Anal Warts (Condylomata Acuminata) – Current Issues and Treatment Modalities

Abstract

HPV infections are currently the most frequent cause of genital infections in the USa. Risk factors are early onset of sexual activity, multiple sexual partners, a history STds, an early age of first pregnancy and tobacco use. In the past, HPV viruses were thought to be STds, but it is now known that penetration is not necessary. Skin-to--skin or mucosa-to-mucosa contact is enough to transmit the virus, which presents high tropism for those tissues. The Papillomaviridae family includes over 120 viruses, some of which have high malignant transformation rates. The most common malignancy connected to HPV is uterine cervix cancer and anal canal cancer. The range of morphology of perianal lesions means that a thorough clinical examination is required, including an anoscopy. Therapeutic modalities often seek to eliminate macroscopic changes rather than focus on the cause of the infection, which leads to a high recurrence rate. Externally located changes can be eliminated with patient-applied treatments. Those located in the anal canal and distal end of the rectal ampulla require treatment by a qualified medical provider. due to the high recurrence rate after standard treatment, special attention has been given to vaccinations. The polyvalent vaccine includes HPV viruses with both low and high malignant transformation risk. This has led to a decrease in the rate of malignancies (Adv Clin Exp Med 2014, 23, 2, 307-311). The Epidemiology and Biology of HPV Anal InfectionsThe Human Papilloma Virus (HPV) used to be thought of as one of the most common sexually transmitted diseases (STds) [1]. However, penetrative sexual contact is not in fact necessary to transmit the virus, which is predominantly transmitted by skin-to-skin or mucosa-to-mucosa contact [2]. The HPV family (Papillomaviridae) consists of more than 120 viruses presenting a tropism towards either the cutaneous or mucosa epithelium. The frequency of HPV infection has risen in the past 35 years, and this can be attributed to a decrease in the age of the first sexual contact as well as an increase in the number of sex partners [3]. HPV is the most common genital infection in the US, and the lifetime risk of at least one HPV infection in women is 75% [1,4]. The prevalence of anal HPV infection is very high: about 57% in HIV-negative men who have sex with men (MSM) [5]; and among HIV-positive men the infection rate is about 60 times higher than in the general male population [6]. Several risk factors for HPV infection have been identified: early onset of sexual activity, multiple sexual partners, a history of STds, an early age of first pregnancy and tobacco use [7].HPV penetrates skin or mucosa up to the basal membrane in search of keratinocytes (basal

Distribution of Human Papillomavirus Genotypes (2014–2016) in Women With Genital Warts at a Sexually Transmitted Disease Clinic in Beijing, China

“…Infection with 'high-risk' HPV is associated with the development of precancerous lesions [8]. Treatments on genital warts are mainly divided into medications and surgery, medications include imiquimod, podophyllin, podofilox and trichloroacetic acid, surgery include freezing with liquid nitrogen, electrocautery, surgical excision and laser treatments [9,10]. Although the short-time effect of above treatment is good, the transmission rate of the related HPV infection is as high as 65%, with a high risk of recurrence [7].…”

Normalization of regulatory T cells, serum TGF-β1, and LTN after 5-aminolevulinic acid-photodynamic therapy in patients with condyloma acuminate

“…The corrosive substances used in the drug therapy increase the damage to the normal skin around the warts, making it more difficult to treat. In addition, the limited penetration of drugs complicates the treatment of larger lesions and CA could easily reoccur (11,12). The 5-aminolevulinic acid photodynamic therapy was first developed by Canadian scholars in the 1990s.…”

Anogenital siğiller: İnsan papilloma virüsü, klinik bulguları ve tedavi stratejileri üzerine bir güncelleme

“…Skin-to-skin or mucosa-to-mucosa contact is enough for the transmission of the virus. [1][2][3][4][5][6][7] Human papilloma virus is the cause of not only benign diseases (anogenital condylomas) but also pre-malignant lesions and different cancers. [2][3] High-risk HPV subtypes (HPV 16 and HPV 18) are the causes of approximately 70% of invasive cervical cancer and it is estimated that 500,000 cases of cervical cancer occur each year worldwide.…”

“…AGWs also called as genital warts, anogenital condylomas or condylomata acuminata-are lesions that develop on the skin and mucosa due to infection with some types of HPV. [1][2][3][4] In this article, the epidemiology, etiology, clinical features of anogenital warts and treatment choices are reviewed in the light of current literature.…”