Imiquimod is effective in the treatment of genital warts and clinical studies suggest activity against common warts as well. We have analyzed the effect of topical imiquimod on gene expression and virus load in human papilloma virus (HPV) 2/27/57-induced common warts. mRNA was extracted from keratinocyte culture, from normal skin, from three untreated common warts and from three common warts treated topically with 5% imiquimod cream twice daily. Differential gene expression was demonstrated by RT-PCR and by cDNA microarray hybridization. We further analyzed viral DNA content in scales from three superficially pared imiquimod-treated warts by real-time PCR. Comparison of normal skin with wart tissue revealed that HPV 2/27/57 infection led to an induction of IL-6, IL-10 and interferon-γ inducible protein (IP10) and to an up-regulation of TGF-β. We could further detect expression of PCTAIRE-3, WNT2B, frizzled-3, notch-2, notch-4 and BRCA2 in normal skin and common warts. Analysis of imiquimod-treated warts demonstrated that imiquimod enhanced IL-6 expression and induced IL-8, GM-CSF, MRP-8 and MRP-14. It could also be shown that imiquimod led to an infiltration of wart tissue with macrophages and to a strong decrease of viral copy number in warts within 3 months of treatment. Our data thus provide molecular proof of principle for imiquimod treatment of cutaneous common warts.

Allergy to human seminal fluid is a rare but potentially life-threatening disorder. Acute symptoms range from local reactions to generalized symptoms. A 30-year-old woman experienced vulvovaginal itching, erythema and swelling as well as generalized urticaria and angioedema of the neck and face after unprotected sexual intercourse. A scratch test with undiluted seminal fluid and the detection of specific IgE antibodies revealed a type I allergy to seminal fluid. Risk factors and therapeutic options are discussed.

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Die 61-jährige Patientin stellte sich mit einer seit 10 Monaten bestehenden Entzün-dung im Bereich des Nagelfalzes des Digitus I-V der linken Hand, Nagelwachstumsstörung und schmerzhafter Bewegungseinschränkung vor. HautbefundAn der linken Hand zeigte sich an Digitus I-V eine Onychodystrophie mit Pustelbildung und Umgebungsrötung an den Fingerkuppen (. Abb. 1). An Digitus II, III und IV zeigten sich Rötung und Schwellung der Fingergelenke mit resultierender Bewegungseinschränkung. Rechts zeigte sich an Digitus I ebenfalls eine Nageldystrophie. Abb. 2 8 Histologie des M. Morbihan