Successful treatment of genital warts with cidofovir cream in a pediatric patient with Fanconi anemia

Abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p> Patients with Fanconi anemia have an increased susceptibility to malignancies associated with human papillomavirus, and thus prevention and early management of human papillomavirus infections in this patient population are crucial. </jats:p></jats:sec><jats:sec><jats:title>Case report</jats:title><jats:p> A nine-year-old girl with Fanconi anemia developed genital warts about three years after undergoing haplo-identical stem cell transplant. The transplant was complicated by chronic graft-versus-host disease, and the patient had therefore received multiple immunosuppressants. The genital warts were treated with several creams, but minimal improvement was reported. </jats:p></jats:sec><jats:sec><jats:title>Management and outcome</jats:title><jats:p> Cidofovir was extemporaneously compounded into an unscented 1% moisturizing cream and applied daily at bedtime to the genital warts. By the end of treatment, the warts had been successfully treated, and no adverse events were reported. The patient is still free of any lesions at six months after completing treatment. </jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p> Although reports have been published on the use of cidofovir cream, most were in adults with non-genital warts. Cidofovir cream may be considered as a treatment option for refractory genital warts in pediatric patients. However, further studies are needed to better define the optimal preparation and dosing for such patient population. </jats:p></jats:sec>

Abordagens terapêuticas do Condiloma Acuminado em crianças e adolescentes

“…O Cidofovir tópico, apesar de também não ser formalmente recomendado para o tratamento de condiloma acuminado, foi utilizado em dois trabalhos 30,31 . Em um deles utilizou-se Cidofovir Creme 1% sobre as lesões de um paciente de nove anos diariamente 30 , enquanto no outro foi feita a mesma porcentagem em dois pacientes, de cinco e seis anos, mas em um utilizando-o uma vez ao dia e no segundo, duas vezes ao dia 31 , por durações variáveis de acordo com a resposta à terapia. O efeito adverso mais pronunciado foi a irritação local, mas a terapia mostrou-se eficaz na Abordagens terapêuticas do Condiloma Acuminado em crianças e adolescentes resolução das verrugas.…”

Severe Community-acquired Pneumonia Caused by Type 7 Human Adenovirus in Immuno competent Adults

“…Cidofovir has been proven to be effective in treating adenovirus pneumonia. [9,[22][23][24]. However, it is expensive, di cult to obtain in China, and has serious side effects, mainly including renal and hematological toxicity.…”

Cutaneous Applications of the Antiviral Drug Cidofovir: A Review

“…In a 9-year-old immunosuppressed pediatric patient with genital warts, cidofovir 1% cream was used following several failed topical therapies [45]. This patient suffered from Fanconi anemia and chronic graft-versus-host disease, and was being concurrently treated with several immunosuppressants (prednisolone, tacrolimus, and mycophenolate mofetil).…”

“…This patient suffered from Fanconi anemia and chronic graft-versus-host disease, and was being concurrently treated with several immunosuppressants (prednisolone, tacrolimus, and mycophenolate mofetil). She developed several papular genital verrucae, to which cidofovir 1% cream was applied daily until complete resolution was achieved after 2 months [45].…”