Successful treatment of giant condyloma acuminatum with combination retinoid and interferon- γ therapy

Elkot

J of Cosmetic Dermatology

et al. 2018

Summary Background Treatment of recalcitrant warts represents a continuing therapeutic challenge. Combination therapies can help improve treatment response, decrease adverse effects, and reduce recurrence. Objective To compare the efficacy, safety and immunological effects of a combined acitretin‐intralesional Candida antigen against acitretin alone and Candida antigen alone for intractable warts. Methods Sixty adult patients with intractable warts were included in this study. Patients were subdivided into three groups, each containing 20 patients. Acitretin alone was taken by patients of group I, Candida antigen alone was injected in patients of group II, and group III received a combination of intralesional Candida antigen and acitretin. Serum cytokine levels of IL‐10 and IFN‐γ were measured before and after therapy in the studied groups. Results Total resolution of warts was achieved in 8 patients (40%) of the acitretin alone group, 9 patients (45%) of the Candida antigen alone group and 15 patients (75%) of the combination therapy group. The therapeutic response was statistically higher in the combined acitretin‐Candida antigen group as compared with either agent alone. Adverse effects were non‐significant in the three groups. There were no statistically significant differences in the serum levels of IFN‐γ and IL‐10 between responders and non‐responders after therapy in the three studied groups. Conclusion The combination therapy of acitretin + Candida antigen is superior to either agent alone. Serum cytokine levels of IL‐10 and IFN‐γ were not associated with clearance or persistence of warts in any of the studied groups.

Section: Discussionmentioning

confidence: 99%

Combination therapy versus monotherapy in the treatment of recalcitrant warts: A clinical and immunological study

Elkot

J of Cosmetic Dermatology

et al. 2018

“…In patients who decline surgery, a biopsy should be performed before initiation of the treatment to confirm the absence of squamous cell carcinoma, although some studies have demonstrated successful treatment of condyloma acuminata with oral retinoid and interferon gamma combination. 14 Cases with giant condyloma acuminata should be verified with computed tomography (CT) or magnetic resonance imaging for the presence of internal organ and lymph node involvement. 12,15,16 In patients with lymph node involvement, lymph node dissection should be performed, and the patient should be kept under oncological control.…”

Section: Discussionmentioning

confidence: 99%

Invasive squamous cell carcinoma originating from a giant penile condyloma

Sır

Güngör²,

Üçer

et al. 2016

Int J STD AIDS

In this case study, we present an unusual case with squamous cell carcinoma originating from a giant condyloma acuminata completely surrounding the penis. A 57-year-old circumcised heterosexual male patient presented with a penile lesion existing for 20 years. Incisional biopsy revealed acanthosis of the squamous epithelium. The patient was operated on under spinal anaesthesia. The lesion was resected circumferentially with macroscopic clearance, resulting in complete degloving of the penile shaft. Neurovascular bundles were preserved. The penile skin was constructed with a split thickness skin graft. Histopathological analysis of the lesion revealed an invasive and well-differentiated squamous cell carcinoma arising on a condyloma, and the surgical margins were free from tumour. The patient was staged as G2 T1 N0 M0 and was followed for one year. He did not have any erectile dysfunction and could engage in intercourse. Pelvic tomographic and physical examination findings did not reveal any episode of recurrence or metastasis. When encountering patients with giant condyloma acuminata, it should not be forgotten that it may be accompanied by squamous cell carcinoma. In addition, tissue excision should be as extensive as possible while keeping in mind the importance of the function. This is the first case of a penile-degloving surgery for giant penile condyloma, supporting conservative and preserving penile surgery for such tumours.

Serbian Journal of Dermatology and Venereology

“…A histopathological verification on the line of resection should be mandatory (23). In inoperable cases, radiotherapy, retinoids, interferon-γ and photodynamic therapy can be efficient, but the number of such reports is limited, therefore they are not widely accepted (24,25,26). In severe cases when the bone tissue is affected, amputation is the main therapeutic modality (7,8,19).…”

Section: Discussionmentioning

confidence: 99%

Verrucous Carcinoma of the Foot - Report of Two Cases

Lalošević¹,

Lekić

Gajić-Veljić

et al. 2016

Verrucous carcinoma (VC) is a rare variant of a well-differentiated squamous cell carcinoma (SCC) with a low grade of malignancy. Epithelioma cuniculatum (EC) is a subtype of VC, usually found on the sole of the foot. Two patients, a 55-year-old female, and a 77-year-old male, with VC were treated at the Clinic of Dermatology and Venereology, Clinical Center of Serbia, from 2002 to 2011. Both patients presented with a tumor on the foot. Incisional biopsies showed a well differentiated squamous cell carcinoma. Foot x-rays showed bone involvement in one case. One patient underwent surgical amputation of the lower extremity, while the other had a partial amputation of the affected foot. In the initial stage of the disease, it is difficult to distinguish pseudoepitheliomatous hyperplasia from verrucous carcinoma. The superficial biopsy of EC lesion may mislead to a histopathological diagnosis of warts or condylomas. Multiple deep biopsies are necessary for accurate and timely diagnosis of verrucous carcinoma.