A plethora of different treatment modalities for treating human papillomavirus (HPV) are available, offering a range of efficacies and balancing several patient needs. Here we discuss pharmacotherapies for HPV, focusing in particular on the mechanism of action and treatment efficacy. Immunomodulators such as Candida antigen, imiquimod and squaric acid stimulate cell-mediated immunity and induce production of antiviral cytokines. Proapoptotic and antiviral treatments such as podophyllin resin, podophyllotoxin gel, bleomycin, 5-fluorouracil, cidofovir and interferon α interfere with the viral reproduction cycle. Other therapies include trichloroacetic acid, acitretin, cantharidin and sinecatechins, some of which operate by epidermal destruction, effects on cellular proliferation and other mechanisms of which are poorly understood. Overall, given the high HPV recurrence rates, adjunctive use of antiviral agents should be considered in treatment, especially when managing severe or complicated presentations.
Skin cancer in darker skin is associated with considerable morbidity and mortality. We sought to assess the clinical characteristics of cutaneous malignancy amongst Hispanic skin cancer patients and compare them to age-matched non-Hispanic Caucasians. In this retrospective study, 150 Hispanic skin cancer patients were identified from electronic medical records and age-matched to 150 non-Hispanic Caucasian controls with skin cancer. The incidence of actinic keratoses (AKs) in Hispanic skin cancer patients (34.0%) was statistically lower than age-matched non-Hispanic Caucasian skin cancer controls (61.3%, P <0.001; odds ratio, 3.08; 95% confidence interval, 1.92 -4.93). Moreover, non-Hispanic Caucasian SCC (squamous cell cancer) controls were much more likely to report AKs (36.1%, P = 0.003) than Hispanic SCC patients (25.0%, P = 0.19). This study illustrates a lower incidence of AKs in Hispanic skin cancer patients as compared to their age-matched non-Hispanic Caucasians. The Hispanic skin malignancies present at a more advanced state and there is usually a lack of awareness in such cases. Therefore, patient knowledge and education is crucial for early detection and prevention of skin cancer in the Hispanic population.
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