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Background and Aim Human papilloma virus‐associated anal intraepithelial neoplasia (AIN) precedes most anal cancers and can be detected at colonoscopy. We aimed to quantify AIN detection rates in a general population undergoing colonoscopy. Methods A retrospective review of a community‐based practice for 2 years until December 2019 was conducted. Results A total of 2525 patients (1051 males and 1474 females; median age 59 years) had 2608 colonoscopies. Ten patients (two males and eight females; median age 57.5 years) had incidentally detected AIN (condyloma acuminatum or AIN1, n = 4; AIN2 or 3, n = 6). AIN was detected in 1 of 261 (95% CI 1/142–1/480) colonoscopies and 1 of 163 (95% CI 1/83–1/321) colonoscopies in women over 40 years old. Conclusions Opportunistically detecting AIN, especially in women over 40 years old, should be an important adjunct to colonoscopy‐based colorectal neoplasia detection., Human papilloma virus‐associated anal intraepithelial neoplasia (AIN) precedes most anal cancers and can be detected at colonoscopy. We aimed to quantify AIN detection rates in a general population undergoing colonoscopy. A retrospective review of a community‐based practice for 2 years until December 2019 was conducted. A total of 2525 patients (1051 males and 1474 females; median age 59 years) had 2608 colonoscopies. Ten patients (two males and eight females; median age 57.5 years) had incidentally detected AIN (condyloma acuminatum or AIN1, n = 4; AIN2 or 3, n = 6). AIN was detected in 1 of 261 (95% CI 1/142–1/480) colonoscopies and 1 of 163 (95% CI 1/83–1/321) colonoscopies in women over 40 years old. Opportunistically detecting AIN, especially in women over 40 years old, should be an important adjunct to colonoscopy‐based colorectal neoplasia detection.

Background: The aim of this study is to evaluate effectiveness and safety of the use of ablative Er:YAG laser for removal of external genital warts (EGW), also called condylomata acuminata (CA).Methods: This is a retrospective cohort study performed at Gynecology Clinic Juna in Ljubljana, Slovenia. All patients older than 18 years that were clinically diagnosed with EGW and were treated with ablative Er:YAG laser between January 2012 and December 2017 were included in the study.Results: A total of 133 female patients (mean age 39.6 ± 12.9 years, range: 19–80) with EGW were eligible to be included in this study. EGW have been present from one to seven months, with a mean presence of 2.1 ± 2.0 months. The majority of the warts were on the labia, major some also on the mons pubis. The size of the lesions was 2–8 mm. The majority of patients, who completed therapy (74 patients out of 116; 64 %) received only one treatment and 82 % of the patients (n = 95) showed complete clearance of the lesions, without recurrence observed to date of analysis. Complete clearance was achieved after an average of 1.33 treatment sessions. Recurrence was reported by 21 patients (18 %). Recorded adverse effects of laser treatment were mild and transient.Conclusion: Er:YAG laser removal of EGW is a simple, quick and safe procedure, particularly suitable for large volume EGW or those that are located in anatomical sites difficult to access by other techniques.

Introduction: An imbalance in type 1 (Th1) and type 2 (Th2) T helper cells is associated with the development and recurrence of condyloma acuminatum (CA); however, the mechanisms underlying this imbalance remain unknown. We investigated soluble fibrinogen-like protein 2 (sFGL2), which is an effector of regulatory T cells (Tregs), to determine its role in the Th1/Th2 imbalance of CA. Methodology: Lesion and blood samples were obtained from 30 CA patients, and these samples were compared with genital skin and blood samples from 20 control subjects. Serum sFGL2, mRNA, and protein levels were estimated using ELISA, quantitative real-time polymerase chain reaction, and western blot, respectively. Immunohistochemical analyses were also conducted. Results: Compared to controls, CA patients had decreased serum sFGL2 levels. However, sFGL2 mRNA and protein levels in the lesions of CA patients were significantly increased. Interleukin (IL)-4 and Foxp3 mRNA levels were upregulated, and interferon (IFN)-γ levels were downregulated in CA patients compared to those in controls. Additionally, the sFGL2 mRNA level positively correlated with Foxp3 and IL-4 levels and negatively correlated with IFN-γ and IL-17 levels. Conclusion: sFGL2 contributes to the underlying Th1/Th2 imbalance in CA pathogenesis.

Both HIV/AIDS and Sexually Transmitted Infection (STI) are transmitted through sexual activites making a parallel port of entry making the two condition increase the each other’s transmission which results as an impact to progression of HIV infection. This study aims to determine the characteristics of HIV/AIDS patients co-infected with sexually transmitted infections in H. Adam Malik General Hospital Medan between 2017 and 2018. This study is a descriptive observational study of 2422 HIV/AIDS patients attending H. Adam Malik General Hospital. Of those, 62 patients were diagnosed with STI coinfection. The majority of patients were male (85,5%) aged within the group of 25 – 49 years old (80,6%), had the level education of high school (88,7%), mostly were entrepreneurs (50%), and were single (59,7%). Most of the patients were already in their Stadium III (80,6%) clinical stage and had CD4+ count < 200/mm3 (51,6%). Condyloma acuminatum (35,5%) was found as the most common type of STI coinfection, and followed by Hepatitis B (33,9%).Based on anamnesis history, behavioral risk factors (66,1%) was the most frequent risk factor

Background Condyloma acuminatum (CA) is both highly infectious and frequently recurring and requires long-term, repeated treatments, which seriously affect the physical and psychological health of patients. The purpose of the present study was to investigate the effectiveness of a combination therapy of traditional Chinese medicine and CO2 laser on CA and the relationship between CA relapse and cellular immunity. Methods The study cohort consisted of 160 CA patients who underwent ambulatory treatment between January 2017 and January 2019 in the Department of Dermatology and Venerology of our hospital. The 160 patients were randomly divided into two groups: a combination therapy group (80 cases), who underwent CO2 -laser treatment followed by three courses of oral traditional Chinese medicine and a control group (80 cases), who were only treated with the CO2 laser to remove warts. The efficacy of the CO2 -laser treatment was evaluated on the first month after treatment and relapse was evaluated at monthly follow-ups for 6 months. Additionally, 20 normal volunteers were also recruited. Three months before and after treatment, the cellular immunity factors of peripheral blood T lymphocyte subsets, including CD4+, CD8+, CD4+/CD8+, and interleukin-2 (IL-2), were detected and compared between CA patients and normal volunteers, the combination therapy and control groups, and the relapse and cure groups to determine whether there were statistical differences. Results Compared with normal volunteers, CA patients exhibited lower CD4+, CD4+/CD8+, and IL-2 levels and higher CD8+ levels (P .05) before treatment. Three months after treatment, factors including CD4+ and CD4+/CD8+ were higher in the combination therapy group than in the control group (P .05); factors including CD4+, CD4+/CD8+, and IL-2 were higher and CD8+ was lower in the cure group than in the relapse group (P Conclusion The therapy combination of traditional Chinese medicine and CO2 -laser treatment can reduce the relapse rate of CA. It might be that traditional Chinese medicine combined with CO2-laser treatment regulate liver meridian, Qi and blood, and restore the balance between various subgroups.

Introduction: Condyloma acuminatum is caused by infection from Human Papilloma Virus (HPV), mostly found in the perineum and genital area. Therefore HPV infection is the most common sexually transmitted infection in the world. Infection often occurs in patients with a decreased immune system, such as Human Immunodeficiency Virus (HIV) infection.Case: A 62-year-old man was diagnosed with condyloma acuminatum in the penis and accompanied by stage IV HIV infection. CD4 + count is 23 cells/μL. Patients were given electric surgical therapy and 80% TCA. After receiving 8 treatments in 3 months, there was no significant improvement.Discussion: There are several therapeutic modalities in the management of condyloma acuminatum. Some considerations in the selection of condyloma acuminatum therapy include size, number, anatomic location of the lesion, patient comfort, side effects and the experience of the doctor in charge. The immune system plays an important role in the successful treatment of HPV infections. The risk of persistence, recurrence, and malignant transformation can increase with the decrease in the immune system by HIV infection as measured by CD4 + counts. In this case, more aggressive treatment will be needed and immunomodulators can be given to increase the success of the therapy.Conclusion: Host immune status has a significant impact on the course of HPV disease and response to treatment. HIV patients have an increased risk of HPV infection, with an increase in the duration and persistence of the disease and thus require aggressive therapy.

Giant condyloma acuminatum, caused by herpes simplex virus infection, is a large cauliflower shaped lesion that has a propensity to infiltrate surrounding tissues with paradoxically benign microscopic/histological appearance. This lesion is often benign, though it does have the potential for malignant transformation. Here we present a case that demonstrates this potential and describes the pathological and histological findings in detail. The report concludes with the clinical reasoning for considering surgical resection in these patients.

Condyloma acuminatum is a highly infectious disease caused by the human papillomavirus. Previous studies have shown that 5-aminolevulinic acid photodynamic therapy can inhibit proliferation of condyloma acuminatum keratinocytes. However, the effect of 5-aminolevulinic acid photodynamic therapy on condyloma acuminatum tissues has not been systematically studied. Here, we investigated possible molecular mechanisms of 5-aminolevulinic acid photodynamic therapy in the treatment of condyloma acuminatum and its effect on the expression of apoptosis inhibitors Bcl-2 and Survivin.Immunohistochemistry streptavidin-peroxidase was used to detect the expression of apoptosis inhibitors Bcl-2 and Survivin in condyloma acuminatum keratinocytes before and after the therapy.The positive expression rates of Bcl-2 and Survivin in condyloma acuminatum keratinocytes before treatment were 87.50% (42/48) and 79.16% (38/48), respectively. The positive expression rates of Bcl-2 and Survivin in condyloma acuminatum keratinocytes after treatment were 37.50% (18/48) and 41.67% (20/48), respectively. The positive expression intensity of Bcl-2 and Survivin in condyloma acuminatum keratinocytes before 5-aminolevulinic acid photodynamic therapy was mostly ++ to +++, and that after treatment was mostly - to +. There were statistically significant differences in the positive expression rate and the expression intensity of Bcl-2 and Survivin in the two groups before and after 5-aminolevulinic acid photodynamic therapy (P 0.001). There was a positive correlation between the expression of Bcl-2 and Survivin in condyloma acuminatum tissues after 5-aminolevulinic acid photodynamic therapy (r = 0.480, P 0.05).5-aminolevulinic acid photodynamic therapy may promote apoptosis of condyloma acuminatum cells by reducing the expression of Bcl-2 and Survivin, suggesting that this is potentially one of the molecular mechanisms of 5-aminolevulinic acid photodynamic therapy in the treatment of condyloma acuminatum.

Podophyllotoxin (PPT) is used to treat condylomata acuminata and works by destabilizing microtubules within epithelial cells, leading to mitotic arrest in metaphase. PPT-induced changes to the epidermis can cause histological findings mimicking dysplasia. Here, we present a case of vulvar condyloma acuminatum treated with PPT, showing ballooning degeneration, necrotic keratinocytes, and mitotic figures. PPT-treated skin may resemble dysplasia or squamous cell carcinoma in situ due to dyskeratosis and frequent mitoses; however, the synchronicity of mitotic figures in early phases of mitosis, as well as the absence of cellular pleomorphism and atypical mitotic figures, allows for distinction from malignancy. This case demonstrates the importance of understanding the histological changes caused by PPT to prevent misdiagnosis and potential overtreatment.

Condyloma acuminatum (CA) is a sexually transmitted disease caused by human papillomavirus (HPV) often with high recurrence rate after treatment. This study aimed to construct and evaluate a nomogram model containing three clinical parameters to predict the recurrence risk of CA after 5-aminolevulinic acid photodynamic therapy (ALA-PDT). A predictive model was established based on a training cohort of 346 CA patients treated with ALA-PDT between January 2013 and July 2018. A validation cohort of 123 CA patients was recruited from August 2018 to December 2019. The least absolute shrinkage and selection operator (LASSO) regression model was used to optimize the clinical feature selection. A nomogram predicting the recurrence of CA after ALA-PDT was constructed based on the predictors identified by LASSO regression. C-index and area under the curve (AUC) values were used to evaluate the discrimination. Calibration was evaluated with a calibration curve. The net benefit was performed via decision curve analysis (DCA). In the training cohort, 55 (15.89%) patients experienced recurrences after ALA-PDT. Predictors selected by LASSO regression were concomitant human immunodeficiency virus (HIV) infection [Hazard ratio (HR) = 4.4; 95% confidence interval (CI), 2.5-7.9; p

We encountered HPV6‐positive cervical papillary squamous cancer (PSCC) that was difficult to diagnose. The case was initially diagnosed and treated for condyloma. To the best of our knowledge, this is the first report of HPV6 infection in PSCC.

’Purpose. To observe the clinical efficacy and safety of carbon dioxide laser combined with ALA photodynamics in the treatment of condyloma acuminatum. Method. A total of 211 patients with condyloma acuminatum admitted to our hospital from April 2018 to June 2021 were selected as the observation object. They were divided into the intervention group (CO2 laser combined with ALA photodynamic therapy, 125 cases) and conventional group (CO2 laser treatment, 86 cases), and the efficacy and incidence of adverse reactions between the two groups were compared. Result. The total effective rate of the intervention group (96.00%) was significantly higher than that of the conventional group (84.88%) ( P < 0.05 ). The total incidence of adverse reactions in the intervention group (8.00%) was lower than that in the conventional group (32.56%) ( P < 0.05 ). Univariate analysis showed that the patient’s smoking history, drinking history, course of disease, wart area, and number of sexual partners were related to the short-term prognosis ( P < 0.05 ). Multivariate logistic regression analysis showed that the patient’s course of disease, the area of the wart body, and the number of sexual partners were independent factors affecting the prognosis of patients with condyloma acuminatum ( P < 0.05 ). Conclusion. Carbon dioxide laser combined with ALA dynamics treatment of condyloma acuminatum significantly improves the clinical efficacy, does not increase the incidence of adverse reactions, and has important clinical therapeutic value. The course of the disease, the area of the wart, and the number of sexual partners are independent factors affecting the prognosis of patients with condyloma acuminatum.

In this work, we used photodynamic therapy(ALA-PDT) to treat 2 patients with perianal hemorrhoids combined with condyloma acuminatum. After 4 photodynamic treatments, the condyloma acuminata skin lesions completely disappeared. At the same time, we unexpectedly found that the patient's hemorrhoids skin lesions had mostly faded, and did not reappear during the half-year follow-up. Photodynamic therapy is satisfactory in the treatment of hemorrhoids combined with condyloma acuminatum, and the recurrence rate is low. We also have found that photodynamic therapy is equally effective on hemorrhoid skin lesions. PDT may be adopted as a new strategy in the study and treatment of hemorrhoids. To the best of our knowledge, no such cases have been reported.

Purpose This study aims to provide an overview of the literature on carcinoma arising from giant perianal condyloma acuminatum. Methods We present a new case of squamous cell carcinoma arising from giant perianal condyloma acuminatum. We also conducted a systematic search of the medical literature using PubMed, Medline, Google, and Google Scholar related to carcinoma arising from giant perianal condyloma acuminatum. The following search terms were used in various combinations: condyloma acuminatum, giant condyloma acuminatum, Buschke-Lowenstein tumor, squamous cell carcinoma, and verrucous carcinoma. The search included articles published before in the English language November 2020. Results A total of 55 article concerning 97 patients with carcinoma (squamous cell carcinoma, verrucous carcinoma, basaloid cell carcinoma, carcinoma insitu) arising from giant perianal condyloma acuminatum meeting the aforementioned criteria were included. The patients were aged from 24 to 82 years (median: 49.6, IQR: 21); 20 were female (median age: 52.5, IQR: 20.5), and 75 were male (median age: 53, IQR: 17.5). The gender data of the remaining two patients could not be obtained. The histopathological features of tumors arising from giant condyloma acuminatum are as follows: squamous cell carcinoma (n = 56), squamous cell carcinoma in situ (n = 16), verrucous carcinoma (n = 19) and basaloid cell carcinoma (n = 1), squamous cell carcinoma + verrucous carcinoma (n = 1), squamous cell carcinoma + squamous cell carcinoma in situ (n = 1), squamous cell carcinoma + basaloid cell carcinoma (n = 1) and malignant behavior (n = 2). Conclusion Giant condyloma acuminatum is a rare variant of anogenital warts. It is known that this tumor, which is mostly thought to be benign, has a high potential for local recurrence and transformation into invasive cancer. Therefore, it is vital that the tumor is resected with clean surgical margins, even if it looks benign, and that aggressive treatment options are not avoided when necessary.

BACKGROUND Condyloma acuminatum (CA) is a common sexually transmitted disease caused by human papillomaviruses. Five-aminolevulinic acid-photodynamic therapy (ALA-PDT) can promote the apoptosis of keratinocytes and inhibit proliferation; however, the effect of ALA-PDT on the immune mechanism of CA tissue is not well understood. In this study, we examined the changes in Toll-like receptor 4 (TRL4) and nuclear factor kappa B (NF-κB) expression in CA tissues before ALA-PDT treatment to determine its effects and possible immune mechanisms. METHODS Immunohistochemistry (streptavidin-peroxidase) was used to detect the expression of TLR4 and NF-κB in the keratinocytes of the patients with CA before and after ALA-PDT treatment. RESULTS Before treatment, the positive TLR4 and NF-κB expression rates in the keratinocytes of the patients with CA were 86.53% (45/52) and 94.23% (49/52), respectively, whereas after treatment, these rates were 44.230% (23/52) and 38.46% (20/52), respectively. Positive TLR4 and NF-κB expression in the keratinocytes of CA was mostly ++ to +++ in intensity before ALA-PDT and mostly ranged from - to + after treatment. The positive expression rate and intensity of TLR4 and NF-κB in the two groups before and after ALA-PDT were significantly different (P < 0.05). There was a positive correlation between the expression of TLR4 and NF-κB in the CA tissues after ALA-PDT (r = 0.486, P < 0.05). CONCLUSIONS ALA-PDT may relieve local immunosuppressive states by reducing TLR4 and NF-κB expression and jointly promoting CA regression, which is a potential molecular mechanism of ALA-PDT in CA treatment.

Background: Human Papilloma virus (HPV) infection is a high incidence entity in the world population. It is highly related to cervical carcinoma, as well as anogenital carcinoma, among others. The presences of bladder HPV lesions are infrequent and there is an association between it and the development of bladder cancer. Case presentation: We present a case of bladder HPV in a woman with a cervical carcinoma history that was presented clinically as a single episode of gross hematuria. We performed a cystoscopy and Holmium laser enucleation of the bladder tumors. Conclusion: We highlight the importance of consider HPV as a differential diagnosis of a bladder tumor, mainly in patients with history of pathologies related with the virus.

Aminolevulinic acid photodynamic therapy (ALA-PDT) has been widely used in the treatment of condyloma acuminatum (CA), but there is a lack of reports on clinical factors related to CA relapse after photodynamic therapy.The clinical data of patients with CA treated with ALA-PDT from April 2018 to December 2019 were retrospectively analyzed, including HPV type, follow-up time and recurrence within 6 months after treatment. The patients were classified into single-type HPV infection and multiple-type HPV infection groups. Besides, the patients were also classified into high-risk HPV infection, low-risk HPV infection, and low + high-risk HPV infection groups. Univariate and multivariate COX regression was performed to analyze whether HPV type was related with CA relapse after photodynamic therapy.A total of 161 CA patients who underwent ALA-PDT were analyzed in this study. CA recurred in 20 patients within 6 months after treatment, with a recurrence rate of 12.4%. Of them, the patients with multiple-type HPV infection made up 85%. Multivariate COX regression analysis revealed that multiple-type HPV infection was associated with CA recurrence (HR:5.0; 95% CI: 1.1-21.4; P = 0.032). Of the patients with CA recurrence, 70% developed low + high-risk infections, a proportion significantly higher than that in patients without CA relapse (16.3%, P0.001). Using low-risk infection as a reference, low + high-risk infection was positively correlated with postoperative recurrence (HR: 6.7; 95% CI: 1.6-26.2; P = 0.006).Multiple-type HPV infection were closely associated with CA recurrence after photodynamic therapy.

S Dermatologists often encounter keratotic or warty lesions in the genital area. Establishing a clear diagnosis may seem challenging, particularly when the differential diagnosis includes bowenoid papulosis, seborrheic keratosis, and condyloma acuminatum. This study aimed to compare the dermoscopic features of bowenoid papulosis (BP), seborrheic keratosis, and condyloma acuminatum in the genital area. All lesions histopathologically confirmed underwent clinical assessment and dermoscopic observation. Dermoscopically, glomerular vessels were predominant in bowenoid papulosis, whereas seborrheic keratosis was the least vascular-patterned disease. Most cases of bowenoid papulosis presented mucosal pigmentation and classified as “flat”. Seborrheic keratosis had a pigmented, cerebriform appearance. Condyloma acuminatum was characterised by a finger-like appearance, highly vascular-patterned features surrounded by whitish halos. Dermoscopic findings can be useful for differentiating the entity of genital keratotic lesions ahead of an invasive method. When dermoscopic features favor BP, different from genital warts, it should be removed completely but conservatively.

A cutaneous horn, cornu cutaneum, is a hard, conical projection composed of compacted keratin that resembles the horns of animals. They commonly occur on sun-exposed areas, including the head, ears, forearms and hands. Cutaneous horns are extremely rare. Although most are benign in nature, a significant portion may harbour a malignant or pre-malignant lesion, and histopathological analysis of the base of the lesion is imperative to categorise it as one of benign aetiology or one of a more sinister pathology. We present a case of a 46-year-old male who presented with a 2-month history of a painless, firm, rapidly growing conical projection arising from his scrotum. Clinically, a non-tender curved, yellow-brown, horn-like projection was observed arising from the median raphe of his scrotum. With informed consent, a full-thickness excision, with adequate excision of the base of the horn, was performed under local anaesthesia. Macroscopically, the exophytic keratinous lesion was 7.5 cm long and 1.8 cm wide, with the length of the horn far outweighing the width at its base. Histopathological analysis confirmed the presence of a cutaneous horn arising from a condyloma acuminatum as evidenced by a verruciform architecture with tiers of parakeratosis in association with hypergranulosis and koilocytes. No dysplastic or malignant changes were present in the epithelium. According to our knowledge, this is the first case in the English literature of a cutaneous horn arising from the scrotal skin.