A 1-bp deletion in the MC04g1399 is highly associated with failure to produce fruit wart in bitter gourd

Fruit wart is an important appearance trait influencing consumer preferences of bitter gourd(Momordica charantia L.).The molecular genetic mechanisms underlying fruit wart formation in bitter gourd are largely unknown.In this study,genetic analysis based on four generations showed that fruit wart formation in bitter gourd was controlled by a single dominant locus named as Fwa.The Fwa locus was initially mapped into a 4.82 Mb region on pseudochromosome 4 by BSA-seq analysis and subsequently narrowed down to a 286.30 kb region by linkage analysis.A large F2population consisting of 2360 individuals was used to screen recombinants,and the Fwa locus was finally fine mapped into a 22.70 kb region harboring four protein-coding genes through recombination analysis.MC04g1399,encoding an epidermal patterning factor 2-like protein,was proposed as the best candidate gene for Fwa via sequence variation and expression analysis.In addition,a 1-bp insertion and deletion(InDel)variation within MC04g1399 was converted to a cleaved amplified polymorphic sequence(CAPS)marker that could precisely distinguish between the warty and non-warty types with an accuracy rate of 100%among a wide panel of 126 bitter gourd germplasm resources.Our results not only provide a scientific basis for deciphering the molecular mechanisms underlying fruit wart formation but also provide a powerful tool for efficient genetic improvement of fruit wart via marker-assisted selection.

Efficacy and safety of local candida immunotherapy in recalcitrant warts in pediatric kidney transplantation:A case report

BACKGROUND Warts are common in recipients of kidney transplantation(KT).Resistant warts which are not amenable to conventional therapies may lead to significant morbidity.Limited data exists on safety and efficacy of local immunotherapy among immunocompromised KT recipients.CASE SUMMARY We report a seven-year-old child who presented with recalcitrant plantar periungual warts in the early KT period.Immunosuppression consisted of tacrolimus,mycophenolate and steroid.Due to failure of conventional anti-wart therapies,he was treated with two sessions of intralesional(IL)candida immunotherapy along with liquid nitrogen cryotherapy leading to complete resolution of the warts.Interestingly,de novo BK viremia was seen about three weeks following the last candida immunotherapy.This required reduction of immunosuppression and other anti-BK viral therapies.Allograft function remained stable but there were donor specific antibodies detected.There also was elevated level of plasma donor derived cell-free DNA.A pneumocystis jirovecii pneumonia occurred ten months following completion of immunotherapy that was successfully treated with trimethoprim-sulfamethoxazole.During this ten-month follow-up period,there have been no recurrence of warts,and transplant kidney function has remained stable.CONCLUSION Stimulation of cell-mediated immunity against the human papilloma virus induced by the IL candida immunotherapy is thought to be a cause for wart resolution.With this therapy,whether it is necessary to augment the immunosuppression to prevent rejection is unclear as that may come with a risk of infectious complications.Larger,prospective studies in pediatric KT recipients are needed to explore these important issues.

Combination of Circumcision and Microwave in Treatment of Genital Warts in Uncircumcised Patients

Objective: To investigate the efficacy of combina-tion of circumcision and microwave on genital wartsin uncircumcised men. Methods: A randomized, prospective study of 109uncircumcised adult men with genital warts was con-ducted in a STD clinic in Zhanjiang, Guangdong. Onegroup (n=54) received microwave therapy only, whilethe other group (n=55) was taken the combination ofcircumcision and microwave therapy. The recurrenceswere observed at the end of months 3, 6 and 12, andoperative complications were also recorded. Results: There were no significant differences inthe mean age and duration of the disease between twogroups (P>0.05). No serious operative complicationswere documented. The recurrence rate in circumci-sion plus microwave group was markedly lower thanthat in microwave group (12.7% vs 29.6%, P<0.05),while the differences in early and late recurrencesbetween two groups showed no statistical significance(P>0.05). Conclusion: Circumcision can be safely performedunder local anesthesia in an outpatient setting. Com-bination of circumcision and microwave can produceexcellent effect as well as less tissue damage,therefore, it may be ideal for uncircumcised patientswith extensive condylomas.

Molecular Epidemiological Study on Prevalence of Human Papillomaviruses in Patients with Common Warts in Beijing Area

Objective To study the circulation, distribution, and genomic diversity of HPVs in common warts in Beijing area of China. Methods Forty eight patients with pathologically diagnosed common warts were screened for the presence of HPV with HPV type-specific PCR and direct sequencing analysis. The genomic diversity of HPVs prevalent in Chinese patients was analyzed based on LCR. Results Forty one （85.5%） samples were positive for HPV DNA, 13（31.7%）-HPV-57, 12（29.3%）-HPV-la, 7（17%）-HPV-27 and 5（12.2%）-HPV-2a. Four cases were infected with two different HPV types, two （4.9%） with HPV-la and HPV-27, one （2.4%） with HPV-1 and HPV-57 and one （2.4%） with HPV-27 and HPV-57. In contrast to the prevalence of single strain of novel HPV-57 variant and HPV-1 prototype, two HPV-2 and three HPV-27 novel variants were found to circulate in Beijing. Conclusion HPV-1, -2, -27 and -57 are predominantly prevalent in patients with common warts in Beijing.

Detection of HPV Types and Neutralizing Antibodies in Women with Genital Warts in Tianjin City,China

The serum samples and corresponding cervical swabs were collected from 50 women with genital warts from Tianjin city, China. The neutralizing antibodies against HPV-16, -18, -58, -45, -6 and -11 in serum samples were tested by using pseudovirus-based neutralization assays and HPV DNAs in cervical swabs were also tested by using a typing kit that can detect 21 types of HPV. The results revealed that 36% （18/50） of sera were positive for type-specific neutralizing antibodies with a titer range of 160-2560, of which 22%（11/50）, 12%（6/50）, 10%（5/50）, 4%（2/50）, 4%（2/50） and 2%（1/50） were against HPVs -6, -16, -18, -58, -45 and -1 l, respectively. Additionally, 60% （30/50） of samples were HPV DNA-positive, in which the most common types detected were HPV-68（18%）, HPV-16（14%）, HPV-58（12%）, HPV-33（8%） and HPV-6, HPV-11, HPV-18 and HPV-52 （6% each）. The concordance between HPV DNA and corresponding neutralizing antibodies was 56% （28/50） with a significant difference （P〈0.05）. The full-length sequences of five HPV types （HPV -42, -52, -53, -58 and -68） were determined and exhibited 98%-100% identities with their reported genomes. The present data may have utility for investigating the natural history of HPV infection and promote the development of HPV vaccines.

Primary intestinal lymphangiectasia with generalized warts

Primary intestinal lymphangiectasia(PIL) is a rare protein-losing enteropathy with lymphatic leakage into the small intestine. Dilated lymphatics in the small intestinal wall and mesentery are observed in this disease. Laboratory tests of PIL patients revealed hypoalbuminemia, lymphocytopenia, hypogammaglobulinemia and increased stool α-1 antitrypsin clearance. Cell-mediated immunodeficiency is also present in PIL patients because of loss of lymphocytes. As a result, the patients are vulnerable to chronic viral infection and lymphoma. However, cases of PIL with chronic viral infection, such as human papilloma virus-induced warts, are rarely reported. We report a rare case of PIL with generalized warts in a 36-year-old male patient. PIL was diagnosed by capsule endoscopy and colonoscopic biopsy with histological tissue confirmation. Generalized warts were observed on the head, chest, abdomen, back, anus, and upper and lower extremities, including the hands and feet of the patient.

Effects of shallomin and podophyllin solution 25% for genital HPV warts in women: a randomized controlled trial

Objective: To compare the effect of shallomin (pure fraction of Allium hirtifolium) with podophyllin 25% solution on external genital human papillomavirus warts in women. Methods: This study was a randomized controlled trial which was performed on two groups of 25 Iranian women with external genital warts at Imam Khomeini Hospital in Ahvaz, Iran. In the first group, shallomin was used once a day for six weeks at home. In the second group, 25% podophyllin solution, was applied on the lesion once weekly for six weeks. Results: Shallomin and podophyllin resulted in wart clearance in 13/23 (56.5%), and 12/24 (50%) of patients, respectively. The clearance rate for shallomin was not significantly different from that of podophyllin (P=0.082). Six weeks after the treatment, the sizes of the lesions in the shallomin group and the podophyllin group decreased by (1.43±0.53) mm and (1.64±0.70) mm, respectively. Conclusion: Shallomin is an effective treatment for genital warts, with similar efficacy to that of podophyllin.

Tuberculin as Intralesional Therapy for Viral Warts—Single-Blind, Split, Placebo, Controlled Study

Background: BCG vaccine as an antigen has proved its effectiveness as an immunotherapy for viral warts. Tuberculin is an antigenic extract of M. tuberculosis capable of eliciting an immunological skin reaction. Objective: To assess the efficacy of tuberculin intralesional injection in the treatment of viral warts. Patients and Methods: This single ,blind, placebo controlled study was conducted at the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from March 2010 to July 2011.Forty-one patients with different types of viral warts were enrolled in this study;tuberculin test was done to patients prior to instillation of intralesional treatment. Then the patients treated by intralesional tuberculin in each lesion located on the right side of the body, and intralesional distilled water in each lesion located on the left side of to a maximum of 3 injections, at 2 weeks interval or until full resolution of these lesions. Patients were evaluated every 2 weeks to assess the regression of their lesions and to record any local and systemic adverse effects. The response to treatment was evaluated by decrease in size and reduction in number of warts. Scoring of response to treatment was as follow: 1) Responders: including patients who showed complete cure or those with good response (>50% reduction). 2) Non responders: including patients who showed minimal response (<50% reduction), or those with no improvement (stable disease and disease progression). The follow up period lasted up to 2 months after the last dose. Results: Thirty out of 41 patients had completed the study, of them 14 (46.66%) patients showed response of their lesions on the right side of the body that were treated with tuberculin;15 patients showed no response, 1 patient showed minimal response, 7 patients showed good response and 7 patients showed complete cure (23.33%). Regarding the lesions treated with intralesional distilled water, 25 patients showed no response, 3 patients showed minimal response, 2(6.66) patients showed good response and no patient showed complete cure of their warts. Of the 14 responder patients to intralesional tuberculin, 10 patients were tuberculin tested positive, and 4 patients were tested negative, and of the 16 non responder patients to intralesional tuberculin, 3 patients were tuberculin tested positive, and 13 patients were tuberculin tested negative which was statistically significant difference. No side effects reported from tuberculin therapy apart from mild pain at site of injection. Conclusion: Intralesional injection of tuberculin is an effective therapy for viral warts when compared with control, possibly through its local immunological action and had no systemic immunological response. Patients with previous BCG vaccine showed better response to tuberculin injection.

Therapeutic Observation on Twenty－one Cases of Common Wart Treated by Acupuncture

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Genital Warts in Infants and Children <br>—Re-Evaluation of Podophylline 15% as an Effective Topical Therapy

Background: Condylomataacuminata is an infection caused by Human Papilloma Virus, rarely reported in infants and children. Podophylline as a treatment for this condition has been used cautiously in this age group. Objective: To report the cases of anogenital warts including condy lomataacuminata in infants and children and to evaluate the effectiveness and side effects of 15% podophyllin in treatment of genital warts. Patient and Methods: Thirty infants and young children were seen in Department of Dermatology and Venereology—Baghdad Teaching Hospital in this case descriptive and therapeutic trial, in the period from January 2011 to August 2012. Their ages ranged from 8 - 72 (30.43 ± 15.85) months, 20 females and 10 males with a female:male ratio of 2:1. The duration of the disease ranged from 1 - 12 (5.26 ± 4.00) months. All demographics data were recorded in this study. History and examination were carried out to all patients. Family members including mothers were assessed about the presence of any type of viral warts in other location of body. Podophyllin (15%) in tincture benzoin was applied once weekly to all viral warts and the parents advised to wash out after 2 hours of application. The number of applications was repeated until full recovery. Follow-up after recovery was carried out for 6 months to watch for any relapse and to record local or systemic side effects. Results: The clinical pictures were mostly acondylomata acuminata in a form of cauliflower like warts in 20 (73.33%) patients, while in 10 (26.77%) patients there were ordinary verruca vulgaris like warts. The location of warts was perianal in 23 (76.66%) patients, genital only in 2 (6.66%) patients, and mixed in 5 (16.66%) patients. Topical applications of podophyllin 15% gave a full recovery in 27 (90%) patients, while in 3 (10%) patients there was partial response. The number of applications ranged from 1 - 4 (2.7 ± 1.42) applications. Follow up for 6 months after recovery showed relapse in only one patient, and no side effects were reported in any patients. Conclusion: There is upsurge of cases of anogenital warts among infants and children. Podophyllin (15%) in tincture benzoin is an effective therapy and no local or systemic side effects were recorded in any case.

Tuberculosis of the Spine (L5, S1) Secondary to Scrofuloderma with Viral Warts in a 15-Year-Old Male

We report this case of a 15-year-old male who presented to the children outpatient clinic (CHOP) of Abia State University Teaching Hospital (ABSUTH), Aba on the 5th of November 2015. He had tuberculosis (TB) of the skin (scrofuloderma) which was not diagnosed and had received treatment other than anti-TB medication. He now presented 9 years after with multiple body discharging sinuses, cicatricial skin lesions, tuberculosis of the spine (L5, S1) with contracture of the Achilles Tendon and genital warts. Subsequent treatment with full anti-TB drugs led to resolution of his illness. A higher index of suspicion is required for early diagnosis of extrapulmonary TB. Prompt and adequate treatment with anti-TB medication ensures cure in such cases. Appropriate control program is also known to improve the outcome and reduce sequelae.

Managing Recalcitrant Warts: Facts about Bacillus Calmette-Guerin (BCG), Mycobacterium Indicus Pranii (Mw Vaccine), and Purified Protein Derivative (PPD) as Immunotherapy

Recalcitrant warts can accurately be defined as warts that persist after six months of conventional therapy. Up to one-third of non-genital warts, especially periungual and plantar warts, become recalcitrant. Traditional treatment options for warts include topical salicylic acid, cryotherapy, and electrocautery;however, patients with recalcitrant warts remain a major therapeutic challenge. There is evidence that immunotherapy can clear recalcitrant warts if traditional treatment fails. Given this, clinical studies published in PubMed and Google Scholar that used Bacillus Calmette-Guerin (BCG), Mycobacterium Indicus Pranii (Mw vaccine), and purified protein derivative (PPD) as immunotherapy for wart, were reviewed in this study. Neither of these treatments has been subjected to a randomized controlled trial, thus to date, there are no standardized protocols to use them. Our review highlights the scientific facts in the clinical applications of the previous options to treat recalcitrant warts and investigate the differences among them, concerning efficacy, adverse effects, dosage, and route of administration.

Treatment of Recalcitrant Viral Warts with Photodynamic Therapy with Mal and Red Light

Background: Photodynamic therapy (PDT) is a treatment for non-melanoma skin cancer. In recent years, its use has expanded to new indications. Viral warts (VW) are some of the most promising. Methods: A retrospective, descriptive, observational study was carried out. Patients who did not respond to cryotherapy were selected and were occluded with methyl aminolevulinate (MAL) for three hours and they were illuminated with red light. Tolerance to treatment was evaluated using a visual analog scale for pain (from 0 to 10). Results: A total of 15 patients with 134 VW were treated. A complete response was obtained in 13 of 15 patients (87%) and in 127 of 134 lesions (95%). The mean number of sessions was 3.1 (range 1 to 6) and the average pain score was 3.1 (range 0 to 8). Conclusions: PDT is a treatment that offers good results in the treatment of VW that are resistant to routine treatment. The treatment was well tolerated in our patient group.

Huge Recalcitrant Warts Treated with Pulse Dye Laser after Conventional Therapies and Others Destructive Physical Modalities Failed

Cutaneous infections with the human papilloma virus, despite being almost always asymptomatic, can induce slow-growing lesions knowed as warts that can remain subclinical for long periods of time. There are several therapeutical options namely keratolytics, retinoids, imiquimod, cryotherapy, electrosurgery, lasers and classic surgery, but none has antiviral effects. We describe the case of a patient with large warts located on the dorsal surface of the right hand, treated with cryotherapy, CO2 laser and topical imiquimod having either no clinical response or quick relapse. Treatment with PDL was started and after 13 sessions, the patient was without lesions, with a good cosmetic result and so far without relapse. This case report is relevant to us and deserves to be published because of the size of the lesions and the great response to PDL despite all the failures with the other treatments.

Local hyperthermia cleared multiple cutaneous warts on a nephrotic syndrome patient

Cutaneous warts are caused by human papillomavirus infection. Immunosuppressive state is one of the risk factors of human papillomavirus infection. A girl diagnosed of nephrotic syndrome and on immunosuppressive therapy developed multiple common warts. We treated her on a single lesion by local hyperthermia therapy at 44 ℃ for 3 consecutive days, each therapy lasted for 30 min. Ten days later, the patient received another 2 consecutive therapy. All lesions are completely resolved at the 9th week after the treatment. No recurrent sign was observed in a 3-mo follow-up. Side effects included burning sensation, stabbing pain at the target site during treatment.

Perianal verrucous epidermal nevus masquerading as warts

Verrucous epidermal naevus(VEN) is a rare form of epidermal naevus. We present a case of VEN occurring over the perianal region of a 7-year-old boy. The lesion was initially thought to be an area of chronic dermatitis; however it was refractory to treatment. Histopathology confirmed the diagnosis of VEN. VEN in the inguinogenital region may be misdiagnosed as flexural psoriasis, genital warts or sexual abuse. This is what precisely happened to our patient for a duration of more than 1 year.

Treatment comparison between warts and pigmental nevus by using new -type CO_2 laser

Objective To evaluate curative effect of new type CO2 laser on warts and pigmental nevus treatment. Methods Both of diseases were treated with the same therapy. We evaluated whether there was apparent difference in cure rate and treatment mean impulse times. In this project, there were 78 patients, among which, 26 cases suffered two diseases. Results Cure rate of warts was 94.2%and that of pigmental nevus was 73.1%. The former was higher than the latter apparently (P< 0.01). But the treatment mean impulse times had no difference (P >0.1). Conclusion One off cure rate of wart is higher than that of pigmental nevus.

化瘀去疣汤内服外用治疗对扁平疣患者中医证候、血清免疫球蛋白及复发的影响

目的:探讨化瘀去疣汤内服外用治疗对扁平疣患者中医证候、血清免疫球蛋白及复发的影响。方法:选取2021年8月~2023年8月收治的132例扁平疣患者,按照随机数表法分为观察组和对照组各66例,对照组采用常规药物治疗,观察组在对照组的基础上采用化瘀去疣汤内服外用治疗,比较两组临床疗效、中医证候积分(皮疹颜色、瘙痒感、身热口干、便干尿黄)、血清免疫球蛋白[IgG、IgA、IgM]、免疫细胞因子[IL-2、IL-10、IFN-γ]及复发率。结果:观察组总有效率高于对照组(P<0.05);治疗后,观察组的中医症候积分(皮疹颜色、瘙痒感、身热口干、便干尿黄)低于对照组(t=6.114;t=5.552;t=6.705;t=5.435,P<0.05);治疗后,观察组血清IgG、IgA、IgM水平高于对照组(t=4.056;t=3.630;t=5.918,P<0.05);治疗后,观察组血清IFN-γ、IL-2高于对照组,IL-10低于对照组(t=9.462;t=5.429;t=8.314,P<0.05);随访6个月,观察组复发率低于对照组(4.55%vs 16.67%,χ2=5.114,P<0.05)。结论:化瘀去疣汤内服外用治疗扁平疣患者的效果显著,可有效提高免疫球蛋白水平,改善免疫细胞因子,降低复发率。

手术联合5-盐酸氨基酮戊酸光动力治疗儿童甲周疣一例

甲周疣常规冷冻治疗常因疼痛和治疗次数多,导致患儿依从性极差,多次治疗也可能导致甲损伤。外科手术可以一次性去除肉眼可见疣体,但无法清除潜在病毒,皮损容易复发。有报道证实5-盐酸氨基酮戊酸光动力治疗可以清除潜在的病毒感染。本文报道一例甲周疣病史3年的患儿,手术去除疣体后,行4次5-氨基酮戊酸光动力治疗,末次治疗后21天创面完全愈合,术后随访半年未见复发。

浅层X线联合维A酸类药物治疗顽固性跖疣一例并文献复习

跖疣是发生于足底的寻常疣,治疗方法包括破坏性疗法、抗增生疗法、免疫疗法等。我们报道一例弥漫性、顽固性跖疣患者,曾应用冷冻治疗、激光治疗、药物治疗等均无效,经浅层X线一次联合维A酸类药物治疗,2个月后皮疹基本痊愈。