A prospective, open, comparative study of 5% potassium hydroxide solution versus cryotherapy in the treatment of genital warts in men

Abstract

BACKGROUNDGenital warts are caused by human papillomavirus infection and represent one of the most common sexually transmitted diseases. Many infections are transient but the virus may recur, persist, or become latent. To date, there is no effective antiviral treatment to eliminate HPV infection and most therapies are aimed at the destruction of visible lesions. Potassium hydroxide is a strong alkali that has been shown to be safe and effective for the treatment of genital warts and molluscum contagiosum. Cryotherapy is considered one of the most established treatments for genital warts. No comparative trials have been reported to date on the use of potassium hydroxide for genital warts.OBJECTIVEA prospective, open-label, randomized clinical trial was conducted to compare topical potassium hydroxide versus cryotherapy in the treatment of genital warts affecting immunocompetent, sexually active men.METHODSOver a period of 10 months, 48 patients were enrolled. They were randomly divided into two groups and selected on an alternative basis for either potassium hydroxide therapy or cryotherapy. While response to therapy did not differ substantially between both treatment modalities, side effects such as local pain and post-treatment hypopigmentation were considerably more prevalent in the groups treated using cryotherapy.RESULTIn our study, potassium hydroxide therapy proved to be at least as effective as cryotherapy and offered the benefit of a better safety profile.CONCLUSIONTopical 5% potassium hydroxide presents an effective, safe, and low-cost treatment modality for genital warts in men and should be included in the spectrum of therapies for genital warts.

2019 IUSTI‐Europe guideline for the management of anogenital warts

“…However, the likely need for repeated clinic visits, with the associated healthcare costs, is a disadvantage. Clinical studies report clearance rates of 44-87% [58][59][60][61][62][63][64][65][66] and recurrence rates of 12-42% at 1-3 months and up to 59% at 12 months after clearance. 62 Several recent studies have compared wart clearance rates with cryotherapy against other treatments including trichloracetic acid (TCA), 66 imiquimod, 62 CO 2 laser 64 and potassium hydroxide.…”

Terapi kondiloma akuminata menggunakan asam trikloroasetat 80% dan kalium hidroksida 10% pada seorang lelaki yang berhubungan seksual dengan lelaki

“…Romiti et al mendapatkan efektivitas yang sama antara KOH 5% dengan KOH 10%, hanya saja efek iritasi didapatkan lebih ringan pada larutan KOH5%. 8,9,[18][19][20] Rekurensi pada KA biasanya terjadi pada 3 bulan pertama setelah pengobatan. Pasien sebaiknya secara rutin memperhatikan timbulnya lesi baru atau kekambuhan.…”

“…Pemeriksaan HRA memiliki sensitivitas 90%, spesifisitas rendah (19,23%), dengan positive predictive value 41,67% dan negative predictive value 75%. 13,[17][18][19][20][21] Pada kasus telah dilakukan pemeriksaan HRA dan tidak ditemukan kondiloma akuminata intraanal maupun tanda-tanda displasia.…”

Comparative Efficacy of 50% Trichloroacetic Acid Solution with 10% Potassium Hydroxide Solution in the Treatment of Plane Warts

“…Potassium hydroxide is a strong metallic base used in the diagnosis of fungal infections, Whiff test for bacterial vaginosis, treatment of male genital warts, and the treatment of molluscum contagiosum in children [14][15][16][17]. It acts by its keratolytic effects that lead to the destruction of virus-infected cells causing resolution of warts.…”