Behandlung HPV-assoziierter analer Läsionen bei HIV-positiven Patienten – chirurgische Abtragung vs. topische Therapie mit Imiquimod

Websky, Martin W. von; Wesselmann, Paul; Schwarze‐Zander, Carolynne; Vilz, Tim O.; Stoffels, Burkhard; Boesecke, Christoph; Rockstroh, Jürgen K.; Kalff, Jörg C.; Pantelis, Dimitrios

doi:10.1055/a-0632-2017

Cited by 2 publications

(2 citation statements)

References 11 publications

(9 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In their follow-up study, Nadal et al had a complete remission rate of 46% after topical treatment [19]. Surgical treatment of anal condylomata or dysplasia seems to have a better outcome after 4 weeks compared to topical treatment with imiquimod, as we were able to show in a comparative study in 2018 [1]. When HPV-associated anal lesions have a considerable influence on the QoL, as we demonstrate here in HIV+ patients, a short and effective therapy is called for.…”

Section: Discussionsupporting

confidence: 55%

See 1 more Smart Citation

HPV-associated anal lesions in HIV+ patients: long-term results regarding quality of life

Wesselmann

Schwarze‐Zander

Boesecke

et al. 2020

Int J Colorectal Dis

Self Cite

View full text Add to dashboard Cite

Purpose HIV infection and concomitant HPV-associated anal lesions may significantly impact on patients' quality of life (QoL), as they are predicted to have negative effects on health, psyche, and sexuality. Material and methods Fifty-two HIV+ patients with HPV-associated anal lesions were enrolled in a survey approach after undergoing routine proctologic assessment and therapy for HPV-associated anal lesions if indicated over a time span of 11 years (11/2004-11/2015). Therapy consisted of surgical ablation and topic treatment. QoL was analyzed using the SF-36 and the CECA questionnaires. Results Fifty-two of 67 patients (77.6%) were successfully contacted and 29/52 provided full information. The mean age was 43.8 ± 12.8 years. The median follow-up from treatment to answering of the questionnaire was 34 months. Twenty-one percent (6/29) of the patients reported suffering from recurrence of condyloma acuminata, three patients from anal dysplasia (10.3%). In the SF-36, HIV+ patients did not rate their QoL as significantly different over all items after successful treatment of HPVassociated anal lesions. In the CECA questionnaire, patients with persisting HPV-associated anal lesions reported significantly higher emotional stress levels and disturbance of everyday life compared to patients who had successful treatment (71.9/100 ± 18.7 vs. 40.00/100 ± 27.4, p = 0.004). Importantly, the sexuality of patients with anal lesions was significantly impaired (59.8/ 100 ± 30.8 vs. 27.5/100 ± 12.2, p = 0.032). Conclusion HPV-associated anal lesions impact significantly negative on QoL in HIV+ patients. Successful treatment of HPVassociated anal lesions in HIV+ patients improved QoL. Specific questionnaires, such as CECA, seem to be more adequate than the SF-36 in this setting.

show abstract

Section: Discussionsupporting

confidence: 55%

“…According to the literature, topical treatment (imiquimod) and surgical ablation are equivalent first-line treatment options for HPV-associated anal lesions. While surgical therapy is associated with shorter treatment duration and better outcome [1] [2], topical treatment with imiquimod is less invasive and more cost-effective.…”

Section: Introductionmentioning

confidence: 99%

HPV-associated anal lesions in HIV+ patients: long-term results regarding quality of life

Wesselmann

Schwarze‐Zander

Boesecke

et al. 2020

Int J Colorectal Dis

Self Cite

View full text Add to dashboard Cite

show abstract

Multi-stage surgery combined with radiotherapy for treatment of giant anterior chest wall keloid

Liu

Yang

et al. 2020

Medicine

View full text Add to dashboard Cite

Rationale: Giant keloids often have indications for surgical resection, but postoperative reconstruction of the skin and high recurrence of keloids are a challenge for clinical treatment. This article reports a rare successful treatment of a giant keloid in the anterior chest wall by multistage surgery combined with radiotherapy, which is why this case is meaningful. Patient concerns: A 66-year-old woman presented a giant keloid with ulcerations and severe itching on the anterior chest wall. She had a history of keloid disease for more than 10 years, and had been treated by multiple operations, with no success. Diagnoses: The patient was diagnosed as keloid based on her history and symptoms. Histopathology findings supported our diagnosis. Interventions: We successfully excised the keloid after 5 operations and 2 rounds of electron-beam radiotherapy, which was applied at 24 hours after the 4th and 5th operation. Outcomes: There was no sign of recurrence over the follow-up period of 24 months. Lessons: The combination of multistage surgery and radiotherapy presents as a good choice for the treatment of giant keloids.

show abstract

Behandlung HPV-assoziierter analer Läsionen bei HIV-positiven Patienten – chirurgische Abtragung vs. topische Therapie mit Imiquimod

Abstract: Surgery is more effective than topical imiquimod as initial therapy of HPV-related anogenital disease in HIV-patients. A synergistic effect could not be demonstrated. On this basis, we recommend surgical treatment of C. ac. and AIN in HIV-patients as first line treatment.

Cited by 2 publications

References 11 publications

HPV-associated anal lesions in HIV+ patients: long-term results regarding quality of life

HPV-associated anal lesions in HIV+ patients: long-term results regarding quality of life

Multi-stage surgery combined with radiotherapy for treatment of giant anterior chest wall keloid

Contact Info

Product

Resources

About