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Oral condyloma acuminatum (OCA) is a less prevalent subtype of condyloma acuminatum and is challenging to treat. We reported two cases of OCA successfully treated with 5-aminolevulinic acid photodynamic therapy (ALA-PDT). After three treatments spaced one week apart, both cases were completely cured without significant adverse reactions and were followed up for one year with no recurrence.

Oral condyloma acuminatum (OCA) is a less prevalent subtype of condyloma acuminatum and is challenging to treat. We reported two cases of OCA successfully treated with 5-aminolevulinic acid photodynamic therapy (ALA-PDT). After three treatments spaced one week apart, both cases were completely cured without significant adverse reactions and were followed up for one year with no recurrence.

Poorly controlled and long-standing hidradenitis suppurativa (HS) increases the risk of squamous cell carcinoma (SCC). We report a 54-year-old woman with an over 20-year history of HS, who had previously undergone wide perineal excision with secondary intention healing and presented with a painful verrucous vulvar plaque and proximal non-healing perineal wound. The patient had four perineal scouting biopsies performed and excisional biopsy with no evidence of high-grade dysplasia or carcinoma on histology. Chromogenic in situ hybridization was negative for HPV 16 and 18 mRNA; the patient's HIV and HSV PCR were also negative. Our patient was treated with interferon alfa-2b with notable clinical improvement. There is currently no standardized stepwise approach to monitoring verrucous lesions in HS patients with significant risk factors for SCC. Our report highlights a vigilant approach to monitoring. If scouting biopsies are negative, complete testing for high risk HPV strains (HPV 16 and 18) is warranted. If negative, we recommend follow up every 6 months with no further biopsies except if overt clinical changes are observed. We also recommend treatment of verrucous changes to decrease risk of possible malignant conversion. Interferon alfa-2b was effective in decreasing the verrucous lesion burden in our patient and may be considered.

Poorly controlled and long-standing hidradenitis suppurativa (HS) increases the risk of squamous cell carcinoma (SCC). We report a 54-year-old woman with an over 20-year history of HS, who had previously undergone wide perineal excision with secondary intention healing and presented with a painful verrucous vulvar plaque and proximal non-healing perineal wound. The patient had four perineal scouting biopsies performed and excisional biopsy with no evidence of high-grade dysplasia or carcinoma on histology. Chromogenic in situ hybridization was negative for HPV 16 and 18 mRNA; the patient's HIV and HSV PCR were also negative. Our patient was treated with interferon alfa-2b with notable clinical improvement. There is currently no standardized stepwise approach to monitoring verrucous lesions in HS patients with significant risk factors for SCC. Our report highlights a vigilant approach to monitoring. If scouting biopsies are negative, complete testing for high risk HPV strains (HPV 16 and 18) is warranted. If negative, we recommend follow up every 6 months with no further biopsies except if overt clinical changes are observed. We also recommend treatment of verrucous changes to decrease risk of possible malignant conversion. Interferon alfa-2b was effective in decreasing the verrucous lesion burden in our patient and may be considered.

A multitude of infectious diseases of viral (genital herpes, herpes zoster, genital warts and molluscum contagiosum), bacterial (syphilis, chancroid, lymphogranuloma venereum, donovanosis, erysipelas, cellulitis and necrotising fasciitis, folliculitis, impetigo, bartholin gland abscess, trichomycosis and erythrasma), fungal (candidiasis and dermatophytosis) and parasitic (pediculosis pubis) origin may affect the vulvar area. Herein, we review the infections and their skin manifestations in the vulvar area.

Background: We estimated the proportion of cervical intraepithelial neoplasia (CIN) cases attributed to 14 HPV types, including quadrivalent (qHPV) (6/11/16/18) and 9-valent (9vHPV) (6/11/16/18/31/33/45/52/58) vaccine types, by region. Methods: Women ages 15-26 and 24-45 years from 5 regions were enrolled in qHPV vaccine clinical trials. Among 10,706 women (placebo arms), 1539 CIN1, 945 CIN2/3, and 24 adenocarcinoma in situ (AIS) cases were diagnosed by pathology panel consensus. Results: Predominant HPV types were 16/51/52/56 (anogenital infection), 16/39/51/52/56 (CIN1), and 16/31/52/58 (CIN2/3). In regions with largest sample sizes, minimal regional variation was observed in 9vHPV type prevalence in CIN1 (~50%) and CIN2/3 (81-85%). Types 31/33/45/52/58 accounted for 25-30% of CIN1 in Latin America and Europe, but 14-18% in North America and Asia. Types 31/33/45/52/58 accounted for 33-38% of CIN2/3 in Latin America (younger women), Europe, and Asia, but 17-18% of CIN2/3 in Latin America (older women) and North America. Non-vaccine HPV types 35/39/51/56/59 had similar or higher prevalence than qHPV types in CIN1 and were attributed to 2-11% of CIN2/3. Conclusions: The 9vHPV vaccine could potentially prevent the majority of CIN1-3, irrespective of geographic region. Notwithstanding, non-vaccine types 35/39/51/56/59 may still be responsible for some CIN1, and to a lesser extent CIN2/3. © 2016 The Authors.

Risk of human papillomavirus (HPV) transmission during laser vaporisation of genital warts or loop electrode excision procedure is controversial. An oral rinse, a nasal swabs, history of HPV-related diseases and data on HPV exposure were collected from 287 employees at departments of dermato-venerology and gynaecology in Denmark. A mucosal HPV type was found among 5.8% of employees with experience of laser treatment of genital warts as compared to 1.7% of those with no experience (p=0.12). HPV prevalence was not higher in employees participating in electrosurgical treatment or cryotherapy of genital warts, or loop electrode excision procedure compared with those who did not. HPV 6 or 11 were not detected in any samples. Hand warts after the age of 24 years was more common among dermatology than among non-dermatology personnel (18% vs. 8.0% P=0.03). Mucosal HPV types are infrequent in the oral and nasal cavity of health care personnel, however, employees at departments of dermato-venereology are at risk of acquiring hand warts.

Introducción: el incremento de las notificaciones por el Papilomavirus Humano (PVH) en los centros de atención a portadores de EST, necesita ser estudiado con mayor profundidad por parte de los servicios que atienden pacientes con enfermedades sexualmente transmisibles. Objetivo: Comparar la magnitud y características clínicas/epidemiológicas de los portadores de condiloma/PVH con o sin infección por el VIH. Métodos: Se realizo un estudio Descriptivo de tipo transversal, con base en los historias clínicas elaboradas entre 1998 y 2000, de los pacientes de la ¿Unidad Mixta de Brasilia¿, que atiende pacientes para ETS/SIDA, de la Secretaria de Salud del Distrito Federal. Fueron estudiados los portadores de condilomas/PVH que conocían su status sorológico para la infección por VIH. Se analizaron las variables sexo, edad, grado de escolaridad, reincidencia de las lesiones y otras ESTs. Se aplicó el Chi cuadrado como prueba de significancia estadística. Resultados: De los 592 individuos analizados, el 75% eran del sexo masculino (444/592). Presentaron las dos patologías (PVH/condiloma/VIH+) el 16,9% de los pacientes analizados. El grupo etáreo de mayor riesgo para la co-infección fue el de 40-44 años, presentando una razón de prevalencia ocho veces mayor que los del grupo etáreo entre 20-24 años. La proporción de individuos con PVH/condiloma/VIH+ en los dos sexos, fue divergente, siendo mayor en las mujeres. Los individuos VIH+ presentaron mayor frecuencia de reincidencias, y de la misma manera, los de menor escolaridad muestran un mayor riesgo para adquirir PVH/Condiloma entre los VIH+, con diferencias estadísticamente significativas. No hubo significancía estadística en la comparación de portadores de ETSs asociados al PVH (clínico/subclínico) o VIH(+ -). Conclusión: La prevalencia de Condiloma/PVH y co-infección (PVH/condiloma/VIH+) entre los usuarios del servicio de ETS es elevada, tornándose necesario intensificar la vigilancia epidemiológica y el sistema de informac, Introduction: the increase in notifications of human papilloma virus (HPV) by sexually transmitted diseases (STDs) programs needs to be better assessed by these services. Objective: to compare the magnitude and the clinical/epidemicological characteristics of bearers of HPV condyloma, with or without infection by human immunodeficiency virus (HIV). Methods: a survey was carried out, from 1998 to 2000, on the charts of patients from the "Unidade Mista de Brasília", a reference center for STD/AIDS of the Department of Health, in Brasilia - Brazil, selecting those which were aware of their serological status for HIV. The variables gender, age, level of education, recurrence of the lesions and other STDs were analyzed. The statistical test applied was "chi-square" with a confidence interval of 95%. Results: 444 out of 592 individuals analyzed were male, 16,9% of which presented both HPV condyloma and HIV+. The age group for higher risk of co-infection was that of 40 to 44 years of age, presenting a ratio of prevalence eight times higher than that of the group 20 to 24 years of age. The proportion of individuals with HPV condyloma/HIV+ in both sexes diverged, being higher for women. The HIV+ individuals presented a higher frequency of recurrences and the lesser educated individuals presented a significantly higher risk to contract HPV condyiloma. No statistical relevance was found in the comparison between STD bearers associated to HPV (clinical and sub-clinical) and/or HIV (+ or -). Conclusion: the prevalence of HPV condyloma and co-infection (HPV condyloma/HIV+) among users of STDs services is high, making it necessary to intensify surveillance, system of information and the prevention of this disease.

ObjectiveOur purpose was to determine the feasibility of selective photosensitization of vulvar condylomas by use of tropical application of 5-aminolevulinic acid.Study designIn vivo fluorescence was assessed and biopsy specimens of condylomas were taken for fluorescence microscopy in 24 patients at different times after application of 2.5% 5-aminolevulinic acid ointment or 20% 5-aminolevulinic acid cream.ResultsBoth in vivo fluorescence imaging and fluorescence microscopy showed selective fluorescence of condylomas of the labia minora and vestibule only within short time intervals, because fluorescence of poorly keratinized normal epithelium was induced by both 5-aminolevulinic acid formulations. In non-hair-bearing skin, lesional fluorescence remained highly selective. Fluorescence microscopy showed that 90 minutes after drug application peak selectivity in epithelial lesional fluorescence was significantly higher with 2.5% 5-aminolevulinic acid ointment (4.5 +/- 0.9) than it was with 20% cream (2.1 +/- 0.2).ConclusionSelective fluorescence of vulvar condyloma acuminatum can be induced by nonselective topical 5-aminolevulinic acid application. Studies evaluating selective photodynamic destruction of condylomas are justified.

ObjectiveOur purpose was to determine the feasibility of selective photosensitization of vulvar condylomas by use of tropical application of 5-aminolevulinic acid.Study designIn vivo fluorescence was assessed and biopsy specimens of condylomas were taken for fluorescence microscopy in 24 patients at different times after application of 2.5% 5-aminolevulinic acid ointment or 20% 5-aminolevulinic acid cream.ResultsBoth in vivo fluorescence imaging and fluorescence microscopy showed selective fluorescence of condylomas of the labia minora and vestibule only within short time intervals, because fluorescence of poorly keratinized normal epithelium was induced by both 5-aminolevulinic acid formulations. In non-hair-bearing skin, lesional fluorescence remained highly selective. Fluorescence microscopy showed that 90 minutes after drug application peak selectivity in epithelial lesional fluorescence was significantly higher with 2.5% 5-aminolevulinic acid ointment (4.5 +/- 0.9) than it was with 20% cream (2.1 +/- 0.2).ConclusionSelective fluorescence of vulvar condyloma acuminatum can be induced by nonselective topical 5-aminolevulinic acid application. Studies evaluating selective photodynamic destruction of condylomas are justified.

type:text, We report the case of 3-year-old girl with condyloma acuminatum. She was brought to our clinic with pruritus, painful urination and foul discharge and treated with electrocautery. Histological examination revealed acanthosis, nuclear basophilic inclusions and vacuolar degeneration. In this case, transmission of the human papilloma virus might have occurred during close, nonsexual contact with the infected mother, and the depressed immune response associated with atopic dermatitis appears to have played an important role in the development of the condyloma acuminatum infection.

We report the case of 3-year-old girl with condyloma acuminatum. She was brought to our clinic with pruritus, painful urination and foul discharge and treated with electrocautery. Histological examination revealed acanthosis, nuclear basophilic inclusions and vacuolar degeneration. In this case, transmission of the human papilloma virus might have occurred during close, nonsexual contact with the infected mother, and the depressed immune response associated with atopic dermatitis appears to have played an important role in the development of the condyloma acuminatum infection.

We report the case of 3-year-old girl with condyloma acuminatum. She was brought to our clinic with pruritus, painful urination and foul discharge and treated with electrocautery. Histological examination revealed acanthosis, nuclear basophilic inclusions and vacuolar degeneration. In this case, transmission of the human papilloma virus might have occurred during close, nonsexual contact with the infected mother, and the depressed immune response associated with atopic dermatitis appears to have played an important role in the development of the condyloma acuminatum infection.

We report the case of 3-year-old girl with condyloma acuminatum. She was brought to our clinic with pruritus, painful urination and foul discharge and treated with electrocautery. Histological examination revealed acanthosis, nuclear basophilic inclusions and vacuolar degeneration. In this case, transmission of the human papilloma virus might have occurred during close, nonsexual contact with the infected mother, and the depressed immune response associated with atopic dermatitis appears to have played an important role in the development of the condyloma acuminatum infection.