Penile warts: an update on their evaluation and management

Abstract

BackgroundPenile warts are the most common sexually transmitted disease in males. Clinicians should be familiar with the proper evaluation and management of this common condition.ObjectiveTo provide an update on the current understanding, evaluation, and management of penile warts.MethodsA PubMed search was completed in Clinical Queries using the key terms ‘penile warts’ and ‘genital warts’. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews.ResultsPenile warts are caused by human papillomavirus (HPV), notably HPV-6 and HPV-11. Penile warts typically present as asymptomatic papules or plaques. Lesions may be filiform, exophytic, papillomatous, verrucous, hyperkeratotic, cerebriform, fungating, or cauliflower-like. Approximately one-third of penile warts regress without treatment and the average duration prior to resolution is approximately 9 months. Active treatment is preferable to watchful observation to speed up clearance of the lesions and to assuage fears of transmission and autoinoculation. Patient-administered therapies include podofilox (0.5%) solution or gel, imiquimod 3.75 or 5% cream, and sinecatechins (polypheron E) 15% ointment. Clinician-administered therapies include podophyllin, cryotherapy, bichloroacetic or trichloroacetic acid, oral cimetidine, surgical excision, electrocautery, and carbon dioxide laser therapy. Patients who do not respond to first-line treatments may respond to other therapies or a combination of treatment modalities. Second-line therapies include topical/intralesional/intravenous cidofovir, topical 5-fluorouracil, and topical ingenol mebutate.ConclusionNo single treatment has been shown to be consistently superior to other treatment modalities. The choice of the treatment method should depend on the physician’s comfort level with the various treatment options, the patient’s preference and tolerability of treatment, and the number and severity of lesions. The comparative efficacy, ease of administration, adverse effects, cost, and availability of the treatment modality should also be taken into consideration.

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

“…[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. [6][7][8][9] Risk factors for the development of AGWs and oral warts include young age, early onset of sexual activity, multiple sexual partners, a history of sexual transmitted disease, tobacco use, failure to use condom, being uncircumcised. 2,4 Epidemiologic data and prevalence in childhood genital warts are still limited.…”

“…HPV types 6 and 11 are responsible for ap-from the lesions should be taken in order to rule out carcinoma. 4,6,8…”

“…Differential diagnoses include pearly penile papules, Fordyce spots, acrochordons, condylomata lata of syphilis, molluscum contagiosum, granuloma annulare, lichen nitidus, lichen planus, seborrheic keratosis, epidermal nevus, lymphangioma circumscriptum, lymphogranuloma venereum, scabies, syringomas, traumatic neuromas, schwannomas, and squamous cell carcinoma. 4,8…”

Coenzyme Q10, Zinc and MDA levels in verruca vulgaris

“…Various factors such as the strength of the skin barrier, viral titre and immunological responses of the patients play a role in the infection. The virus infects the epithelial basal cells and this situation triggers proliferation of epithelial basal cells [1,2]. Although various treatment options for verruca exist, it is occasionally resistant to treatment or may resolve spontaneously due to a natural immune response.…”

Viral metagenomics updated the prevalence of human papillomavirus types in anogenital warts

“…Thus far, over 200 types of HPV have been fully characterized and predominantly assigned into three genera: Alphapapillomavirus, Betapapillomavirus and Gammapapillomavirus [2,3]. Anogenital wart (AGW) is one of the most widespread sexually transmitted diseases caused by HPV, being generally associated with HPV6 and HPV11 [4,5]. Although many other HPV types including HPV 16,18,[30][31][32][33]35,39,[41][42][43][44][45][51][52][53][54][55][56], and 59 have also been detected in AGWs [6][7][8], the currently licensed HPV vaccines for AGW mainly provide protection against infections with HPV6 and HPV11 due to the fact that the two types of HPV accounted for more than 80% of the cases [9].…”