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At least 19 recordsLinked to original sources

PubMed2001

Local treatments for cutaneous warts.

BACKGROUND: Viral warts caused by the human papilloma virus represent one of the most common diseases of the skin. Any area of skin can be affected although the hands and feet are by far the commonest sites. A very wide range of local treatments are available. OBJECTIVES: To assess the effects of different local treatments for cutaneous, non-genital warts in healthy people. SEARCH STRATEGY: We searched the Cochrane Controlled Trials Register (March 1999), the Skin Group trials register (March 1999), MEDLINE (1966 to August 2000), EMBASE (1980 to August 2000) and a number of other key biomedical and health economics databases. In addition the cited references of all trials identified and key review articles were searched. Pharmaceutical companies involved in local treatments for warts and experts in the field were contacted. SELECTION CRITERIA: Randomized controlled trials of local treatments for cutaneous non-genital viral warts in immunocompetent human hosts were included. DATA COLLECTION AND ANALYSIS: Study selection and assessment of methodological quality were carried out by two independent reviewers. MAIN RESULTS: Forty-nine trials were identified which fulfilled the criteria for inclusion in the review. The evidence provided by these studies was generally weak because of poor methodology and reporting. In 17 trials with placebo groups that used participants as the unit of analysis the average cure rate of placebo preparations was 30% (range 0 to 73%) after an average period of 10 weeks (range 4 to 24 weeks). The best available evidence was for simple topical treatments containing salicylic acid, which are clearly better than placebo. Data pooled from six placebo-controlled trials show a cure rate of 144/191 (75%) compared with 89/185 (48%) in controls, odds ratio 3.91 (95% confidence interval 2.40 to 6.36), random effects model. Most of the bigger trials of cryotherapy studied different regimens rather than comparing cryotherapy with other treatments or placebo. Pooled data from two small trials that included cryotherapy and placebo or no treatment, showed no significant difference in cure rates. In two other trials comparing cryotherapy with salicylic acid no significant difference in efficacy was demonstrated. There was no consistent evidence for the effectiveness of intralesional bleomycin. Four studies, using warts rather than individuals as the unit of analysis, had widely varying results which could not be meaningfully pooled. There was some evidence for the efficacy of dinitrochlorobenzene, a potent contact sensitizer. Pooled data from two small studies comparing dinitrochlorobenzene with placebo showed cure rates of 32/40 (80%) and 17/40 (43%) respectively, odds ratio 5.42 (95% confidence interval 1.99 to 14.75), random effects model. Only limited evidence was found for the efficacy of topical 5-fluorouracil, intralesional interferons and photodynamic therapy. Bleomycin, dinitrochlorobenzene, 5-fluorouracil, interferons and photodynamic therapy are potentially hazardous or toxic treatments. REVIEWER'S CONCLUSIONS: There is a considerable lack of evidence on which to base the rational use of the local treatments for common warts. The reviewed trials are highly variable in method and quality. Cure rates with placebo preparations are variable but nevertheless considerable. There is certainly evidence that simple topical treatments containing salicylic acid have a therapeutic effect. There is less evidence for the efficacy of cryotherapy and no convincing evidence that it is any more effective than simple topical treatments. Dinitrochlorobenzene appears to be effective but no more so than the safer, simpler and cheaper topical treatments containing salicylic acid. The benefits and risks of 5-fluorouracil, bleomycin, interferons and photodynamic therapy remain to be determined.

Administration, Topical↗

PubMed1976

Cell-mediated immunity (CMI) to human wart virus and wart-associated tissue antigens.

Lymphocyte transformation (LT) and leucocyte migration inhibition in agarose were used to demonstrate cell-mediated immune response to purified human wart virus and wart tissue extract in various subjects with warts and those without past history of warts. Most individuals bearing warts for less than 1 year duration showed positive cell-mediated responses to both the virus and tissue extract whereas very few of those who had warts for longer duration responded to either antigenic preparation. The difference was statistically significant. Subjects who had warts in the past also showed positive responses but these tended to decrease in degree with time. Surprisingly a group of subjects who never had warts before also responded to stimulation with the virus, but not to the extract. The positive response to stimulation with wart tissue extract reflects the presence of wart associated antigens other than the virus. Cell-mediated immunity against the wart virus and wart-associated antigens is probably important in preventing the persistence or even establishment of disease but this protective immunity is short-lived. The lack of quantitative correlation between LT and leucocyte migration inhibition demonstrable in this study suggests that these two are separate events in in vitro lymphocyte stimulation with antigens.

Adult↗

PubMed1978

Hunan wart-virus antibodies in patients with genital and skin warts.

A comparative follow-up study of the antibody response against human wart-virus was performed, using the immunodiffusion and complement fixation methods on patients with condylomas and skin warts. By the immunodiffusion method, 13% of the patients with skin warts and 3% of the patients with condylomas showed greater than or equal to fourfold increase of antibody titre during the follow-up of 2--35 months. The findings show some typical features of the weak antibody response of a chronic virus infection and suggest a serological overlapping between condyloma viruses and certain group of skin wart-viruses. The antibody prevalence in age-matched controls is shown to be significantly higher than that in the wart or condyloma patients' initial serum samples. This is indicative of the protective function of antibodies against warts and condylomas. Also the analysis of the history of warts in patients with condylomas suggests that protection against condylomas can be acquired from previous warts, evidently by immunological mechanisms. In a control group of medical students, human wart-virus antibodies were frequently (52%) found in subjects without any history of warts. This finding supports the view that human wart-virus can frequently induce latent or subclinical infections in human beings.

Adult↗

PubMed2003

Warts are not merely blemishes on the skin: A study on the morbidity associated with having viral cutaneous warts.

Eighty-five people aged 2-76 years with 250 common and plantar warts were followed prospectively for 9 months. The majority (57; 67%) had one to two warts. Of the 54 subjects who had a past history of warts, 41 (75.9%) had sought treatment for them. Twenty-four (58.5%) said that treatment had been unsuccessful; 22 (53.7%) experienced pain during their treatment; 14 (34.1%) said that treatment had been inconvenient; nine (22%) required multiple treatments; and eight (19.5%) said the treatment resulted in the development of scars. The quality-of-life assessment related to their current warts revealed that 81.2% were moderately to extremely embarrassed by them; 70.5% were moderately to extremely concerned about negative appraisal by others for having them; 24.7% said that it was moderately to extremely difficult to play sport because of their warts. Moderate to severe discomfort from their warts occurred in 51.7% of people and 35.4% said they had moderate to severe pain. During the 9-month study period, 27 (31.8%) of the participants had at least one wart regress spontaneously with 49 (19.6%) of the 254 warts regressing during that time. These data confirm the impression that a wart is not merely a blemish on the skin. Warts have the potential to cause considerable morbidity at times; this should be taken into account when a patient asks for treatment.

Adolescent↗

PubMed1991

Increased incidence of cervical cytological abnormalities in women with genital warts or contact with genital warts: a need for increased vigilance?

OBJECTIVE: To determine whether women who have a history of genital warts or whose sexual partners have such a history were more likely to have borderline or dyskaryotic cervical smears than other women. DESIGN: Prospective study conducted over a five month period. SETTING: A genitourinary medicine clinic in Cambridge, UK. PATIENTS: One hundred and eighty five women who attended the clinic during the study period, on whom cervical cytology was performed. Ninety-seven had a history of genital warts and twenty had partners with genital warts. METHODS: Cervical cytology taken by standard methods. Demographic data and sexual history obtained by questionnaire. Colposcopy was performed on patients with a history of warts or wart contact. OUTCOME MEASURED: Relative incidence of cytological abnormalities in the various groups of patients. RESULTS: "Borderline" nuclear change was the most frequent abnormality reported in the wart contact group (six cases) whereas mild dyskaryosis was the most frequent abnormal finding in those women with a history of warts (21 cases). CONCLUSIONS: Women with warts or contact with genital warts were more likely to have borderline or dyskaryotic cervical smears than women without such a history. Recommendations for follow-up of these patients are made.

Adult↗

PubMed1977

Warts and wart virus antibodies in patients with systemic lupus erythematosus.

Warts were found in 25 out of 56 patients with definite or probable systemic lupus erythematosus (SLE) but in only 19 out of 160 control patients. Warts were particularly prevalent in elderly patients with SLE. The corticosteroid and antimalarial drugs used to treat SLE did not influence the frequency of warts. Wart-virus antibodies were found significantly less often in patients with SLE than in controls: antibodies were detected in 23 out of 51 patients and in 40 out of 54 controls. Ihe findings suggest that some deficiency in the immune mechanisms of patients with SLE predisposes them to develop warts. There was an inverse correlation among the patients with SLE between the occurrence of warts and rheumatoid factor activity. This suggests that rheumatoid factor may interfere with resistance to warts.

Adolescent↗

PubMed2002

An interesting response to diphencyprone (DPC) sensitization on facial warts: review of DPC treatment for viral warts.

BACKGROUND: This paper highlights the sometimes impressive effect of diphencyprone (DPC) sensitization on warts resistant to other treatments and is interesting in view of the fact that all the warts apparently responded, despite only a very small area being treated. METHODS: A 31-year-old woman with a 5-year history of widespread facial plane warts that had proved resistant to repeated treatments with cryotherapy and topical preparations was sensitized to diphencyprone. RESULTS: After application of DPC to the warts within only a 1-cm(2) area of the face, all the facial warts became inflamed and resolved, including those not actively treated. Complete clearance occurred with no recurrence. CONCLUSION: DPC appears to be a valuable, safe and well-tolerated treatment for resistant viral warts and can be considered as a first line treatment. We review its use and action in this paper

Cyclopropanes↗

PubMed1998

A case of a human-papillomavirus-60-induced wart with clinical appearance of both pigmented and ridged warts.

Human papillomavirus (HPV) type 60 infection is histologically associated with characteristic homogeneous intracytoplasmic inclusion bodies. However, it remains unclear whether the virus is associated with cystic, pigmented or ridged plantar warts. We report a 51-year-old Japanese female with a HPV-60-induced plantar wart which showed the clinical appearance of both pigmented and ridged warts. Masson-Fontana staining revealed increased melanin granules in the epidermis of the wart. This observation suggests that HPV-60 may be associated not only with cystic warts but also with the specific morphology of ridged warts, and the biological disorder of hyperpigmentation may be controlled by additional unknown factors which differ from case to case.

Female↗

PubMed1978

Efflorescence of new warts: a sign of onset of involution in flat warts.

The sudden eruption of large numbers of tiny new warts in a patient with multiple flat warts often signals the onset of involution and subsequent regression of all flat warts. We have observed 5 such cases and, in this report, describe 2 cases in which the sudden efflorescence of many new warts was used as a sign to predict accurately the onset of involution and subsequent regression of all flat warts. Correlation of the histopathological and clinical findings provides an explanation for this phenomenon.

Adult↗

PubMed1994

Human papillomavirus type 60-associated plantar wart. Ridged wart.

BACKGROUND: We had recently cloned a new cutaneous human papillomavirus type 60 (HPV-60) from a plantar cyst with characteristic pathologic changes and identified it in additional cysts. However, it is not known whether or not HPV-60 infection causes the other cutaneous lesions. OBSERVATIONS: Six plantar warts were found in five patients. These warts were found either with concomitant plantar cysts (four patients) or without an accompanying cyst (one patient). All warts showed a similar clinical appearance, including a smooth and slightly elevated surface and the retained appearance of the dermal ridges. Their histopathologic features were identical to those found in the wall of the cysts reported previously, namely hyperkeratosis with vacuolated structure with or without nuclei in the horny layer and amorphous eosinophilic cytoplasmic inclusions in the cells with peripherally located nuclei in the granular and prickle cell layers. By Southern blot analysis, all warts were found to harbor HPV-60 DNA. In addition, immunohistochemistry and in situ hybridization analysis revealed the presence of viral capsid antigen and viral genome in these lesions, respectively. CONCLUSION: We conclude that HPV-60 infection on the plantar skin causes the warty lesion, designated as ridged wart, distinct from those infected with other cutaneous human papillomaviruses.

Adolescent↗

PubMed1999

A human homolog of Drosophila warts tumor suppressor, h-warts, localized to mitotic apparatus and specifically phosphorylated during mitosis.

We identified a human homolog of Drosophila warts tumor suppressor gene, termed h-warts, which was mapped at chromosome 6q24-25.1. The h-warts protein has a serine/threonine kinase domain and is localized to centrosomes in interphase cells. However, it becomes localized to the mitotic apparatus, including spindle pole bodies, mitotic spindle, and midbody, in a highly dynamic manner during mitosis. Furthermore, h-warts is specifically phosphorylated in cells at mitotic phase, most likely by Cdc2 kinase. These findings suggest that h-warts functions as a component of the mitotic apparatus and is involved in proper progression of mitosis.

Amino Acid Sequence↗

PubMed2004

Rate and predictors of new genital warts claims and genital warts-related healthcare utilization among privately insured patients in the United States.

BACKGROUND: Little non-clinic-based data are available on incident genital warts rates and related healthcare use. GOAL: : The goal of this study was to describe the incidence and predictors of genital warts and associated healthcare utilization patterns among a group of privately insured patients in the United States. STUDY: Health claims were evaluated prospectively from 5,914,107 privately insured individuals. RESULTS: The rate of new genital warts claims per 100,000 person-years at risk, age-standardized to the 2001 U.S. privately insured population, increased from 117.8 in 1998 to 205.0 in 2001. The highest rates were among 20- to 29-year-olds. The majority of claims came from dermatology and obstetrics/gynecology. CONCLUSIONS: The incidence of genital warts, as measured by the rate of new claims, appears to be rising. Age associations with the rate of new genital warts claims differed by gender; these associations may be influenced by changes in health-seeking behavior, potentially driven by health awareness.

Adolescent↗

PubMed1993

Common warts from immunocompetent patients show the same distribution of human papillomavirus types as common warts from immunocompromised patients.

We studied the papillomaviruses (HPV) found in 131 common warts from 111 immunocompetent patients by amplification of viral DNA sequences with the general-primer-mediated polymerase chain reaction (PCR). The virus types were determined by restriction-enzyme cleavage and reverse-blot analysis. Results were confirmed by using the Southern blot technique. Forty patients harboured HPV 2a, 25 individuals showed HPV 2c and 13 yielded HPV 57. Common warts from 16 patients were induced by a variant of HPV 57. HPV 7 was found in four patients. HPV 1 was identified in two patients, and there was evidence for HPV 4 in only one case. One individual yielded an HPV type which was only weakly related to HPV 2. Three patients were infected by more than one HPV type. PCR did not demonstrate HPV-DNA in warts from six individuals. The distribution and variation of HPV types found in the common warts of immunocompetent patients were similar to the findings in immunocompromised patients reported by other authors.

Blotting, Southern↗

PubMed1985

Primary tissue culture of spontaneously regressing flat warts. In vitro attack by mononuclear cells against wart-derived epidermal cells.

Although tumors may be resolved due to host immune response, it is difficult to obtain direct evidence of this in man. Numerous flat warts, human papilloma virus type 3-induced papillomas, disappear systemically and simultaneously after showing inflammatory changes. Histologically, there is a dense cellular infiltration composed of lymphocytes and mononuclear phagocytes as identified by alpha-naphthyl acetate esterase staining in situ, the former being predominant in most cases. The primary tissue culture of such inflamed flat warts from ten cases revealed a proliferation of wart-derived keratinocytes as is the case with ordinary flat warts. However, in nine of the ten cases, massive mononuclear cells, most of which were T-lymphocytes, migrated out of the explants and began to attack these keratinocytes, inducing degenerative changes. These findings indicate that cell-mediated tumor cell destruction rather than antiviral reaction induces systemic spontaneous regression of multiple papillomas in man.

Adolescent↗

PubMed1989

[A new type of viral wart? A case of viral wart having intracytoplasmic filamentous substances].

Reported was a 16-year old Japanese girl suffering from peculiar viral warts on the soles. All lesions showed whitish punctate keratotic appearance. Three biopsy specimens taken from one patient were found to have particular intracytoplasmic basophilic eosinophilic filamentous substances in each cell. These intracytoplasmic substances were quite different from those of myrmecia, which was described as inclusion wart by Lyell and Myles. Myrmecia is caused by human papillomavirus type 1 (HPV-1) and its intracytoplasmic substances are characterized by numerous intracytoplasmic eosinophilic granules. In spite of that immunohistologically papillomavirus common antigens were detected, HPV-1,2,4 was never detected by in situ hybridization method in our case. We assume that our case is a new type of viral wart.

Adolescent↗

PubMed2005

How condom use, number of receptive anal intercourse partners and history of external genital warts predict risk for external anal warts.

Few analytic opportunities have allowed us to evaluate the role that specific sexual acts and male latex condoms play in the acquisition of external anal warts (EAW) using longitudinal data. The acquisition of EAWs occurs from epithelial contact with other HPV-infected surfaces, and hence is dependent upon sexual behaviour. Our objectives were to classify the relative importance of condom use, receptive anal intercourse (RAI) and prior history of EGWs on acquisition of EAWs. The observational Multicenter AIDS Cohort Study followed 2925 men over nine semiannual study visits for behavioural and physical examinations with laboratory testing. The main outcome measure was the occurrence of examiner-diagnosed EAWs in a homosexual population. EAWs were diagnosed among 10% of men studied across 22,157 visits reviewed for this study. Men with history of EGWs were more likely than those previously unaffected to have developed EAWs (cOR = 2.4 (2.0, 2.9)), as were men who reported multiple anoreceptive intercourse partners (e.g., compared with men who reported no RAI partners, men with 1, 2-5, > or = 6 RAI partners had crude risk ratios 1.0 (0.8, 1.3), 1.6 (1.2, 2.1), 3.9 (2.7, 5.8), respectively). These relations persisted after other demographic and sexual risk factors were controlled for in the analyses. Consistent condom usage showed no protective effect for EAWs in our crude or adjusted analyses. Patient education messages should be tailored to reflect our uncertainty about the protective nature of condoms for the development of anal warts, but to continue to assert the protective effects of a limited lifetime number of sexual partners and the heightened risk for wart recurrence once infected.

Anus Diseases↗

PubMed1983

Characterization of two HPV-3 related papillomaviruses from common warts that are distinct clinically from flat warts or epidermodysplasia verruciformis.

We have recently identified two unusual human papillomavirus (HPV) isolates while engaged in an ongoing study of wart disease in meat handlers and veterinarians. The papillomas from which these two viruses were isolated clinically resembled verruca vulgaris rather than either flat warts or epidermodysplasia verruciformis (EV). These two previously uncharacterized HPVs were molecularly cloned and characterized with respect to known HPVs. The genomes of the two viruses exhibited dramatically different restriction endonuclease cleavage patterns but were found to have significant sequence homology to each other, as well as to HPV-3 and a new virus isolated from a patient with EV. Neither of the two new HPV isolates exhibit detectable sequence homology under stringent conditions of hybridization or share similar restriction endonuclease cleavage patterns with previously characterized HPV types 1,2,4,5,6b, or a previously isolated HPV from meat handlers.

Adolescent↗

PubMed1977

Superficial radiotherapy of warts: results of treating 531 warts.

The fear of injurious effects has almost completely halted the use of radiotherapy in the cure of warts. Over a period of 24 years, the authors have treated 531 warts with both orthovoltage and superficial radiation equipment without any adverse effects. The selection of superficial or orthovoltage units was not dependent on the size of the lesion and was thought to be completely random.

Adolescent↗