Rearrangements of the upstream regulatory region of human papillomavirus type 6 can be found in both Buschke-Löwenstein tumours and in condylomata acuminata.

Clinically malignant Buschke-Löwenstein tumours and benign condylomata acuminata are caused by human papillomaviruses (HPVs), predominantly HPV-6 and -11. In some cases, the HPV-6 genomes found in Buschke-Löwenstein tumours and in verrucous carcinomas differ from HPV-6b isolated from a benign genital wart, by rearrangements of the upstream regulatory region (URR). To evaluate the frequency and role of mutations of the URR of HPV-6 we analysed 42 condylomata acuminata and four Buschke-Löwenstein tumours by the polymerase chain reaction and restriction enzyme cleavage. Using only four different restriction enzymes we could demonstrate four distinct restriction patterns, indicating that naturally occurring HPV-6 isolates display a high degree of DNA polymorphism within the URR. One Buschke-Löwenstein tumour and two condylomata acuminata yielded rearranged URRs with DNA duplications. All three lesions harboured multiple HPV-6 variants, suggesting that cellular or environmental factors facilitate the development of rearrangements. Therefore, rearrangements of the URR may represent only secondary events in condylomata acuminata and Buschke-Löwenstein tumours which do not necessarily confer a higher malignant potential to the infected cell.

Base Sequence↗

PubMed1993

Analysis of human papillomavirus types in exophytic condylomata acuminata by hybrid capture and Southern blot techniques.

Exophytic condylomata acuminata of the external genitalia of 40 patients were analyzed for human papillomavirus (HPV) DNA by the Southern blot and hybrid capture methods. All lesions were initially analyzed by the Southern blot method by using a mixture of HPV type 6, 11, 16, and 18 whole genomic probes. Southern blots demonstrated characteristic PstI restriction patterns of HPV type 6, 11, or 16 in all but one lesion. HPV 6 subtypes accounted for 28 of 39 HPV-positive lesions. Twenty-seven of these 28 lesions contained HPV type 6a, and 1 lesion contained HPV type 6c. Eight lesions contained HPV type 11 and three contained HPV type 16. Two of the three condylomata acuminata containing HPV type 16 were obtained from solid-organ transplant recipients receiving immunosuppressive medications. The third lesion containing HPV type 16 was a typical exophytic condyloma acuminatum from a woman with previously resected vulvar carcinoma. The hybrid capture assay detected HPV DNAs in all lesions except the Southern blot-negative lesion. Twenty-five lesions were positive for the A probe only (HPV types 6 and 11 and related types). All of these lesions were found to contain HPV type 6 or 11 sequences in the Southern blot assay. The remaining 14 lesions were positive for both the A probe and the B probe (HPV types 16 and 18 and related types). The strongest signal in these 14 lesions by the hybrid capture assay was consistent with the result of the Southern blot assay in all but one case. We conclude that (i) HPV type 6a is the most common type found in these lesions, (ii) HPV type 16 may be present more often in exophytic condylomata acuminata from immunosuppressed individuals, (iii) hybrid capture is a useful tool for documenting the presence of HPV sequences in DNAs from exophytic condylomata acuminata, and (iv) in samples containing multiple HPV types, hybrid capture allows detection of minority HPV types.

Blotting, Southern↗

PubMed1994

[Study of histopathological and ultrastructural differences between condylomata acuminata and pseudocondyloma of vulvae].

Histopathological alterations of condylomata acuminata were characterized by hyperkeratosis, parakeratosis, acanthosis, elongation of the rete ridges, pseudoepitheliomatous hyperplasia, discrete or grouped koilocytes, proliferation and dilatation of dermal capillaries, lymphocytic and histocytic infiltration around dermal capillaries. Histopathological pattern of pseudocondyloma of vulvae were characterized by finger-shaped configuration, epithelium was similar to normal of mucous membrane without atypia. The lesion was composed of a rich vascular network surrounded by connective tissue and a mild lymphocytic infiltration. Ultrastructural alterations of condylomata acuminata were characterized by proliferation of basal cells, enlarged and swollen nuclei in all layers, 1-4 large nucleoli, 1-3 nuclear bodies, interchromatin granules and perichromatin granules in some proliferating nuclei, swollen mitochondria, dilated endoplasmic reticulum, and dissolved glycogen. Ultrastructural alterations of pseudocondyloma of vulvae were characterized by proliferation of mucomembranous epithelial cells, mild swollen nuclei, 1-2 nucleoli, no nuclear body interchromatin and perichromatin granule, the dilatation of interstitial capillaries, and abundant fibril bundles in the dermis. Thus, the histopathological and ultrastructural manifestations of condylomata acuminata and pseudocondyloma of vulvae were significantly different. It may be of help in differentiation between the two disease.

Adolescent↗

PubMed1989

[Condylomata acuminata of the external genitalia and dysplasia of the uterine cervix].

Condylomata acuminata of the external genitalia and dysplasias of the uterine cervix The prevalence of cervical abnormalities indicative of papillomavirus infection and/or dysplasia was evaluated in a group of women previously treated for vulvar condylomata acuminata. The results obtained seem to demonstrate that the women affected by vulvar condylomata acuminata are particularly exposed to the risk of acquiring slight or moderate grade dysplasias. However, the lack of severe dysplasias in our patients tends to suggest that cervical dysplasias associated to vulvar condylomata acuminata are characterized by a poor inclination towards neoplastic evolution.

Adult↗

PubMed1996

[Differentiation of condylomata acuminata from pseudocondyloma by using multiple primer pairs polymerase chain reaction].

Condylomata acuminata were differentiated from pseudocondyloma by using multiple primer pairs polymerase chain reaction (PCR) technique. The paraffin-embedded tissues of 95 cases of condylomata acuminata and 33 cases of pseudocondyloma were detected for HPV DNA. Results show that HPV 6/11 DNA are found in 86/95 (90.5%) cases of condylomata acuminata, and no HPV DNA is detected in 33 cases of pseudocondyloma. The results suggest that pseudocondyloma is not associated with HPV. Multiple primer pairs PCR technique is a preferable method for differentiating condylomata acuminata from pseudocondyloma.

Adolescent↗

PubMed1992

[Cryosurgery of condylomata acuminata gigantea--a contribution to therapy].

Two cases of condylomata acuminata gigantea treated with cryosurgery are described. A clinical and histologic differentiation from Buschke-Loewenstein's tumours, sex-specific differences, possible malignant transformations and differential diagnostic diseases are described and references are made to confusions with condyloma-like, primary carcinomas. Compared to conservative surgical treatment of condylomata acuminata gigantea, cryosurgery offers the advantage of rapid necrosis of the condylomata which are repelled without any further surgical intervention and heal without scars. Therefore we consider cryosurgery a more refined technique in treatment of condylomata acuminata gigantea. In extensive involvement, however, cryosurgical measures must be repeated.

Adult↗

PubMed1985

[Cryotherapy of giant condylomata acuminata--a contribution to therapy (photographic report)].

Three cases of condylomata acuminata gigantea were treated with cryosurgery. Compared to conservative surgical treatment of condylomata acuminata gigantea, cryosurgery offers the advantage of rapid necrosis of the condylomata which are repelled without any further surgical intervention and heal without scars. Therefore we consider cryosurgery the more refined technique in treatment of condylomata acuminata gigantea. In extensive involvement, however, cryosurgical measures must be repeated.

Adolescent↗

PubMed1985

A comparative immunoperoxidase and histopathologic study of condylomata acuminata.

Thirty-seven lesions from 29 patients with condylomata acuminata were comparatively studied by peroxidase-antiperoxidase (PAP) technique and routine histopathology. PAP staining demonstrated papillomavirus common antigen (PCA) mostly in the granular layer of the epidermis in 22 of 37 lesions (59%) of condylomata acuminata. Presence of PCA is closely correlated with the following histopathologic findings: 1) coarse keratohyalin granules; 2) perinuclear vacuolization or koilocytotic cells in the granular layer; 3) hyperkeratosis with focal parakeratosis. From these findings it is concluded that these histopathologic findings suggest the presence of PCA, and that the presence of papillomavirus may play a role in the formation of these histopathologic features of condylomata acuminata.

Antigens, Neoplasm↗

PubMed1987

Identification of human papillomavirus types in male urethral condylomata acuminata by in situ hybridization.

An in situ hybridization technique was applied under stringent conditions to paraffin sections of urethral condylomata from male patients to determine the presence of DNA sequences of human papillomavirus (HPV) types 6, 11, 16, and 18. The material consisted of 15 classical condylomata acuminata, two flat condylomata, and five recurrent lesions. HPV DNA sequences could be identified in all 15 condylomata acuminata; in 13 lesions, two types of viral DNA were observed (types 6 and 11 in 12, types 6 and 18 in one). In the remaining two condylomata acuminata, only HPV type 11 was present. One of the two flat condylomata was negative with all the probes, and one was borderline-positive for HPV 6. Four of five recurrent lesions contained the same types of viral DNA as the primary lesions, albeit with slight differences in the intensity of viral expression. One lesion was negative with all probes. We conclude that urethral condylomata in males contain the same types of HPV as seen in other anogenital lesions of both sexes and that infection with two viral types is common. In situ hybridization with HPV DNA probes is applicable to archival material and therefore may prove to be of value in future epidemiologic studies comparing lesions in sexual partners. The determination of viral type may have therapeutic implications.

Adolescent↗

PubMed1990

[Clomiphene citrate ointment in the local treatment of condylomata acuminata].

The hypothesis underlying local treatment of Condylomata acuminata with clomiphene citrate is based on the assumption that susceptibility to this disease in women depends on the relative amount of oestrogen receptors in the affected, as opposed to the unaffected areas. We postulate blockade of these skin receptors after local application of clomiphene citrate ointment. A pilot study was conducted in 15 patients aged 20-33 with Condylomata acuminata. After only 2 months a complete remission was recorded in 12 patients (= 80%).

Administration, Topical↗

PubMed1989

Dinitrochlorobenzene treatment of condylomata acuminata.

Fifteen patients with treatment-resistant condylomata acuminata have been treated by application of Dinitrochlorobenzene (DNCB). The agent was applied weekly as a 0.5 or 1% solution in acetone for a period of 6 to 8 weeks. Patients were sensitised 15 days before the onset of treatment by applying a 2% DNCB solution on the right arm in a quantity of 0.15 ml. In one patient treatment had to be stopped because of local irritation and one discontinued treatment. In the other 13 patients all lesions cleared completely. Patients were followed up for a year and no recurrence has appeared as yet. DNCB seems to be useful agent for treatment-resistant condylomata acuminata and justifies further clinical trials.

Adult↗

PubMed1984

CO2-laser treatment of condylomata acuminata.

Fifty-two consecutive patients with condylomata acuminata were treated with CO2-laser under general anesthesia. In many of the cases, previous conventional treatment had failed. The effectiveness of the treatment was found to be between 75 and 87%. It caused few complication or complains. Eighty-three percent of the patients expressed satisfaction with the treatment. Laser treatment of condylomata acuminata is an alternative to conventional treatment in tractable cases and in cases where conventional methods are contra-indicated.

Adolescent↗