Condylomata acuminata of HIV-positive men may harbour focal areas of dysplasia: relevant implications for the management of human papillomavirus-induced disease in high-risk patients

Kreuter, Alexander; Wieland, Ulrike

doi:10.1111/bjd.14855

Cited by 4 publications

(5 citation statements)

References 10 publications

(12 reference statements)

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“…Sexually transmitted infections (STIs) are one of the important manifestations of HIV. The prevalence of condyloma acuminata in HIV ranges from 8.8% to 53% [12,13]. 1.9% of our cases suffered from condyloma acuminata.…”

Section: Discussionmentioning

confidence: 71%

Mucocutaneous disorders in HIV/AIDS at a tertiary care hospital in Nepal: An observational study

Rajput¹,

Das²,

Paudel³

et al. 2021

Our Dermatol Online

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Background: Mucocutaneous manifestations in HIV infections are common. However, they have not, so far, been studied in Nepal. The aim of this study was, therefore, to describe mucocutaneous manifestations in Nepalese HIV patients. Materials and Methods: The following is a hospital-based, descriptive, cross-sectional study conducted in the Department of Dermatology and Venereology and Antiretroviral Treatment (ART) Center of Tribhuvan University Teaching Hospital (TUTH) from May 2017, through October 2018. Patients aged 16 years and above diagnosed with HIV were included in the study, for whom history and clinical examinations were performed. The study variables were age, sex, a clinical diagnosis of dermatological problems, clinical stages of HIV/AIDS, as per the World Health Organization (WHO) classification criteria, and the CD4 count. Results: A total of 52 patients were included in the study. The mean age upon presentation was 38.77 ± 10.9 years. The mean CD4 count was 464.27 ± 255.13. Females were more affected than males (female:male = 1.4:1). Mucocutaneous manifestations were the following: fungal infections (10; 19.3%), viral infections (6; 11.6%), parasitic infestations (3; 5.8%), bacterial infections (4; 7.7%), sexually transmitted infections (2; 3.8%), seborrheic dermatitis (3; 5.8%), idiopathic pruritus (3; 5.8%), recurrent oral ulcers (3; 5.8%), urticaria (3; 5.8%), pruritic papular eruptions (2; 3.8%), eczemas (2; 3.8%), acne (2; 3.8%), angular cheilitis (2; 3.8%), xerosis cutis (2; 3.8%), and others (5; 9.6%). Conclusions: The study showed that fungal infections are common in HIV patients, followed by viral infections and parasitic infestations. Seborrheic dermatitis, idiopathic pruritus, recurrent oral ulcers, and urticaria were found to be common inflammatory skin diseases in HIV.

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Section: Discussionmentioning

confidence: 71%

Mucocutaneous disorders in HIV/AIDS at a tertiary care hospital in Nepal: An observational study

Rajput¹,

Das²,

Paudel³

et al. 2021

Our Dermatol Online

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“…16,17 Indeed, genital warts may harbour focal areas of intraepithelial neoplasia, particularly in HIV-positive men. 18 A frequent location of genital warts is the perianal area. 19 Therefore, perianal warts might represent a clinical marker for anal HR-HPV infection and may be associated with an elevated risk of anal cancer, particularly among MSM.…”

Section: Introductionmentioning

confidence: 99%

“…Genital warts are the most common sexually transmitted infection (STI) worldwide and are caused by low‐risk (LR) HPV, although mixed infections with oncogenic HPV genotypes are quite common 16,17 . Indeed, genital warts may harbour focal areas of intraepithelial neoplasia, particularly in HIV‐positive men 18 . A frequent location of genital warts is the perianal area 19 .…”

Section: Introductionmentioning

confidence: 99%

Perianal warts as a risk marker for anal high‐risk‐human papillomavirus (HPV) detection and HPV‐associated diseases

Cerejeira

Cunha

Coelho

et al. 2020

Acad Dermatol Venereol

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Background Genital warts are the most common sexually transmitted infection (STI) and are caused by human papillomavirus (HPV). Persistent anal infection by oncogenic genotypes of HPV is a determinant for anal cancer. Currently, anal cancer screening is not widely implemented. Objectives Our aim is to evaluate the role of perianal warts as a risk marker for anal high-risk (HR) HPV detection and anal dysplasia. Methods In this observational, retrospective, cohort study of attendees of a STI outpatient clinic between January 2010 and June 2018, all human immunodeficiency virus (HIV)-positive men who have sex with men (MSM) who performed anal cytology, anal HPV DNA detection and anoscopy were included. A comparison was made between patients with and without perianal warts. Primary endpoint: proportion of patients with an abnormal anal cytology. Secondary endpoints: proportion of patients with (i) anal HR-HPV detection; (ii) anal HPV 16 detection; (iii) abnormal anal biopsy; and (iv) anal high-grade squamous intraepithelial lesion (HSIL). Results Seventy-eight individuals were included: 39 with perianal warts and 39 without perianal warts. Subjects with perianal warts more frequently had an abnormal anal cytology (71.8% vs. 38.5%; P = 0.003). This group also had a higher rate of anal HPV 16 detection (38.5% vs. 12.8%; P = 0.01). No differences were detected in the proportion of patients with anal HR-HPV detection, with an abnormal anal biopsy or with anal HSIL. Perianal warts was an independent risk factor for an abnormal anal cytology (OR: 7.2) and for anal HPV 16 detection (OR: 6.7). Conclusion Given the high risk of anal cancer in HIV-positive MSM, effective screening strategies are greatly needed. This study suggests that the presence of perianal warts is a suitable risk marker for anal HPV 16 detection and anal dysplasia.

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“…[ 1 7 ] Clinical data show that anal canal CA accounts for about 14% of CA patients, more than half of the men with anal canal warts are men who have sex with men (MSM), and about 20% of HIV-positive MSM anal canal CA patients have anal canal warts combined with high-grade squamous intraepithelial neoplasia. [ 8 9 ] With high curative effect and low recurrence rate, ALA-PDT is currently recommended treatment for anal canal CA; however, PDT-related pain is still a major challenge. [ 2 10 ] Anti-HPV biological dressing, a newly marketed topical drug, has a strong inhibitory activity on HPV infection.…”

Section: Discussionmentioning

confidence: 99%

Anal Canal Condyloma Acuminatum Treated with Anti-HPV Biological Dressing

Liu

et al. 2022

Indian Journal of Dermatology

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Background: Anal canal condyloma acuminatum (CA) is a refractory disease with a high recurrence rate caused by human papillomavirus (HPV). Multiple clinical trials demonstrate that anti-HPV biological dressing is safe and effective in treating HPV infection, which has been used in treating high-risk HPV-positive and cervical intraepithelial neoplasia I (CIN I) patients. Yet, there is still a lack of clinical data for the treatment of anal canal CA. Aims and Objectives: To evaluate the clinical efficacy and application value of anti-HPV biological dressing in anal canal CA. Materials and Methods: Taken currently recommended treatment 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) as a positive control, 128 patients were included with 64 in each group, and a prospective, randomized, positive controlled, non-inferiority clinical trial was conducted. After removing visible skin lesions with conventional microwave, the treatment group was given anti-HPV biological dressing, while the control group received the conventional ALA-PDT treatment. Patients were followed up on the 1st, 12th and 24th weeks after the treatment. The cure rate, recurrence rate, HPV-negative conversion rate, and adverse events were recorded. Results: In the 1st, 12th and 24th weeks after treatment, the cure rate, recurrence rate and HPV-negative conversion rate of the treatment group and the control group showed no statistically significant difference. In the treatment group, 56 patients developed transient mild itching and all were relieved spontaneously, while in the control group, most of the patients experienced obvious pain and some patients needed symptomatic treatment. No severe systemic adverse events were observed. Conclusion: Compared with ALA-PDT, topical application of anti-HPV biological dressing has comparable promising outcomes in the treatment of anal canal CA, with fewer side effects and simpler operation making it suitable for clinical applications.

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Condylomata acuminata of HIV-positive men may harbour focal areas of dysplasia: relevant implications for the management of human papillomavirus-induced disease in high-risk patients

Abstract: Linked Article: Siegenbeek van Heukelom et al. Br J Dermatol 2016; 175:735–743.

Cited by 4 publications

References 10 publications

Mucocutaneous disorders in HIV/AIDS at a tertiary care hospital in Nepal: An observational study

Mucocutaneous disorders in HIV/AIDS at a tertiary care hospital in Nepal: An observational study

Perianal warts as a risk marker for anal high‐risk‐human papillomavirus (HPV) detection and HPV‐associated diseases

Anal Canal Condyloma Acuminatum Treated with Anti-HPV Biological Dressing

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