Giant condyloma acuminate due human papilloma virus type 16 in an infant successfully treated with topical imiquimod therapy

Dinleyici, Meltem; Saracoglu, N.; Eren, Makbule; Kılıç, Ömer; Çiftçi, Evrim; Sağ, Çiğdem; Kara, Ateş

doi:10.4081/dr.2015.6134

Cited by 20 publications

(15 citation statements)

References 15 publications

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“…However, when studied for the treatment of molluscum contagiosum in children, while demonstrating no efficacy for this condition, neither were there any serious adverse events and local side effects were similar to those in adults. 4 Case reports and case series have reported successful treatment of AGW with imiquimod [5][6][7][8] which is consistent with our experience of treating these children, with full explanation and informed consent from the child (where appropriate and possible) and the person with parental responsibility for them.…”

Section: Finally What About Treatment?supporting

confidence: 72%

How to manage children with anogenital warts

Kingston

Smurthwaite²,

Dixon

et al. 2016

Sex Transm Infect

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Section: Finally What About Treatment?supporting

confidence: 72%

How to manage children with anogenital warts

Kingston

Smurthwaite²,

Dixon

et al. 2016

Sex Transm Infect

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“…Our results are in line with recent case reports of (giant) condylomas associated with HPV 16. 15,16 Interestingly, Sturegard et al 17 have found HPV 16 in 12.9% of 621 cytobrush samples collected from the surface of clinically diagnosed genital condylomas of mostly heterosexual patients from Malmö, Sweden. In 31 of 621 (5%) of the samples, HPV 16 was the only HPV type detected.…”

Section: Discussionmentioning

confidence: 99%

High-grade Dysplasia in Anogenital Warts of HIV-Positive Men

et al. 2016

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IMPORTANCE Human papillomavirus (HPV)-induced anogenital lesions are very frequent in men who have sex with men (MSM) who are HIV-positive (HIV+). Anogenital warts (AGWs) are considered benign lesions caused by low-risk HPV-types, whereas anogenital dysplasias are potential cancer precursors associated with high-risk HPV-types. Both types of lesions can usually be distinguished clinically. OBJECTIVE To describe a case series of HIV+ MSM with typical AGW that harbored different grades of dysplasia. DESIGN, SETTING, AND PARTICIPANTS For this retrospective virological analysis, we recruited 25 HIV+ MSM with AGWs (n = 38) harboring areas of dysplasia and 22 patients who were HIV-negative (HIV−) with AGWs seen between February 2013 and March 2015 at a tertiary dermatological referral center for anal cancer screening. Dysplasia-containing AGW tissue of HIV+ MSM were compared with randomly selected AGWs of patients who were HIV−. MAIN OUTCOMES AND MEASURES Histopathological analysis, immunohistochemical staining for p16 INK4a and Ki67, HPV-typing, and viral load determination in AGWs of HIV+ compared with patients who were HIV−. RESULTS Overall, 25 HIV+ MSM with AGWs (mean [SD] age, 47.3 [11.1] years) harboring areas of dysplasia and 22 patients who were HIV− (5 women, 17 men; mean [SD] age, 35.5 [12.8] years) with AGWs were included in this study. The 38 dysplasia-containing AGWs of HIV+ MSM harbored low-grade dysplasia in 6 cases (16%), high-grade dysplasia in 31 cases (81%), and areas of invasive anal carcinoma in 1 (3%) case. With the exception of 1 biopsy, all low-grade lesions were p16 INK4a-negative, whereas 25 of 31 (81%) AGWs with high-grade lesions or an anal carcinoma were p16 INK4a-positive. Only low-risk HPV-types were present in 11 samples (29%; 2 low-grade lesions and 9 high-grade lesions), low-risk and high-risk types were found in 19 samples (50%; 1 low-grade lesion and 18 high-grade lesions), and only high-risk HPV-types were present in 8 samples (21%; 3 low-grade lesions, 4 high-grade lesion, and 1 cancer-containing lesion). High low-risk HPV DNA loads were found in low-grade and high-grade lesions, while high high-risk HPV DNA loads were only found in AGWs harboring high-grade lesions. The 22 AGWs of patients who were HIV− showed no signs of dysplasia, and p16 INK4a-staining was always negative. All of these samples carried low-risk HPV types, and in 2 cases high-risk HPV-types were detected additionally. CONCLUSIONS AND RELEVANCE In contrast to immunocompetent patients, AGWs of HIV+ MSM may harbor high-grade dysplasia or even invasive squamous cell carcinoma. A substantial proportion of these lesions may only contain low-risk HPV-types. Anogenital warts in patients who are HIV+ should be evaluated histopathologically to exclude cancer precursors.

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“…Although imiquimod has been used in the past for treatment of BLT, excepting one case, that too of a vulvar BLT in a young woman, it was always combined with another modality (Table 1). [5][6][7][8][9][10] We successfully treated our patient, a noncandidate for surgery and oral retinoids, with 16 weeks of monotherapy with imiquimod resulting in complete lesional clearance and at least five-year relapse-free period. Although combination therapy remains the mainstay of treatment of BLT, standalone treatment with imiquimod may be attempted in a special case scenario.…”

Section: Discussionmentioning

confidence: 99%

Successful nonsurgical treatment of penile Buschke–Löwenstein tumor with 12 weeks of 5% imiquimod alone

Sonthalia¹,

Gandhi

Agrawal

et al. 2019

Int J STD AIDS

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Anogenital warts, also known as condylomata acuminata caused by human papillomavirus constitute the most common sexually transmitted infection. Rarely, the disease may evolve into a huge cauliflower-like growth called giant condyloma acuminatum or Buschke–Löwenstein tumor (BLT). In contrast with normal anogenital warts, BLT displays local invasion, lack of spontaneous resolution, posttreatment recurrence, and potential for malignant transformation. Although radical excision with split-thickness skin grafting is considered its first-line treatment, it is not always feasible. While many other treatments have shown variable success and recurrence rates, topical imiquimod 5%, a popular evidence-based therapy for warts has also been reported as an efficacious treatment for BLT. We present a case of penile BLT where the patient refused surgery but recovered completely with no recurrence at five years following 16 weeks’ therapy with topical 5% imiquimod. Excepting a single reported case, this might be another case where BLT resolved with imiquimod as a standalone therapy. We also present a succinct review of past cases of BLT treated with imiquimod.

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Giant condyloma acuminate due human papilloma virus type 16 in an infant successfully treated with topical imiquimod therapy

Cited by 20 publications

References 15 publications

How to manage children with anogenital warts

How to manage children with anogenital warts

High-grade Dysplasia in Anogenital Warts of HIV-Positive Men

Successful nonsurgical treatment of penile Buschke–Löwenstein tumor with 12 weeks of 5% imiquimod alone

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