Unusual presentation of penile giant condyloma acuminatum with spontaneous prepuce perforation: A case report

BACKGROUND Giant condyloma acuminatum(GCA)is an uncommon condition affecting the anogenital area.CASE SUMMARY Here,we report an 88-year-old male patient who presented with a 5-year history of a progressive appearance of multiple cauliflower-like warts over his penile shaft,pubis region,and groin as well as urine leakage along the distal penile shaft.Physical examination revealed an ulcerative skin perforation with pus discharge under the distal prepuce base,which was initially suspected to be a urethral fistula.However,during surgery,it was discovered that the perforation was caused by a giant condyloma lesion that had obliterated the prepuce opening,with infection and high pressure causing subsequent skin perforation.He underwent circumcision and wide excision with electrocauterization of the warts.He was discharged after the surgery,and the residual lesion was treated with imiquimod and low-dose oral tegafur-uracil.CONCLUSION Penile GCA can cause prepuce perforation and can be postoperatively treated with imiquimod and low-dose oral tegafur-uracil.

Telomerase Activity in Condyloma Acuminatum Tissue with Different HPV Types

Summary: The telomerse activity in condyloma acuminatum (CA) tissue with human papillomavirus (HPV) types of 6/11 and 16/18 was detected to investigate the function of telomerase in the occurrence, development and carcinogenesis of genital CA. Forty-two biopsies from patients with gennital CA and 30 control tissue samples were tested for telomerase activity, HPV presence and types. The telomerase activity was determined by modified telomerase repeat amplification protocol (TRAP) assay and HPV typing by polymerase chain reaction (PCR) with typing-specific primers. Results showed that HPV-DNA was negative and the expression rate of telomerase was 16.7 % in all normal skin samples. All CA samples were positive for HPV (6/11 type was found in 32 cases, 16/18 in 3 and mixed type in 7). Telomerase activity was detectable in all CA patients. The telomerase activity in CA of 16/18 type was apparently higher than in CA of 6/11 type. It was concluded that the hyperplasia in CA might be increased as a result of HPV infection, suggesting that the activation of telomerase by HPV, especially by 16/18 type may play a role in the etiology and carcinogenesis of genital CA.

Anal carcinoma in giant anal condyloma, multidisciplinary approach necessary for optimal outcome:Two case reports and review of literature

BACKGROUND Anal cancers are caused by human papilloma virus(HPV). Buschke-Lowenstein tumor also known as giant anal condyloma(GCA) is a variant of giant neglected anal tumors arising from warts caused by HPV infection. HPV are a family of double-stranded DNA viruses and primarily cause sexually transmitted disease of the genitalia and oropharyngeal mucosa. These tumors are slow growing;locally destructive large verrucous masses.CASE SUMMARY We present a series of two cases with large anal tumors harboring invasive cancers and highlight their presentation and management. Tumors with high risk HPV subtypes(HPV 16, 18, 31, 33) may progress into invasive squamous cell carcinoma(SCC). Untreated GCA can attain enormous size and extend into the pelvic organs and bony structures. Some tumors show malignant degeneration into SCC and are often difficult to diagnose given the large size of the tumors.Complete surgical excision with negative margins is the treatment of choice and necessary to prevent recurrence. This is often not feasible and leaves large surgical wounds with tissue defects with delay in healing and increases postoperative morbidity. Pelvic reconstructive techniques including muscle flaps and grafts are often necessary to close the defects. Human immunodeficiency virus and immunocompromised patients generally do poorly with standard treatments.CONCLUSION A multidisciplinary team of colorectal and plastic surgeons, medical and radiation oncologists along with combination treatment modalities are necessary when malignant transformation occurs in GCA, for optimal outcomes.

The Efficacy of Podophyllin Cautery Added to Surgical Excision for Eradication of Vulvar Condylomata Accuminata;Randomized Controlled Trial

Context: Condyloma acuminatum is a common morbidity caused by human papillomavirus infection. Objective: To compare the recurrence rate after surgical excision with or without podophyllin cautery. Design, Setting, Participants: Sixty women were enrolled in a study that was conducted in Cairo from Jan-2017 to Mar-2018. Interventions: All women received the same preparations. After randomization;in the study group (N = 30), podophyllin cautery was added to surgical removal in the follow-up period. In the control group (N = 30), only surgical removal was used. Main Outcome Measure: The main outcome measure was the estimation of the recurrence of the lesion during the follow-up period. The secondary outcome measures were the incidence of adverse events. Results: Both groups were comparable (p-value > 0.05) with regard to the age and BMI. Recurrence was significantly lower (P = 0.001) in the study group than the control group. In the study group, five cases (17.2%) have recurrence whereas, in the control group, 18 (60.0%) had suffered recurrence. The ARR was 42.8% (CI 95%: 18% - 60.9%) with RR of 0.29 (CI 95%: 0.12% - 0.67%) and NNT2 (CI 95%: 6% - 2%). During the follow-up period, 19 cases (65.5%) of the study group experienced pain versus only eight cases (26.7%) in the control group (p = 0.003). However, the development of scars was less in the study group 7 (24.1%) than in the control group 19 (63.3%), (p = 0.002). Conclusion: Podophyllin cautery, when added to surgical removal, is effective in decreasing the incidence recurrence in cases with condylomata acuminata.

The Expression of Fas/FasL in Peripheral Blood Lymphocytes and the Level of IL-2 in Serum of Patients with Condyloma Acuminata

In order to investigate the role of the expression of the Fas/FasL in peripheral blood lymphocytes and the level of IL 2 in serum of patients with condyloma acuminata in the immune pathogenesis of CA, flow cytometry, indirect immunofluorescence labeling and ELISA were performed to detect the expression of the apoptotic regulatory proteins Fas/FasL in PBLC and the level of IL 2 in serum of 60 patients with different course of CA. The results showed that the expression of Fas/FasL in PBLC of the group of short course in CA was significantly higher than that of the normal controls ; the expression of Fas, FasL in PBLC of the group of long course CA was significantly higher than that of the group of short course and the normal controls ( P <0.05 and P <0.01, respectively); the level of IL 2 in serum of the group of short and long course CA was significantly lower than that of the group of normal controls ; the negative relation was revealed between the expression of Fas/FasL in PBLC and the level of IL 2 in serum of patients with CA . It was suggested that the abnormal apoptosis in PBLC and decreased level of IL 2 in serum of CA might play an important role in the course of CA.

THERAPEUTIC EFFECT IN 216 CASES OF ACNE,CHLOASMA,AND FLAT CONDYLOMA TREATED WITH MOULD-LIKE MASKS CONTAINING CHINESE DRUGS

Application of mould-like masks is oneof the external therapies recently used in thetreatment of common face-marring skindiseases.From December 1988 to June1989,our department treated 216 cases ofache,chloasma and flat condyloma by ap-plying respectively ache-removing,patch-dispelling,and wart-ehminatingmasks we made up by combining variousChinese drugs,and obtained fairly good re-sults.The work is reported as follows.

A comparative study on the angiogenic activity of condyloma acuminatum and basal cell carcinoma

Ａｃｏｍｐａｒａｔｉｖｅｓｔｕｄｙｏｎｔｈｅａｎｇｉｏｇｅｎｉｃａｃｔｉｖｉｔｙｏｆｃｏｎｄｙｌｏｍａａｃｕｍｉｎａｔｕｍａｎｄｂａｓａｌｃｅｌｌｃａｒｃｉｎｏｍａ（曾抗）；ＷａｎｇＲｕｉｓｈａｎ（王瑞善），ＷａｎｇＨｏｎｇｔａｏ（王鸿涛）；ＷｕＲａ...

CO_(2)LASER PLUS PHOTODYNAMIC THERAPY VERSUS CO_(2)LASER IN THE TREATMENT OF CONDYLOMA ACUMINATUM:A RANDOMIZED COMPARATIVE STUDY

To compare the efficacy and safety of CO_(2)laser plus 5-aminolevulinic acid(ALA)photodynamic therapy(PDT)with CO_(2)laser for the treatment of multiple condyloma acuminatum(CA),120 patients with multiple CA were allocated into two groups—combined group(CO_(2)laser plus ALA-PDT,n=60)and CO_(2)laser group(CO_(2)laser plus placebo-PDT,n=60).After CO_(2)laser,a 20%ALA or a placebo solution was applied to the CA area 3 h before illumination with red light(635 nm,100mW/cm^(2),80 J/cm^(2)).The treatment was repeated seven days after the first treatment if the lesions were not completely resolved.The complete response rate,recurrence rate and adverse effects in the two groups were analyzed.After two treatments,the complete response rates in the CO_(2)laser group and combined group were 100%(509/509)and 100%(507/507)in the CA(p>0:05),respectively.The recurrence rates in the CO_(2)laser group and combined group were 44.9%(229/509)and 10.6%(54/507)in the CA(p<0:05),respectively.The adverse effects in CO_(2)laser group was more than that in combined group.The combined group is a more effective treatment for multiple CA compared with CO_(2)laser group.T/S.Style the highlighted text as abstract.

Management of Giant Ano-Vulvar Condyloma in a Structure with Limited Resources

Buschke-Lowenstein Tumor (BLT) or Giant Acuminate Condyloma (GAC) is an uncommon clinical entity rarely published in Cote d’Ivoire and Africa. It is a viral infection with increasing sexual transmission due to the resurgence of HIV infection. This observation is the first case recorded in our service in three decades. The treatment is resolutely surgical, in our context of sub-medicalization, in the absence of other therapeutic means. Most of the time the progression is favorable, but the prognosis can be aggravated by the HIV coinfection. Through this observation, the authors insist on the prevention of all sexually transmitted infections, particularly, with HPV and HIV, by sexual education (abstinence, fidelity, port of condom) and the systematic vaccination before any sexual activity.

Anogenital Condyloma: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects of 74 Cases in Benin

The aim of this study was to study the epidemiological, clinical, therapeutic and evolutionary aspects of anogenital warts in Benin. A retrospective cohort study was conducted over a 4-year period from January 1st, 2013 to December 31st, 2016 at the Dermatology-Venerology Clinic of Cotonou. A total of 74 patients, including 67 men and middle aged 35.1 ± 10.3 years, were received for anogenital condyloma during the study period, accounting for 2.1% of the total and 28.2% of patients were received for sexually transmitted infection. The most common clinical form was acuminated condyloma (61 cases;82.4%). HIV serology was positive in 12 patients (16.2%). Therapeutically, the use of electrocoagulation was systematic in 80% of cases. The evolvement is noticeable when 37% of the cases were recidivated and the rate of loss of sight after the first consultation was 60.8%. Early diagnosis and improvement of the technical platform will help to improve the quality of care for these patients.

MICROSTRIP APPLICATOR FOR TREATMENT OF CERVICAL EROSION AND CERVICAL CONDYLOMA ACUMINATUM

This Paper introduces a microstrip applicator for treatment of cervical erosion and cervical condyloma acuminatum with microwave tissue coagulationmethod. The principle of the applicator,the theoretical calculation of near field distribution of the applicator covered with a lossy dielectric, the experimental resultsfor its performance of the impedance matching and for microwave leakage energyare reported. Finally,the therapeutic method and effects are presented.

Effect of hTERC and FOXP3 gene magnification in condyloma acuminate lesion on the immune response and cell apoptosis

Objective:To study the effect of hTERC and FOXP3 gene amplification in condyloma acuminate lesions on the immune response and cell apoptosis.Methods:The condyloma acuminate lesions diagnosed between May 2014 and October 2016 and the normal skin tissue from circumcision during the same period were collected to extract RNA and then determine hTERC, FOXP3 and apoptosis-related gene mRNA amplification, and after protein extraction, the protein levels of immune response-related cytokines were determined.Results:hTERC, FOXP3, Livin and Survivin gene mRNA amplification as well as IL-4 and IL-10 protein levels in condyloma acuminatum lesions were significantly higher than those in normal skin tissue while TRAIL, Caspase-3 and PDCD4 mRNA amplification as well as IL-2 and TNF-α protein levels were significantly lower than those in normal skin tissue;IL-2 and TNF-α protein levels in condyloma acuminatum lesions with high FOXP3 mRNA expression were significantly lower than those in condyloma acuminatum lesions with low FOXP3 mRNA expression while IL-4 and IL-10 protein levels were significantly higher than those in condyloma acuminatum lesions with low FOXP3 mRNA expression;Livin and Survivin mRNA amplification in condyloma acuminatum lesions with high hTERC mRNA expression were significantly higher than those in condyloma acuminatum lesions with low hTERC mRNA expression while TRAIL, Caspase-3 and PDCD4 mRNA amplification were significantly lower than those in condyloma acuminatum lesions with low hTERC mRNA expression.Conclusion:Highly expressed hTERC and FOXP3 genes in condyloma acuminatum lesions can inhibit apoptosis and inhibit antiviral immune response respectively.

The Lymphoblastoid Cell Lines of Recurrence Condyloma Acuminatum Patients Produce Lower Level of Tumor Necrosis Factor Stimulated with LPS

To study the mechanism of Condyloma acuminatum (CA) recurrence, and the association of CA recurrence with the ability of the host derived lymphoblastoid cell lines (LCL) stimulated by LPS to produce tumor necrosis factor (TNF), EBV-transformed B LCL were used as TNF producing cells The ability of LCL stimulated by LPS to produce TNF was measured by bioassay The results showed that the LCL from CA patients (including recurrent and non-recurrent CA patients) produced similar level of TNF stimulated by LPS to that of normal controls (29 54%±11 28% vs 34 31%±11 46%, P =0 1498) The LCL of CA recurrent patients produced significantly lower amount of TNF than that of non-recurrent CA patients (23 72%±7 41% vs 37 33%±11 10%, P =0 0032) Compared with the normal controls, CA recurrent patients showed a decreased ability to produce TNF (23 72%±7 41 vs 34 31%±11 46, P =0 0054), whereas CA non recurrent patients had the similar ability to the controls (37 33%±11 10 vs 34 31%±11 46, P =0 4914) It was concluded that the onset of CA was not relevant to the individual’s ability to produce TNF But the recurrence of CA was associated with the ability to produce TNF It was also indicated that the TNF involved cellular immunity might play an important role in the clearance of the residual HPV by the host after

Correlation between the Expression of Fas, Bcl-2 in Peripheral Blood Lymphocytes and the LeveL of IFN-γ,IL-4 in Serum of Patients with Condyloma Acuminata

In order to investigate the correlation between the expression of the apoptotic regulatory proteins (Fas, Bcl 2) in peripheral blood lymphocytes (PBLC) and the level of IFN γ and IL 4 in serum of the patients with condyloma acuminata (CA) in the immune pathogenesis of CA, indirect immunofluorescence labeling method of flow cytometer and solid sandwich ELISA method were performed for detecting the expression of Fas, Bcl 2 in PBLC and the level of IFN γ and IL 4 in serum of 60 cases of CA. The results showed the expression level of Fas in PBLC of CA was significantly higher than in the normal control group, but the expression level of Bcl 2 was significantly lower (both P< 0.01). The level of IFN γ in serum of CA was significantly lower than in the normal control group ( P< 0.01), but IL 4 was significantly lower (both P< 0.01). The expression of Fas in PBLC had a negative correlation with the level of IFN γ in serum of patients with CA, but had a positive correlation with the level of IL 4; The expression of Bcl 2 had a positive correlation with the level of IFN γ, but had a negative correlation with the level of IL 4. All the correlation coefficients had significant differerce by t test ( P< 0.01). It was suggested abnormal apoptosis in PBLC, the suppressed secretion of the THl associated cytokines (eg: IFN γ) and the increased secretion of the TH2 asssociated cytokines (eg: IL 4) existed in the patients with CA and might play an important role in the immune pathogenesis of CA.

Expression of MDM2 Protein and mRNA in Condyloma Acuminata

In order to investigate the role of murine double minute 2 (MDM2) in cell proliferation and carcinogenesis in condyloma acuminatum (CA), immunohistochemistry and in situ hybridization were used to detect the expression of MDM2 protein and mRNA in normal skin and skin lesions of CA of vulva. PCR was also used to detect HPV types. The results showed that in 32 observed CA specimens, the expression of MDM2 protein and mRNA was detected in 18(56.25 %)and 22(68.75 %)respectively, while the co-expression of MDM2 protein and mRNA was found in 14. PCR results revealed that HPV6/11 and HPV16/18 subtypes were shown in 28(87.5 %)and 4 (12.5 %)respectively out of 32 CA specimens. Out of the 18 positive specimens expressing MDM2 protein, HPV6/11 subtypes were shown in 15 and HPV16/18 subtypes in 3. In 22 positive specimens expressing MDM2 mRNA, HPV6/11 subtypes were shown in 18 and HPV16/18 subtypes in 4. No expression of MDM2 protein and MDM2 mRNA was observed in normal skin. Our study indicated that the overexpression of MDM2 might be involved in malignant proliferation and carcinogenesis of CA.

Expression of CD40 and CD40L on Peripheral Blood Mononuclear Cells in Patients with Condyloma Acuminatum

To observe the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with condyloma acuminatum (CA), flow cytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls (6.58 %±2.74 % vs 14.81 %±6.12 %, t=5.703, P<0.05); the average level of CD40L in CA patients was also significantly lower than that in the controls (0.73 %±0.54 % vs 2.67 %±2.43 %, t=3.532, P<0.05). Our resutls suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.

DIFFERENTIATION OF PSEUDOCONDYLOMA OF VULVA AND CONDYLOMA ACUMINATA BY DOT BLOT HYBRIDIZATION AND POLYMERASE CHAIN REACTION

ＤＩＦＦＥＲＥＮＴＩＡＴＩＯＮＯＦＰＳＥＵＤＯＣＯＮＤＹＬＯＭＡＯＦＶＵＬＶＡＡＮＤＣＯＮＤＹＬＯＭＡＡＣＵＭＩＮＡＴＡＢＹＤＯＴＢＬＯＴＨＹＢＲＩＤＩＺＡＴＩＯＮＡＮＤＰＯＬＹＭＥＲＡＳＥＣＨＡＩＮＲＥＡＣＴＩＯＮＬｉｕＹｕｅｈｕａ刘跃华；Ｗａｎｇ...

Changes of Circulating Platelet-Derived Growth Factor and Granulocyte Colony-Stimulating Factor in Patients with Condyloma Acuminatum

Objective: To study the expression levels of platelet-derivedgrowth factor (PDGF) and granulocyte colony-stimulatingfactor (G-CSF) in peripheral blood and their role in thepathogenesis of Condyloma acuminatum (CA). Methods: Sera were taken from 70 patients with Condylomaacuminatum and compared with 35 healthy controls. PDGFand G-CSF in serum were quantitated using a dual antibodysandwich enzyme-linked immunoabsorbent assay (ELISA). Results: Serum concentrations of PDGF and G-CSF weresignificantly increased in patients with Condylomaacuminatum (CA) compared to controls (P<0.001 and P<0.005respectively). Serum levels of PDGF and G-CSF correlatedwith clinical severity of CA, but no significant difference wasobserved between different duration of disease groups. Asignificant positive correlation was noticed between neutrophilcount and G-CSF levels ( γ=0.38, P<0.001), and the neutrophilcount showed no significant correlation with PDGF. Conclusion: The results indicated that increased expressionof PDGF and G-CSF in peripheral blood might be involved inpathogenesis of CA.

Perianal Giant Condyloma Acuminatum:A Case Report

Rare giant condyloma acuminatum (CA) reported by this paper is an interesting unusual case in China. Giant CA is a tumor that primarily affects the genital and perianal areas. Its feature is the high rate of local recurrence and

COMPARISON BETWEEN IMMUNOFLUORESCENCE AND PCR IN DETECTING HUMAN PAPILLOMA VIRUS IN CONDYLOMA ACUMINATA

Objective To compare the effectiveness of immunofluorescence and polymerase chain reaction (PCR) in detecting human papilloma virus (HPV) in condyloma acuminata (CA). Methods HPVs in CA tissues from 60 patients were detected by immunofluorescence and PCR, respectively. Different subtypes of HPVs were also identified with restriction fragment length polymorphism (RFLP). Results The positive detective rates of immunofluorescence and PCR were 56.67% (34/60) and 96.67% (58/60), respectively (P<0.01). RFLP results showed HPV6 and HPV11 were the main subtypes in the detected virus, which accounted for 98.28%. Conclusion The sensibility of PCR is superior to that of immunofluorescence.