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.

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 treatment

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.

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 eondyloma aeuminatum （CA）, flow eytometry 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.

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 transformation into squamous cell carcinoma. Making choice of wide surgical excision and using interferon as antiviral and immunoenhancement for CA after operation, we obtain satisfactory functional and cosmetic results.

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.

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.

A Correlative Analysis of Cervical Lesions in Patients with Vulva Condyloma Acuminatum

OBJECTIVE To analyze the relation ship among vulva condyloma acuminatum, high-risk human papillomavirus (HPV) infections and cervical epithelium lesions. METHODS From May 2002 to April 2004 patients with vulva condyloma acuminatum were examined employing vulva biospy, colposcopy, high-risk HPV-DNA test and cervical bioscopy. RESUTS In 418 cases of vulva condyloma acuminatum, verified by pathologic analysis, high-risk HPV(+) infections were detected in 68.7%(287/418) of the cases. Among those patients, 20.6% (59/287) had concurrent subclinical cervical intraepithelial neoplastic (CIN) lesions. Among the high-risk HPV(-) 31.3 % (131), patients 7.6% (10/131) had concurrent subclinical CIN lesions. Pathological examination results: cervicitis, 167 (40.0%); cervical HPV infection, 182 (43.5%); CIN-I, 51 (12.2%); CIN-II, 16(3.83%); CIN-III, 2 (0.5%); cervical cancer, none. Another patient had vulva condyloma acuminatum with valva intraepithelial neoplasia (VIN) II^III. CONCLUSION It was concluded that simultaneous cervical HPV infection of many types was rather common in patients with vulva condyloma acuminatum. Vulva condyloma acuminatum is the chief clinical symptom which hints at a high possibility of infection with high-risk HPV. The patients are at high-risk for CIN and cervical cancer. We must pay more attention to the cervix in cases with vulva condyloma acuminatum.

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.

An Analysis of HPV Infection and Distribution in Cervical and Genital Samples With Condyloma Acuminatum:A Retrospective Study

Objective:Human papillomavirus(HPV)causes condyloma acuminata,which is one of the most widespread sexually transmitted diseases.This study was aimed to evaluate the prevalence of HPV infection and HPV genotype distribution in patients with condyloma acuminatum in Urumqi,China.Methods:A total of 835 cervical and genital samples were collected from outpatients treated for condyloma acuminatum between December 2016 and December 2018.HPV genotyping was performed with the HPV Genotyping Real-time PCR Kit for 23 different HPV types.Statistcal analysis was conducted using the chi-square test.Results:The total prevalence of HPV infection was 80.72%(674/835)in patients with condyloma acuminatum in Urumqi.The HPV genotypes were HPV-6(372/835,44.55%),HPV-11(180/835,21.56%),HPV-16(91/835,10.90%),HPV-43(65/835,7.78%),HPV-42(56/835,6.71%),and HPV-58(53/835,6.35%).Among HPV-infected individuals,49.11%(331/674)were infected by a single HPV subtype,while 50.89%(343/674)were infected by multiple HPV subtypes.The prevalence of HPV infection was higher in females(82.14%,276/336)than in males(79.76%,398/499)(χ^(2)=0.73,P=0.39),and higher in other ethnicities(86.36%,133/154)than in people of Han ethnicity(79.76%,541/681)(χ^(2)=3.866,P=0.049).The peak prevalence of HPV infection was observed in the age groups of 20-29 years and 30-39 years.Conclusion:HPV infection was detected in most patients with condyloma acuminatum in Urumqi with prevalence of 80.72%,and the most common HPV types were HPV-6,-11,-16,-43,-42,and-58.The detection of HPV genotypes is very important to monitor HPV infection so that effective treatment is administered to patients with condyloma acuminatum.

Im munomodulatory and Therapeutic Effect of Lentinan in Treating Condyloma Acuminatum

Objective: To observe the immunomodulatory and therapeutic effect of lentinan in treating condyloma acuminatum (CA). Methods: Thirty six CA patients were randomly divided into two groups, 19 in the treated group treated with lentinan and CO 2 laser irradiation, and 17 in the control group, treated with laser irradiation alone. Their T lymphocyte subsets of peripheral blood and level of serum interleukin 2 (IL 2) and soluble interleukin 2 receptor (SIL 2R) were determined before and after treatment, and the recurrence rates of the two groups were compared. Results: After treatment, in the treated group, the CD 4/CD 8 ratio, serum IL 2 raised and serum SIL 2R lowered significantly (P <0.05, 0.05, 0.05 respectively) as compared with before treatment, while those parameters were not changed significantly in the control group. The recurrence rate of the treated group was lower than that of the control group. P <0.05. Conclusion: Lentinan could modulate the cellular immunofunction of CA patients and reduce the recurrence rate of CA cases.

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

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尖锐湿疣患者恐惧疾病进展现状及影响因素

目的探讨尖锐湿疣患者恐惧疾病进展现状及相关影响因素。方法采用便利抽样法,选取从2021年12月至2023年1月在郑州大学第一附属医院确诊为尖锐湿疣的263例患者。采用患者一般资料调查表、中文版恐惧疾病进展简化量表、中文版痛苦表露指数量表、心理弹性量表简表等进行调查,使用SPSS 25.0中Spearman秩相关分析和多重线性回归分析影响尖锐湿疣患者恐惧疾病进展的相关因素。结果患者恐惧疾病进展得分为(38.21±5.64)分,心理弹性得分为[73.00(65.00,77.00)]分,自我表露得分为[35.00(31.00,39.00)]分,患者的心理弹性水平、自我表露水平、确诊时间、是否首次治疗是影响患者恐惧疾病进展水平的相关因素。结论关注病程较长的患者,在首次治疗时进行干预,促进患者自我表露,提高心理弹性水平,降低患者疾病进展的恐惧感。

尖锐湿疣与雌激素、孕激素相关性的研究进展

尖锐湿疣(CA)是一种以肛门生殖器部位增生性损害为主要表现的性传播疾病,其发病主要与HPV感染及机体免疫应答障碍相关。CA发病率女性高于男性,妊娠期高于非妊娠期,性激素可能与CA发生发展有关。本文就雌孕激素与尖锐湿疣的相关性作一综述,分析雌孕激素与尖锐湿疣在HPV感染及细胞免疫的Th1/Th2、Th17/Treg平衡等方面可能存在的联系,探讨雌孕激素在尖锐湿疣发病及复发中所起的作用,以期为尖锐湿疣的临床诊治提供新思路。

点阵二氧化碳激光联合光动力治疗肛门尖锐湿疣复发因素分析

目的:通过回顾性分析点阵二氧化碳(carbon dioxide,CO_(2))激光联合5-氨基酮戊酸光动力疗法(5-aminolevulinic acid photodynamic therapy,ALA-PDT)治疗肛门尖锐湿疣(condyloma acuminatum,CA)患者的临床资料,以评估影响术后复发的因素。方法:收集2015年4月─2022年12月间在南通大学附属南通第三医院皮肤科接受点阵CO_(2)激光联合光动力治疗的肛门CA患者,分为复发组和治愈组,分析两组患者的临床资料,采用Cox回归模型对患者的临床特征进行单因素及多因素回归分析。结果:56例肛门CA患者纳入分析,其中复发8例,未复发48例,复发率为14.28%。单因素及多因素Cox回归分析表明,点阵CO_(2)激光次数(>1次)与肛门CA复发呈正相关[HR=13.0,95%CI(2.1,79.9),P=0.006],不合并基础疾病与复发呈负相关[HR=0.1,95%CI(0,0.4),P=0.003]。结论:CO_(2)激光次数及合并基础疾病是点阵CO_(2)激光联合光动力治疗肛门CA复发的独立影响因素。

冷冻联合派特灵治疗尖锐湿疣的效果及对患者BFGF、PIAS1、Foxp3水平的影响

目的:探究冷冻联合派特灵对尖锐湿疣患者皮损处碱性成纤维细胞生长因子(BFGF)、激活STAT蛋白抑制因子1(PIAS1)、翼状螺旋转录因子P3(Foxp3)水平的影响。方法:选取100例2018年6月—2019年6月于常州市武进人民医院治疗的尖锐湿疣患者,随机数字表法将其分为对照治疗组及联合治疗组,各50例。对照治疗组采用冷冻治疗,联合治疗组采用冷冻联合派特灵治疗。对比两组γ干扰素(IFN-γ)、白介素-2(IL-2)、白介素-10(IL-10)水平、T淋巴细胞亚群、BFGF、PIAS1、Foxp3、性功能评价,治疗效果、复发情况等。结果:治疗后,与对照治疗组比较,联合治疗组IL-10、CD8^(+)、BFGF、PIAS1、Foxp3水平均低,IFN-γ、IL-2、CD4^(+)、CD4^(+)/CD8^(+)水平、性功能均高(P<0.05)。联合治疗组治疗总有效率高于对照治疗组,复发率低于对照治疗组(P<0.05)。联合治疗组总并发症发生率略高于对照治疗组,差异无统计学意义(P>0.05)。结论:冷冻联合派特灵可显著改善尖锐湿疣患者机体免疫功能、炎症反应,抑制BFGF、PIAS1、Foxp3表达,改善临床症状。

血清正五聚蛋白3、富亮氨酸α-2-糖蛋白1水平变化与尖锐湿疣复发的关系

目的探讨血清正五聚蛋白3(PTX3)、富亮氨酸α-2-糖蛋白1(LRG1)水平变化与尖锐湿疣(CA)复发的关系。方法选取2020年1月至2022年1月武汉市第一医院收治的120例CA患者(CA组)作为研究对象。根据患者治疗后复发情况进一步分为复发组(n=64)和无复发组(n=56)。选取同期健康体检者120例设为对照组。采用酶联免疫吸附试验法检测血清PTX3、LRG1水平。采用多因素Logistic回归分析CA患者复发的影响因素。采用受试者工作特征(ROC)曲线评价血清PTX3、LRG1及其联合对CA患者复发的预测效能。结果CA组PTX3、LRG1水平显著高于对照组(P<0.05)。与无复发组比较,复发组熬夜、避孕套使用、性伴侣人乳头瘤病毒(HPV)感染人数及白介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、PTX3、LRG1水平显著较高(P<0.05)。Logistic分析结果显示,IL-6、IL-1β、TNF-α、CRP、PTX3、LRG1均是CA复发的独立危险因素(P<0.05)。CA患者血清PTX3与LRG1呈正相关(r=0.680,P<0.05),PTX3与IL-6、IL-1β、TNF-α、CRP呈正相关(r=0.587、0.523、0.592、0.566,P<0.05),LRG1与IL-6、IL-1β、TNF-α、CRP呈正相关(r=0.547、0.508、0.559、0.531,P<0.05)。ROC曲线结果显示,血清PTX3、LRG1水平及二者联合预测CA复发的曲线下面积(AUC)分别为0.742、0.795、0.878,其中联合预测的AUC显著高于二者单独预测(Z=2.490、1.615,P<0.05)。结论CA患者血清PTX3、LRG1水平显著上升,其可增加CA复发的风险,均可作为CA复发的预测因子。

疏肝健脾解毒方辅助光动力疗法对女性尖锐湿疣患者HPV病毒载量及免疫调节的作用

目的观察疏肝健脾解毒方辅助光动力疗法对女性尖锐湿疣患者人乳头瘤病毒(HPV)病毒载量、免疫调节的作用。方法选取2022年3月—2022年10月收治的108例女性尖锐湿疣,随机数字表法分为2组,每组54例。2组均采取常规基础治疗,对照组配合光动力疗法,观察组配合疏肝健脾解毒方辅助光动力疗法,疗程3个月。观察2组临床疗效、HPV病毒载量、转阴率、干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、IL-10、T淋巴细胞亚群、MyD88信号通路蛋白表达[白细胞介素-1受体相关激酶-1(IRAK1)、IRAK4、肿瘤坏死因子受体相关因子6(TRAF6)]、女性性功能指数(FSFI)、尖锐湿疣生活质量评定量表(CECA10)评分及随访3个月复发情况。结果观察组总有效率96.30%(52/54)高于对照组81.48%(44/54)(P<0.05)。治疗1、3个月后,观察组HPV病毒载量、血清IL-10水平以及IRAK1、TRAF6、IRAK4表达量低于对照组,转阴率、CD3+、CD4+、CD4+/CD8+、血清IFN-γ和IL-2水平以及FSFI、CECA10评分高于对照组(P<0.05)。观察组复发率9.26%(5/54)低于对照组27.78%(15/54)(P<0.05)。结论疏肝健脾解毒方辅助光动力疗法对女性尖锐湿疣疗效显著,能降低HPV病毒载量,提高转阴率,抑制炎症反应及MyD88信号通路蛋白表达,调控机体免疫功能,阻断病情进展及复发。

基于网络药理学探讨派特灵治疗尖锐湿疣的作用机制

目的基于网络药理学研究外用派特灵治疗尖锐湿疣(CA)的作用机制。方法基于网络药理学的方法,经研究表明派特灵是主要由金银花、苦参、白花蛇舌草、鸦胆子、五倍子、蛇床子和大青叶等组成的中药复方制剂,通过中药系统药理学数据库与分析平台(TCMSP)数据库获取派特灵主要组成中药的活性成分与相应靶点;通过GeneCards数据库获得与CA相关的疾病靶点,取其基因与靶点交集制作韦恩图;通过STRING数据库和Cytoscape3.7.1软件共同构建蛋白互作网络(PPI),应用R语言下载安装Bioconductor数据库中的相关R包对交集得到的核心靶点进行相应的基因本体(GO)和京都基因与基因组百科全书(KEGG)富集分析。结果在TCMSP数据库共获取109个活性化合物,主要为β谷甾醇、鸦胆甙、槲皮素等,GeneCards数据库共获取疾病靶点74个,PPI网络分析显示共涉及前列腺素内过氧化物合酶-2(PTGS-2)、B细胞淋巴瘤/白血病-2(BCL-2)、过氧化物酶体增殖物激活受体-γ(PPAR-γ)、血管内皮生长因子-A(VEGF-A)、同期蛋白D1(CCND1)等15个核心蛋白,GO、KEGG富集分析显示派特灵可以通过各类癌症通路、人乳头状瘤病毒(HPV)感染、磷脂酰肌醇3激酶-蛋白激酶B(PI3K-Akt)、人巨细胞病毒感染信号通路等多途径、多靶点作用于CA。结论派特灵通过抗HPV病毒、调节免疫等方面达到治疗CA的目的。

中医药防治男性人乳头瘤病毒感染

人乳头瘤病毒(human papilloma virus,HPV)是最常见的性传播病毒之一。目前女性HPV感染的自然史及其后果研究甚多,但对男性相关HPV感染的流行病学报道相对较少。男性HPV感染与生殖器疣及阴茎癌、肛门周围癌、口咽癌等恶性肿瘤的发展密切相关,严重危害男性的身心健康。随着性观念的转变与性取向的多元化,男性HPV感染率呈逐年上升趋势。本文从HPV感染的现代医学研究、中医对男性HPV感染病症的认识、未病先防、既病防变等方面进行文献综述,为中医药防治男性HPV感染提供文献参考。