Diabetes and genital warts: an unhappy coalition

Yong, Mellissa; Parkinson, Kathryn; Goenka, Niru; O'Mahony, Colm

doi:10.1258/ijsa.2010.010061

Cited by 18 publications

(27 citation statements)

References 13 publications

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“…These are duration of wart, site of wart, size of wart, type of wart, previous treatment, age of the patient, concomitant illness and smoking. 7 In this study, we found that patients with more than 30 years of age and chronic smokers have reduced the clearance rate of wart in group B and C. Similar to our study Horn et al has found significant correlation between age and clearance of wart. 8 On the contrary Gamil et al and Fahime Khozeimeh et al stated that age had no effect on the therapeutic response in immunotherapy treated warts.…”

Section: Discussionsupporting

confidence: 90%

Comparison of cryotherapy versus intralesional measles, mumps, rubella vaccine versus their combination therapy in Indian patients with cutaneous wart: a single centre prospective observational study

Vanarase

2019

Int J Res Dermatol

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Background: Need for more effective and less time consuming therapeutic method is current necessity for treatment of cutaneous warts. The objective of the study was to evaluate and compare the efficacy, safety of cryotherapy versus intralesional measles, mumps, rubella (MMR) vaccine versus combination of cryotherapy and intralesional MMR vaccine in Indian patients with cutaneous wart.Methods: This prospective observational study was conducted in 60 patients of cutaneous warts. Patients were divided into three groups viz., group A, group B and group C. Group A was treated with cryotherapy alone, Group B received intralesional injection 0.1 to 0.3 ml of MMR vaccine alone and Group C received combination of group A and group B therapy. In each group treatment was repeated at 3 week interval for a maximum of 4 sittings. Percentage of improvement was evaluated using visual analogue scale (VAS) for local as well as distant (non-inoculated) warts. Follow-up was made every 2 months till 4 months to detect any recurrence.Results: For local warts in second half of treatment (12th week) patients of Group B and Group C showed significantly better response than patients in Group A. For distant warts in first half of treatment session patients showed significantly better response to Group C than as compared to Group B therapy (p<0.039).Conclusions: Immunotherapy with MMR is superior treatment than cryotherapy for cutaneous warts with minimum side effects but the combination of cryotherapy with intralesional MMR has shown to have complementary effect in treatment response.

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Section: Discussionsupporting

confidence: 90%

Comparison of cryotherapy versus intralesional measles, mumps, rubella vaccine versus their combination therapy in Indian patients with cutaneous wart: a single centre prospective observational study

Vanarase

2019

Int J Res Dermatol

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“…Guidance for daily practice situations and the subsequent action that can be taken are shown in Table …”

Section: Methodsmentioning

confidence: 99%

“…• Determine if the patient has other conditions, such as diabetes, which are associated with more extensive AGW and recurrences that may require prolonged treatment 80 • More ablation and prolonged imiquimod courses may be required • It is recommended not to use imiquimod if there is eczema, psoriasis or other dermatoses in the genital area 77 to pre-treat the AGW with an immunotherapy for 2 months to see whether an immune response can be stimulated. If the warts are still present following this treatment, an ablative technique can be used to remove the AGW.…”

Section: Heavy Cigarette Smokingmentioning

confidence: 99%

“…Guidance for daily practice situations and the subsequent action that can be taken are shown in Table 4. 3,8,12,16,23,26,30,50,54,56,62,66,[72][73][74][75][76][77][78][79][80] Preventing AGW Anogenital warts can now be effectively prevented using the quadrivalent (HPV 6, 11, 16 and 18) or nanovalent (HPV 6, 11, 16, 18, 31, 33, 45, 52 and 58) HPV vaccines; these protect against HPV types that cause AGW, cervical cancer and other types of anogenital and oral cancer. The HPV quadrivalent vaccine has shown to be up to 100% effective in preventing AGW in association with vaccine-type HPV in women.…”

Section: Guidance For Daily Practice Situationsmentioning

confidence: 99%

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Position statement for the diagnosis and management of anogenital warts

O'Mahony

Gomberg

Skerlev

et al. 2019

Acad Dermatol Venereol

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Background Anogenital warts ( AGW ) can cause economic burden on healthcare systems and are associated with emotional, psychological and physical issues. Objective To provide guidance to physicians on the diagnosis and management of AGW . Methods Fourteen global experts on AGW developed guidance on the diagnosis and management of AGW in an effort to unify international recommendations. Guidance was developed based on published international and national AGW guidelines and an evaluation of relevant literature published up to August 2016. Authors provided expert opinion based on their clinical experiences. Results A checklist for a patient's initial consultation is provided to help physicians when diagnosing AGW to get the relevant information from the patient in order to manage and treat the AGW effectively. A number of frequently asked questions are also provided to aid physicians when communicating with patients about AGW . Treatment of AGW should be individualized and selected based on the number, size, morphology, location, and keratinization of warts, and whether they are new or recurrent. Different techniques can be used to treat AGW including ablation, immunotherapy and other topical therapies. Combinations of these techniques are thought to be more effective at reducing AGW recurrence than monotherapy. A simplified algorithm was created suggesting patients with 1–5 warts should be treated with ablation followed by immunotherapy. Patients with >5 warts should use immunotherapy for 2 months followed by ablation and a second 2‐month course of immunotherapy. Guidance for daily practice situations and the subsequent action that can be taken, as well as an algorithm for treatment of large warts, were also created. Conclusion The guidance provided will help physicians with the diagnosis and management of AGW in order to improve the health and quality of life of patients with AGW .

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“…For instance, patients with T2D are at increased risk of HPV-associated cancers, including cervical cancer and head and neck cancer 18–20 . Moreover, diabetic patients develop more extensive HPV-related genital warts and they are more prone to disease recurrence as compared to non-diabetic subjects 21 . In addition to epidemiological observations, our group has successfully shown that diabetes could act as a co-factor to promote HPV-driven tumorigenesis in db/db mice bearing CUP-1 (HPV-16 E7 transformed) xenograft 22 .…”

Section: Discussionmentioning

confidence: 99%

Exendin-4 Exhibits Enhanced Anti-tumor Effects in Diabetic Mice

Law

Wong

Chan

et al. 2017

Sci Rep

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Type 2 diabetes (T2D) is associated with increased risk of cancers. In this connection, we previously demonstrated the promoting effect of diabetes on HPV-associated carcinogenesis using a xenograft model in db/db diabetic mice. The underlying mechanism of this observation might be partly contributed by dysregulated immune response in diabetes. In this study, we hypothesized that the impaired anti-tumor immune response in diabetic status could be modulated by exendin-4, a glucagon-like protein receptor agonist which exhibits anti-diabetic effects. We inoculated 10-week old db/db mice with 2 × 107 CUP-1 cells (Human Papilloma Virus (HPV)-16 E7 transfected continuous cell line) subcutaneously underneath the scruff, and treated mice with high (30 nmol/kg) or low (10 nmol/kg) dose of exendin-4 for 13 days. Compared with control groups, exendin-4 suppressed subcutaneous tumor growth in a dose-dependent manner, accompanied by increased interferon (IFN)-γ secreting CD8+ cytotoxic T lymphocyte (CTL)/Foxp3+ regulatory T cell (Treg) ratio as well as Th1 proinflammatory cytokines IFN-γ and IL-2. Collectively, these findings suggested an anti-tumor effect of exendin-4 in diabetic conditions, which might be resulted from direct immunomodulation.

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Diabetes and genital warts: an unhappy coalition

Cited by 18 publications

References 13 publications

Comparison of cryotherapy versus intralesional measles, mumps, rubella vaccine versus their combination therapy in Indian patients with cutaneous wart: a single centre prospective observational study

Comparison of cryotherapy versus intralesional measles, mumps, rubella vaccine versus their combination therapy in Indian patients with cutaneous wart: a single centre prospective observational study

Position statement for the diagnosis and management of anogenital warts

Exendin-4 Exhibits Enhanced Anti-tumor Effects in Diabetic Mice

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