Treatment of Condylomata Acuminata Using a New Non-Vapor-Generating Focused Ultrasound Method following Imiquimod 5% Cream

Abstract

Condylomata acuminata is the most common sexually transmitted disease in the world. Physical treatments include excision, cryotherapy, electrocautery and ablative CO<sub>2</sub>, and Nd:YAG laser ablation, while topical treatments include imiquimod immunotherapy and antimitotic podophyllotoxin or sinecatechins. Efficacies of all methods are low, and recurrences are very common. A new combined method is presented as a single case in a 25-year-old male patient diagnosed with numerous condylomas on the penis, scrotum, and lower abdomen. The treatment consisted of a 7-week topical monotherapy using 5% imiquimod cream followed by local treatment with 20 MHz high-intensity focused ultrasound on remaining recalcitrant lesions. Results showed resolution of approximately 70% of the condylomas after imiquimod treatment, and full resolution of all recalcitrant condylomas treated subsequently with high-intensity focused ultrasound. The method is concluded to be safe and effective and, furthermore, presents a new physical method that does not generate airborne infectious human papillomavirus particles that pose a health risk for the medical team performing therapy. Further studies in larger populations are recommended to confirm the combined efficacy of the proposed method.

Treatment of Cutaneous Neurofibromas in Patients with Neurofibromatosis Type 1

“…treatment pain further, premedication in the form of topical analgesic cream or oral pain relief tablets has been successfully reported earlier [7,12], and this approach could therefore also be applied to pain-sensitive patients in this case.…”

“…The treatment is performed in a clinically simple procedure, where each individual cNF is covered by HIFU doses, in a session taking approximately 1 min per tumor. The treatment is thus performed with very similar methodology, dosing, and duration compared to previously reported cases on a range of other common dermatological lesions treated by HIFU [7][8][9][10][11][12].…”

“…While even lower pain level is always preferred, this reported moderate level would potentially allow for treatment of several tens of cNF in one single coherent session. To decrease treatment pain further, premedication in the form of topical analgesic cream or oral pain relief tablets has been successfully reported earlier [7, 12], and this approach could therefore also be applied to pain-sensitive patients in this case.…”

“…The device has earlier been demonstrated to provide safe and efficient treatment of other dermatological conditions, including basal cell carcinoma and Kaposi’s sarcoma [7], actinic keratosis [7, 8], seborrheic keratosis [9], superficial vascular tumors [10], and various papillomavirus [11, 12]. Pain levels have been reported to be tolerable without anesthetics, typically with a pain score around 3–6 on a 0–10 numerical rating scale.…”

Healing Process after High-Intensity Focused Ultrasound Treatment of Benign Skin Lesions: Dermoscopic Analysis and Treatment Guidelines

“…This approach offers a highly selective form of treatment, causing minimal damage to surrounding tissues while achieving effective tissue ablation [3]. The remarkable aspect of HIFU lies in its ability to create highly controlled and localized thermal and mechanical effects [4][5][6][7]. Moreover, the utilization of HIFU in dermatology has expanded with the introduction of a 20 MHz HIFU system, enabling the delivery of therapeutic focal points at the dermal and epidermal levels with high precision [8].…”