Immunosuppression may be present within condyloma acuminata

Poole, Caroline Le; Denman, Cecele J.; Arbiser, Jack L.

doi:10.1016/j.jaad.2008.08.011

Cited by 28 publications

(29 citation statements)

References 34 publications

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“…This may be because of reduced immunity during pregnancy, changes in hormone levels (for example, elevated progesterone levels), and increased vaginal discharge resulting in a more moist local environment (16).…”

Section: Discussionmentioning

confidence: 99%

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Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety

Yang

Zhu

Dang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract.Patients with condyloma acuminata (CA) during pregnancy represent a special risk group. The outcomes of many treatment methods for such cases are not satisfactory. The purpose of the present study was to evaluate the treatment outcome and safety of cryotherapy combined with proanthocyanidins (PCs) for CA in pregnant women. In this study, 46 pregnant women with CA were treated with cryotherapy combined with PCs. The lesions were sprayed with liquid nitrogen until the color of the wart changed from flesh colored to purple. A PC-containing formulation was then sprayed onto a non-woven fabric or single-layer gauze and applied to the affected area. The PC treatment was applied for 20 min, 2 or 3 times per day. All patients were followed up at 1 and 3 months. No visible warts remained after the cryotherapy and PC treatment. At the 1-month follow-up, only 1 case of recurrence was identified. At 3 months, 5 cases of recurrence were identified, and the recurrence rate was 10.9%. The satisfaction rate of the patients was 94% at 1 month and 87% at 3 months after treatment. All pregnancies resulted in healthy live births without delivery complications. Cryotherapy combined with PCs is indicated to be a safe and effective procedure and may serve as a treatment option for pregnant women with CA. IntroductionCondyloma acuminata (CA) are symptomatic genital lesions caused by human papilloma virus (HPV). Patients who have CA during pregnancy are a particular risk group. During pregnancy, vaginal secretions contacting the skin and mucous membranes are more abundant (1), meaning that the vulva will remain in a moist and immersed state, which would be problematic for CA patients. Several factors associated with pregnancy can promote the growth of HPV-induced lesions, for example, pregnancy hormones and reduced immunoresponsiveness. Cases of CA in pregnancy are normally characterized by fast-growing warts, and a reduced tolerance and poor compliance to treatment (2).Only a small number of treatments have been tested and recommended in pregnancy; at present, bi-and tri-chloroacetic acid (BCA/TCA), cryotherapy, electrocautery and surgical excision, including laser treatment, are the only recommended treatments. In addition to high recurrence rates, significant side effects have been observed for these methods, including local ulceration and scar formation, which may reduce a patient's compliance with treatment requirements (3). Moreover, medicine could potentially cause fetal malformation and laser treatment and surgical excision may cause uterine contraction, or even abortion (1,4).Cryotherapy is widely used for the treatment of CA. During the cryotherapy procedure, liquid nitrogen freezes the tissue and thereby causes necrosis; the treatment also stimulates specific immune responses, such as an immunomodulatory action of T lymphocytes against the remaining viable wart tissue (5,6). The advantages of cryotherapy are that it is simple, inexpensive, rarely causes scarring or depigmentation, and is safe for use in pregnancy.Pro...

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Section: Discussionmentioning

confidence: 99%

“…The wart undergoes necrosis at low temperatures. In addition, cryotherapy treatment is able to induce an antigen-specific immune response and cytokine release (16).…”

Section: Discussionmentioning

confidence: 99%

Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety

Yang

Zhu

Dang

et al. 2016

Experimental and Therapeutic Medicine

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“…In particular, HPV-positive tonsillar SCCs exhibit an elevated number of FoxP3-positive tumour-infiltrating lymphocytes, when compared to HPV-negative cases [27]. High numbers of regulatory T cells specific for HPV antigens have been identified in cervical cancer [44], as well as higher number of FoxP3-positive T cells in acuminate condylomata than in control tissue [45,46]. There is mounting evidence that the immune response has an important prognostic impact in many HPV-associated tumours and precancerous lesions like CIN and cervical carcinoma or head and neck carcinomas [24,47].…”

Section: Discussionmentioning

confidence: 99%

“…The LCD-array HPV 3.5C uses primer pairs and capture probes specific for HPV types 06, 11, 16, 18, 31, 33, 35, 39, 42, 44, 45, Tumours negative for HPV were examined a second time using a multiplex HPV genotyping assay. GP5+/GP6+ primer-based multiplex PCR and genotyping were performed using Luminex-based multiplexed genotyping (MPG, multiplexed HPV genotyping, Multimetrix, Heidelberg, Germany) for detection of 18 high-risk HPV genotypes (HPV 16,18,26,31,33,35,39,45,51, 52, 53, 56, 58, 59, 66, 68, 73 and 82) and 6 low-risk HPV genotypes (HPV 6, 11, 42, 43, 44 and 70) [13,14] Quantification of lymphocytes The number of labelled lymphocytes was counted for each case in five different representative high-power fields (HPFs) (×40 objective; 22-mm field of view ocular) of tumour tissue and adjacent stroma using an Olympus BX40 microscope (Olympus Europe Holding GmbH, Hamburg, Germany), blinded to the HPV status of tumours.…”

Section: Immunohistologymentioning

confidence: 99%

Human papilloma virus status of penile squamous cell carcinoma is associated with differences in tumour-infiltrating T lymphocytes

et al. 2014

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Meta-analyses show that approximately half of all squamous cell carcinomas (SCCs) of the penis are associated with a human papillomavirus (HPV) infection. As data about the tumour microenvironment of HPV-positive and HPV-negative penile carcinomas is scarce and conflicting, we examined tumour-infiltrating lymphocyte populations in such cases. The HPV status of 28 penile SCCs was determined by polymerase chain reaction, while the number and distribution of different lymphocyte populations were analysed by immunohistochemistry on whole sections of paraffin-embedded tumour specimens. The average number of tumour-infiltrating T cells in HPV-associated SCC was higher than in HPV-negative SCC, and their phenotype showed strong polarization towards a T helper 1 and cytotoxic immune response. In addition, we identified more tumour-infiltrating regulatory T cells in HPV-positive carcinomas, which might represent a mechanism of immune evasion. The present study provides further evidence that the tumour microenvironment of HPV-positive carcinomas differs from that of HPV-negative carcinomas.

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“…[5,6] This could serve as a tumor antigen, and neoplastic B lymphocytes might be defective in presenting this tumor antigen to the host. We have found deficiencies in antigen presentation in warts, [7] and lymphomas might be deficient in presentation of mutant proteins.…”

mentioning

confidence: 74%

286 Regression of diffuse B-cell lymphoma of the leg with intralesional gentian violet

Rao

Morris

Rice

et al. 2017

Journal of Investigative Dermatology

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In this case report, a patient of primary cutaneous diffuse B-cell lymphoma, leg type was treated with intralesional gentian violet as she was judged to be too medically fragile for conventional chemotherapy due to advanced age and multiple serious comorbidities. Gentian violet (crystal violet/hexamethyl pararosaniline) is a triphenylmethane dye. It has been shown to have an inhibitory effect on NADPH oxidase, an enzyme family which is found in abundance in reactive oxygen-driven tumors such as melanoma and lymphoma. We hypothesize that intralesional gentian violet treatment caused signalling changes in the lymphoma which allowed for immune clearance of the lymphoma. Complete resolution of the patient's lesion was noted on a follow-up visit. KeywordsDiffuse B-cell lymphoma; gentian violet; NADPH oxidases We present a case of an 84-year-old woman who presented in January 2015 with three nodules on her right leg. Biopsy of these lesions revealed primary cutaneous diffuse B-cell lymphoma, leg type (PCLBCL of the leg). The overlying epidermis was unremarkable. Provided immunohistochemical stains demonstrated the atypical lymphoid cells to be positive for CD20, BCL2 and BCL6 and negative for CD3 and CD30.The patient was treated with radiation therapy due to multiple comorbidities, including coronary artery disease, diastolic heart failure, sleep apnoea and diabetes mellitus. She underwent radiation therapy of 30 Gray in 10 sessions, resulting in remission of the initial nodules. However, three new nodules appeared outside the radiation field, which resolved with a single intravenous dose of rituximab. She was lost to follow-up until December 2015, when she presented with a 3-cm nodule on her right anterior leg ( Figure 1A).A punch biopsy of the nodule was performed, and gentian violet was introduced into the cavity and allowed to heal by secondary intention. The biopsy was consistent with recurrent PCLBCL of the leg ( Figure 1C,D), but did contain infiltrating T lymphocytes ( Figure 1E).

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Immunosuppression may be present within condyloma acuminata

Cited by 28 publications

References 34 publications

Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety

Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety

Human papilloma virus status of penile squamous cell carcinoma is associated with differences in tumour-infiltrating T lymphocytes

286 Regression of diffuse B-cell lymphoma of the leg with intralesional gentian violet

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