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PubMed1987

Treatment of vaginal condylomata acuminata by weekly topical application of 5-fluorouracil.

Twenty nonpregnant women with condylomata acuminata of the vagina were studied to assess the effectiveness of weekly topical 5-fluorouracil application. All patients were instructed to insert an applicator one-third full of 5% 5-fluorouracil cream (approximately 1.5 g) deeply into the vagina at bedtime once each week for ten consecutive weeks. The response to this treatment was evaluated by colposcopy and cytology three and six months after initiation of therapy. Seventeen patients (85%) showed no evidence of the disease when examined three months after treatment. Three women, although improved, had persistent vaginal condylomata, which responded to a second course of 5-fluorouracil given twice each week. After a follow-up of ten to 20 months (mean 15.8 months), 16 patients remained free of disease, two developed recurrence, and two were lost to follow-up. Two women developed mild vulvar irritation and eight had vaginal discharge. It is concluded that weekly topical application of 5% 5-fluorouracil is well tolerated and highly effective in treating vaginal condylomata acuminata.

Administration, Intravaginal↗

PubMed1998

Risk factors for incident and recurrent condylomata acuminata among men. A population-based study.

BACKGROUND AND OBJECTIVES: The rapid increase in the number of physician office visits for condylomata acuminata and the association of human papillomavirus and cancer has prompted renewed interest in the epidemiology of this sexually-transmitted disease. Few epidemiologic studies have examined what risk factors are associated with condylomata acuminata in men. GOAL: To determine what factors may predispose a man to the occurrence of condylomata acuminata. STUDY DESIGN: A population-based case-control study was conducted among male members of a health maintenance organization. Patients were men 18 years or older who were seen for condyloma at one of four primary care clinics of Group Health Cooperative of Puget Sound between April 1, 1987 and September 30, 1991. Control subjects were frequency matched to the patients on clinic site, race, and age. In-person interviews were used to ascertain exposure histories from both patients and control subjects. RESULTS: Recurrent condyloma was reported by about one third of our patients. Patients with multiple partners were strongly associated with developing the disease. Several factors were either more strongly or only associated with recurrent disease. Other behavioral measures, such as recreational drug use, were also related the occurrence of condyloma. CONCLUSION: These results confirm the sexual-transmitted mechanism of condyloma in men. Exposure to multiple partners was associated with elevated risk of both recurrent and incident disease. Other cofactors may be involved in the etiology of condyloma.

Adolescent↗

PubMed1990

Condylomata acuminata of the bladder: a rare cause of intraluminal-filling defects.

Condylomata acuminata is a sexually transmitted disease commonly affecting the mucocutaneous surfaces of the anogenital region. Extension to the bladder is exceedingly rare. We present a case of condylomata acuminata causing intraluminal-filling defects of the bladder in a patient being evaluated for chronic urinary tract infections.

Adult↗

PubMed1989

Podophyllin versus scissor excision in the treatment of perianal condylomata acuminata: a prospective study.

Thirty-seven patients with previously untreated perianal condylomata acuminata were randomly treated by application of 25 per cent podophyllin or scissor excision. The result of treatment was assessed by an independent observer. At 6 weeks, scissor excision completely cleared the warts from 16 of 18 patients (89 per cent) compared with 15 of 19 patients (79 per cent) treated with podophyllin. Following complete clearance by surgery, two patients had recurrent warts at 18 weeks and a further single patient at 42 weeks, giving a cumulative recurrence rate of 19 per cent. In contrast, five of 15 patients whose warts were cleared by podophyllin had recurrent warts at 18 weeks and a further four at 42 weeks representing a cumulative recurrence rate of 60 per cent (X2 = 3.95, d.f. = 1, P = 0.05). At 42 weeks six patients (32 per cent) were free of disease in the podophyllin group compared with 13 (72 per cent) in the scissor excision group (X2 = 4.6, d.f. = 1, P = 0.03). Scissor excision is therefore preferable to podophyllin application in the treatment of perianal condylomata acuminata.

Adult↗

PubMed2002

HIV-1 infection and risk of vulvovaginal and perianal condylomata acuminata and intraepithelial neoplasia: a prospective cohort study.

BACKGROUND: Information about vulvovaginal and perianal condylomata acuminata and intraepithelial neoplasia in women infected with HIV-1 is needed to develop guidelines for clinical care. Our aim was to investigate the incidence of these lesions in HIV-1-positive and HIV-1-negative women and to examine risk factors for disease. METHODS: In a prospective cohort study, 925 women had a gynaecological examination twice yearly-including colposcopy and tests for human papillomavirus DNA in cervicovaginal lavage-for a median follow-up of 3.2 years (IQR 0.98-4.87). FINDINGS: Vulvovaginal and perianal condylomata acuminata or intraepithelial neoplasia were present in 30 (6%) of 481 HIV-1-positive and four (1%) of 437 HIV-1-negative women (p<0.0001) at enrollment. Women without lesions at enrollment were included in an incidence analysis. 33 (9%) of 385 HIV-1-positive and two (1%) of 341 HIV-1-negative women developed vulvovaginal or perianal lesions, resulting in an incidence of 2.6 and 0.16 cases per 100 person-years, respectively (relative risk 16, 95% CI 12.9-20.5; p < 0.0001). Risk factors for incident lesions included HIV-1 infection (p = 0.013), human papillomavirus infection (p=0.0013), lower CD4 T lymphocyte count (p = 0.0395), and history of frequent injection of drugs (p=0.0199). INTERPRETATION: Our results suggest that HIV-1-positive women are at increased risk of development of invasive vulvar carcinoma. Thus, we recommend that, as part of every gynaecological examination, HIV-1-positive women should have a thorough inspection of the vulva and perianal region, and women with abnormalities-except for typical, exophytic condylomata acuminata-should undergo colposcopy and biopsy.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Natural interferon alfa for treatment of condylomata acuminata.

The activity of natural (leukocyte) interferon alfa in the treatment of condylomata acuminata was assessed in a randomized, double-blind, placebo-controlled, multicenter trial. Interferon alfa (Alferon N Injection) or placebo was injected into lesions twice weekly for up to eight weeks. Eighty-six patients were given interferon alfa, and 72 were given placebo. Eighty-six percent of interferon alfa-treated patients and 89% of placebo-treated patients had received previous therapy for condylomata acuminata. Side effects, usually flulike symptoms, occurred briefly after the injections; if present, they disappeared before the end of the third week of therapy. Treatment completely eliminated warts in 62% of interferon alfa-treated patients compared with only 21% of placebo-treated patients. Natural interferon alfa given intralesionally is an effective and safe treatment even in patients with recurrent or recalcitrant genital warts.

Adult↗

PubMed2003

Treatment of large lower genital tract condylomata acuminata with local excision plus topical acetic acid. A preliminary study.

OBJECTIVE: To evaluate recurrence after excision plus a brief topical application of 99% acetic acid for anovulvar condylomata acuminata. STUDY DESIGN: Thirty women having extensive involvement of the lower genital tract with condylomata acuminata were selected for treatment. In all cases treatment was done on an outpatient basis under local anesthesia. On finalizing the excision, topical 99% acetic acid was briefly applied for (3 seconds) to the surgically treated surface, 0.2 mL for each 10 cm2 of anovulvar surface, with a sterile cotton applicator; immediately afterward, the anovulvar surface was washed with sterile water for 1 minute to neutralize the 99% acetic acid. The primary end point was to measure the rate of local recurrence after therapy. RESULTS: Twenty-six of 30 patients (86.6%) had complete resolution of large genital tract condylomata acuminata with 1-3 local excisions plus brief topical application of 99% acetic acid. Four of 30 patients (13.3%) experienced local recurrence after therapy. CONCLUSION: In this preliminary study, local excision plus a brief topical application of 99% acetic acid with rapid neutralization with sterile water under local anesthesia was well tolerated, without serious local complications and with an acceptable rate of recurrence (13.3%).

Acetic Acid↗

PubMed1984

Topical treatment of condylomata acuminata with Solcoderm.

Of 85 patients with condylomata acuminata treated topically with Solcoderm, the lesions were apparently eradicated in all but 11 (12.9%), and recurrences were noted in 6 during a 3-month follow-up. Only 1 treatment was required in 55 (64.7%) of the treated subjects.

Acetates↗

PubMed1994

Typing of human papillomaviruses in condylomata acuminata from Greece.

DNA samples from recurrent condylomata acuminata biopsies of Greek males and females were examined for the presence of human papillomavirus (HPV) DNA using high-stringency Southern blot hybridization analysis. Of the twenty-six biopsies, 25 were positive for the HPV 6/11-related DNA sequences, and when further analyzed with the polymerase chain reaction (PCR) the HPV-negative biopsy was also positive for HPV 6/11 DNA. Nineteen specimens were further characterized based on their Pstl restriction endonuclease hybridization pattern. Twelve biopsies were positive for HPV 6a, one biopsy was positive for HPV 11a, and one biopsy was positive for HPV 6c DNA. Three specimens contained HPV 6/11 related DNA that gave an unusual Pstl pattern, and one specimen appeared to represent a multiple HPV infection containing HPV 6/11- and HPV 31/35/39-related sequences. Finally, one sample contained a mixture of HPV 6a DNA and an HPV 6a-like genome. Biopsies were also taken from adjacent apparently normal tissue, 0.5 cm away from the lesion, in 19 of the patients. Only one of these was found to be positive for HPV 6a DNA by Southern blot analysis.

Adult↗

PubMed2005

[Molecular detection of specific HPV types in Condylomata acuminata].

To detect HPV in genital warts (Condylomata acuminata, CA) for infection rate and association of specific HPV types between males and females, and to provide support for the development of HPV vaccines, we designed HPV type-specific oligonucleotide primers to amplify DNA fragments encoding L1 viral capsule protein. SSP-PCR was conducted in duplication for each CA sample from male and female patients. DNA of TA-cloned HPV was used as positive control, and deionized H2O was used as negative control. A total of 22 clinical samples, 13 from males and 9 from females, was collected from patients diagnosed with CA at hospitals in Beijing and Handan. HPV viral DNA was amplified in all 22 samples analyzed, with 100% detection rate. TA-cloning and sequencing of the PCR products confirmed correct amplification of HPV type-specific fragments. Of the 13 samples from males, 5 were infected with HPV6, 6 with HPV11, and 2 with HPV6 + HPV11. Of the 9 samples from females, 3 were infected with HPV6, 2 with HPV11, and 4 with both HPV6 and HPV11 infection. In addition, high-risk types HPV16, HPV18, HPV33, HPV35, HPV45, HPV54, HPV56 and HPV58 were also detected in 4 female samples that were mixed with cervical cell debris during sample collection. However, no HPV types other than HPV6 and HPV11was detected in all CA-only samples in this study. We have established a sensitive and reliable laboratory procedure for HPV detection and classification. Using the method, we reached 100% detection rate of HPV in the CA samples. Our results confirm that HPV6 and HPV11 are primarily responsible for CA, and there is no specific association of HPV types between warts in males and females.

Capsid Proteins↗

PubMed1991

Condylomata acuminata and risk of cancer: an epidemiological study.

OBJECTIVE: To determine whether patients with condylomata acuminata have an increased risk of developing cancer. DESIGN: Prospective cohort study on patients diagnosed as having condylomata acuminata. The number of malignant tumours in the cohort was compared with national incidences obtained from the Swedish Cancer Registry. SETTING: Dermatology department of the Karolinska Hospital, Stockholm, Sweden. SUBJECTS: 3260 patients (2549 males and 711 females, median (range) age 23 (1-80) years) seen during 1969-84, with a mean follow up of 7.8 years. MAIN OUTCOME MEASURES: Number of malignant tumours observed in the cohort during the study period and expected number from national incidence. RESULTS: There were 27 malignancies in the study group. There was no significant increase genital cancer in females compared with the national incidence. Only one patient had invasive cervical cancer (relative risk = 1.8; 95% confidence interval 0 to 10.1). Seventeen women had cervical carcinoma in situ (1.5; 0.9 to 2.5) compared with an expected number of 11.5; this increase was not significant. For males 22 cancers were observed at all sites (1.6; 1.0 to 2.5). The number of genitourinary cancers observed in males was almost three times higher than expected (2.6; 1.2 to 5.0). CONCLUSION: The results indicate that the risk of developing cervical carcinoma in situ or invasive cervical cancer after a genital human papillomavirus infection is less than previously thought. The implications of increase in the genitourinary malignancies in males are uncertain.

Adult↗

PubMed1998

A randomized phase II study comparing four different interferon therapies in patients with recalcitrant condylomata acuminata.

BACKGROUND: Interferon (IFN) alpha and IFN gamma have synergistic in vitro and in vivo effects and have each been used in the treatment of anogenital condylomata acuminata. STUDY GOALS: To compare the efficacy and safety of regional 3 x 10(6) U IFN alpha (Group A), 3 x 10(6) U IFN gamma (Group B), 1.5 x 10(6) U IFN alpha plus 1.5 x 10(6) U IFN gamma (Group C), and 3 x 10(6) U IFN alpha plus 1.5 x 10(6) U IFN gamma (Group D) in the treatment of recalcitrant anogenital condylomata acuminata. STUDY DESIGN: Six-week courses of regional IFNs were administered in a randomized, double-blind, multicenter study. Response was assessed as change in the total area affected by condylomata. RESULTS: The treatments of Groups A, B, and C were similarly effective (complete response in 13.6%, 18.5%, and 16.0%, respectively). Group D had the lowest rate of complete response (3.8%), but this combination was the most effective when partial and complete responses were combined (73.0%). CONCLUSION: Regional IFN is a moderately effective and safe treatment in patients with recalcitrant anogenital condylomata acuminata. Combinations of IFNs alpha and gamma were not superior to IFN monotherapy.

Condylomata Acuminata↗

PubMed1983

[Perianal condylomata acuminata in a 13-month-old girl].

We report on the occurrence of condylomata acuminata in the perianal region of a 13 months old girl. This observation seems to be remarkable because of the early onset as well as the fact that all other published case-reports of condylomata acuminata of this age group are concerned with boys.

Age Factors↗

PubMed2003

Condylomata acuminata in a boy.

BACKGROUND: Human papillomaviruses, or HPV, are etiologic agents of all types of warts, including those associated with sexual transmission. Although previously rare in children, condylomata acuminata in the mouth have been reported for the past 10 to 15 years, and the possibility of sexual abuse needs to be considered. CASE DESCRIPTION: A 4-year-old boy with poor dental health presented with a wartlike mass on his upper lip, as well as two similar penile lesions. The lesions, cauliflowerlike and pedunculated in appearance, were excised, underwent biopsies and were subtyped via in situ hybridization. All of the lesions tested positive for HPV subtypes 6 and 11, which are the subtypes most often associated with anogenital warts (condylomata acuminata). Although both parents reported having genital warts, the specific mode of transmission to the child was not determined. CLINICAL IMPLICATIONS: Cases of oral condylomata acuminata in children need to be treated as possible instances of sexual abuse, and it is incumbent on the dentist to alert the appropriate community agency for follow-up.

Child Abuse, Sexual↗

PubMed1986

[5-Fluorouracil treatment of condylomata acuminata].

25 patients (2 females, 23 males, 20 to 40-year-old) suffering from condylomata acuminata (19 genital, 2 anal, and 4 genitoanal lesions) were locally treated with salicylic acid containing 5-fluorouracil (Verrumal) once a day. This therapy resulted in complete healing within 12 days on an average. 5 patients showed a relaps after 2 weeks to 5 months and were treated again. The treatment failed in a 40-year-old patient suffering from condylomata acuminata genitalis.

Administration, Topical↗

PubMed1988

Condylomata acuminata of the urinary bladder. Natural history, viral typing, and DNA content.

Three patients with condylomata acuminata of the urinary bladder are reported. Two of the patients were immunosuppressed, and one had longstanding extensive condylomata acuminata of the external genitalia and adjacent areas. All lesions recurred at least once and were difficult to treat. The diagnosis was confirmed by in situ hybridization on archival material with human papillomavirus (HPV) DNA probes under stringent conditions. In two of the patients, probes for HPV types 6 and 11 were positive; HPV 11 only was identified in one patient. Probes for HPV types 16 and 18 and pBR322 vector controls were negative. In one patient with a strong hybridization signal, the lesion was also positive for common papillomavirus antigen. DNA content measured by cytophotometry of Feulgen-stained whole nuclei isolated from lesions in two patients revealed a markedly aneuploid DNA pattern. Whether this is a factor in the behavior of the lesions is not known at this time. Although rare, HPV infection of the urinary bladder may result in widespread condylomatosis and may mimic giant condylomas of Buschke-Löwenstein or even verrucous carcinomas, sometimes necessitating radical treatment. Nevertheless, until there is proof to the contrary, the lesions must be considered benign and should not be confused with squamous cancer of the bladder.

Adult↗

PubMed1998

[Condylomata acuminata in childhood: report of a case].

OBJECTIVE: To report an additional case of condylomata acuminata in a child, review the literature and discuss the medicolegal implications due to the possibility of sexual abuse. METHODS/RESULTS: The diagnosis, treatment and clinical course of the lesions are discussed. Psychological evaluation of the child discarded infection by sexual transmission. CONCLUSION: Condylomata acuminata in children represent a diagnostic difficulty due to the possibility of infection by sexual transmission, although it should be taken into account that non sexual transmission of this sexually transmissible disease is very frequent in childhood.

Child, Preschool↗

PubMed1995

[Use of CO2 laser in the treatment of condylomata acuminata of the anogenital region in pregnant women].

The first results of treatment of condylomata acuminata of anogenital region in 11 pregnant women were presented. The analysis were made in Department of Reproduction, Institute of Gynecology and Obstetrics, Academy of Medicine, Poznań. All patients were treated between 28 and 35 week of pregnancy. After first laser-therapy the healing achieved in 9 women. The second lasertherapy was required in 2 patients. It was done after 3 weeks. Complete destruction of pathological changes was obtained. All women had vaginal delivery and no complications (connected with HPV infection) in their newborns were found. The authors said that CO2-lasertherapy under colposcopic control is a reliable method for treatment of condylomata acuminata in pregnant women.

Adolescent↗