Skin infections in pregnancy

Müllegger, Robert R.; Häring, Nina; Glatz, Martin

doi:10.1016/j.clindermatol.2016.02.009

Cited by 32 publications

(17 citation statements)

References 96 publications

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“…Guidance for daily practice situations and the subsequent action that can be taken are shown in Table …”

Section: Methodsmentioning

confidence: 99%

“…• Explain that smoking depresses the immune system, particularly in relation to viruses 74 and it is well recognized that smokers have more difficulty clearing warts and are more likely to get recurrences. 16 Smoking cessation should be encouraged Pregnancy • Explain that pregnancy is an immune suppressed state and therefore wart infections can become large during pregnancy but will usually disappear within weeks of delivery 76 • During pregnancy, the warts should not be treated if they do not represent an obstacle to delivery. If needed, only use ablative methods, e.g., cryotherapy or trichloroacetic acid 3,12,50 • Avoid extensive laser vaporization, electrocautery or surgery during the 6-8 weeks before delivery • Be aware that in rare cases, HPV can be transmitted during child birth resulting in recurrent respiratory papillomatosis in the infant 73,78 Immune suppression • Establish the patient's HIV status • Check to see whether they are on immunosuppressive drugs for inflammatory bowel disease, rheumatoid arthritis etc.…”

Section: Heavy Cigarette Smokingmentioning

confidence: 99%

“…Guidance for daily practice situations and the subsequent action that can be taken are shown in Table 4. 3,8,12,16,23,26,30,50,54,56,62,66,[72][73][74][75][76][77][78][79][80] Preventing AGW Anogenital warts can now be effectively prevented using the quadrivalent (HPV 6, 11, 16 and 18) or nanovalent (HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58) HPV vaccines; these protect against HPV types that cause AGW, cervical cancer and other types of anogenital and oral cancer. The HPV quadrivalent vaccine has shown to be up to 100% effective in preventing AGW in association with vaccine-type HPV in women.…”

Section: Guidance For Daily Practice Situationsmentioning

confidence: 99%

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Position statement for the diagnosis and management of anogenital warts

O'Mahony

Gomberg

Skerlev

et al. 2019

Acad Dermatol Venereol

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Background Anogenital warts ( AGW ) can cause economic burden on healthcare systems and are associated with emotional, psychological and physical issues. Objective To provide guidance to physicians on the diagnosis and management of AGW . Methods Fourteen global experts on AGW developed guidance on the diagnosis and management of AGW in an effort to unify international recommendations. Guidance was developed based on published international and national AGW guidelines and an evaluation of relevant literature published up to August 2016. Authors provided expert opinion based on their clinical experiences. Results A checklist for a patient's initial consultation is provided to help physicians when diagnosing AGW to get the relevant information from the patient in order to manage and treat the AGW effectively. A number of frequently asked questions are also provided to aid physicians when communicating with patients about AGW . Treatment of AGW should be individualized and selected based on the number, size, morphology, location, and keratinization of warts, and whether they are new or recurrent. Different techniques can be used to treat AGW including ablation, immunotherapy and other topical therapies. Combinations of these techniques are thought to be more effective at reducing AGW recurrence than monotherapy. A simplified algorithm was created suggesting patients with 1–5 warts should be treated with ablation followed by immunotherapy. Patients with >5 warts should use immunotherapy for 2 months followed by ablation and a second 2‐month course of immunotherapy. Guidance for daily practice situations and the subsequent action that can be taken, as well as an algorithm for treatment of large warts, were also created. Conclusion The guidance provided will help physicians with the diagnosis and management of AGW in order to improve the health and quality of life of patients with AGW .

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“…Guidance for daily practice situations and the subsequent action that can be taken are shown in Table …”

Section: Methodsmentioning

confidence: 99%

Section: Heavy Cigarette Smokingmentioning

confidence: 99%

Section: Guidance For Daily Practice Situationsmentioning

confidence: 99%

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Position statement for the diagnosis and management of anogenital warts

O'Mahony

Gomberg

Skerlev

et al. 2019

Acad Dermatol Venereol

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“…A terhesség alatt kialakult primer fertőzés egyik legsúlyosabb, gyakori szövődménye a varicella pneumonia, amely az esetek 5-20%-ában alakul ki és akár 40%-ban letális kimenetelű lehet (42). A tüdő-gyulladás mellett a vírusfertőzés kapcsán kialakulhat hepatitis, encephalitis, jelentkezhet glomerulonephritis, arthritis, thrombocytopaenia is (33,43). Az övsömör előfordulása terhességben, az átlag populációhoz képest gyakoribb.…”

Section: Varicella-zoster Fertőzésunclassified

“…Szisztémás tünetek és szö-vődményes lefolyás (láz, perzisztáló exanthemák, haemorrhagiás tünetek, pneumonia) esetén parenteralis kezelést kell alkalmazni naponta 8 óránként 10-15mg/kg dózisban, 7-10 napig (43,45).…”

Section: Varicella-zoster Fertőzésunclassified

Congenital and perinatal viral infections and their consequences

Dalmády¹,

Rózsa²,

Csoma³

2018

BVSZ

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Association Between Fetal Safety Outcomes and Exposure to Local Podophyllotoxin During Pregnancy

Andersson

Andersen

2020

JAMA Dermatol

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IMPORTANCEPodophyllotoxin is an antimitotic agent primarily used in the local treatment of anogenital warts. Data that enable the assessment of the fetal safety of podophyllotoxin use during pregnancy are lacking.OBJECTIVE To investigate the association between local podophyllotoxin exposure during pregnancy and risk of adverse fetal outcomes. DESIGN, SETTING, AND PARTICIPANTSThis cohort study obtained individual-level pregnancy data from various nationwide registries in Denmark from the study period of January 1, 1997, through December 31, 2016, resulting in a cohort of 1 650 649 pregnancies. Pregnancies with multiple records on overlapping dates and pregnancy records with implausible or missing information on gestational age were excluded. Local podophyllotoxin-exposed pregnancies were compared with unexposed pregnancies and matched in a 1:10 ratio according to propensity scores on a wide set of baseline characteristics. Five distinct study cohorts were constructed, one for each outcome analysis. Sensitivity analyses included a comparison of podophyllotoxin-exposed pregnancies with pregnancies with podophyllotoxin use only before pregnancy onset. Data analyses were performed from April 27, 2019, to June 26, 2019. EXPOSURES Filled prescription for local podophyllotoxin.MAIN OUTCOMES AND MEASURES Primary outcomes were major birth defects and spontaneous abortions. Secondary outcomes were preterm births, small-for-gestational-age (SGA) size, and stillbirths. Logistic regression was used to estimate the prevalence odds ratios (ORs) of major birth defects, preterm births, and SGA size, and Cox proportional hazards regression modeling was used to estimate hazard ratios (HRs) of spontaneous abortions and stillbirths. RESULTSThis study included 9229 pregnancies (mean [SD] maternal age at pregnancy onset, 27.7 [5.2] years) for the analyses of major birth defects and 18 590 pregnancies (mean [SD] maternal age at pregnancy onset, 26.4 [6.0] years) for the analyses of spontaneous abortions. Among the podophyllotoxin-exposed pregnancies, 29 infants (3.5%) were diagnosed with major birth defects, compared with 286 (3.4%) among the unexposed pregnancies. A total of 141 podophyllotoxin-exposed pregnancies (8.3%) ended in spontaneous abortion, compared with 1626 (9.6%) among the unexposed pregnancies. No statistically significant associations were found between podophyllotoxin exposure during pregnancy and major birth defects (prevalence odds ratio [OR], 1.02 95% CI, 0.69-1.50), spontaneous abortions (HR, 0.87; 95% CI, 0.73-1.04), preterm births (prevalence OR, 1.08; 95% CI, 0.86-1.35), SGA size (prevalence OR, 1.01; 95% CI, 0.85-1.22), or stillbirths (HR, 0.58; 95% CI, 0.18-1.86). Sensitivity analyses of the primary outcomes achieved similar results. CONCLUSIONS AND RELEVANCEFindings from this study suggest that podophyllotoxin use during pregnancy may be safe, as it did not appear to be associated with an increased risk of adverse fetal outcomes. These findings may help guide clinicians, patients, and drug regulatory authorit...

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Skin infections in pregnancy

Cited by 32 publications

References 96 publications

Position statement for the diagnosis and management of anogenital warts

Position statement for the diagnosis and management of anogenital warts

Congenital and perinatal viral infections and their consequences

Association Between Fetal Safety Outcomes and Exposure to Local Podophyllotoxin During Pregnancy

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