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Wart Treatment

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1821. Combined surgery and cidofovir is an effective treatment for genital warts in HIV-infected patients. (Abstract)

Combined surgery and cidofovir is an effective treatment for genital warts in HIV-infected patients. To evaluate the efficacy of surgical-cidofovir (SCT), surgical (ST) and cidofovir (CT) treatment of genital warts in HIV-infected patients.Open randomized prospective pilot study.Outpatients attending the sexually transmitted disease service of the II Dept of Infectious Diseases, L Sacco Hospital, Milan-Italy.Consenting HIV-positive patients with anal-genital warts recruited from January 2000 (...) to March 2001.Three treatment arms: surgical excision by electrocautery, topical 1% cidofovir-gel (5 days per week, maximum 6 weeks) and electrocautery-cidofovir treatment with 1% cidofovir-gel applied within 1 month of surgical treatment (5 days per week for 2 weeks).Rate of wart clearance and time and rate of relapses within a 6-month follow-up period.Complete response was achieved in 93.1% of 29 patients treated by ST, 76.2% of 26 treated by CT and in 100% of 19 patients treated by SCT (P = 0.0033

2002 AIDS Controlled trial quality: uncertain

1822. Comparison of combination of cimetidine and levamisole with cimetidine alone in the treatment of recalcitrant warts. (Abstract)

Comparison of combination of cimetidine and levamisole with cimetidine alone in the treatment of recalcitrant warts. Various immunomodulating agents have been used in the treatment of recalcitrant warts, but none is uniformly effective. Drugs like cimetidine and levamisole have been tried with varying success rates. Given the different target activities of immunomodulation by levamisole and cimetidine, we questioned whether the combination might be more effective and conducted this double-blind (...) comparative trial of a combination of cimetidine and levamisole versus cimetidine alone. Forty-eight patients with multiple recalcitrant warts were assigned to two treatment groups (A and B) in double-blind fashion. Of the 48 patients, 22 in group A and 21 in group B were able to be evaluated. At the end of therapy, cure rates obtained were 45.5% (10/21) in cimetidine treated patients (group A) and 85.7% (18/21) in combination treated patients (group B). A statistically significant improvement was seen

1999 The Australasian journal of dermatology Controlled trial quality: uncertain

1823. Human leukocyte derived interferon-alpha in a hydrophilic gel for the treatment of intravaginal warts in women: a placebo-controlled, double-blind study. (Abstract)

Human leukocyte derived interferon-alpha in a hydrophilic gel for the treatment of intravaginal warts in women: a placebo-controlled, double-blind study. This placebo-controlled, double-blind study was aimed to evaluate the clinical efficacy, safety and tolerability of human leukocyte interferon-alpha (2 x 10(6) IU/g) incorporated in a hydrophilic gel (hydroxyethylcellulose, 1%) to cure intravaginal warts in women. Preselected, subjects (n=60) who ranged between 18 and 50 years of age (mean (...) the 4-week treatment period, patients were examined on a weekly basis. Cure was defined as absence of clinical signs of infection, as well as PCR and Southern blot hybridization confirmed negative HPV DNA on molecular assay. By the cessation of the therapy 41.7% patients and 44.4% intravaginal warts were cured. Code disclosure revealed that interferon-alpha (2 x 10(6) IU/g) in gel had cured 73.3% patients, and 79.3% intravaginal warts, while placebo healed 10% patients and 8.1% lesions (active gel

1998 International journal of STD & AIDS Controlled trial quality: uncertain

1824. Phase I safety and antigenicity of TA-GW: a recombinant HPV6 L2E7 vaccine for the treatment of genital warts. (Abstract)

Phase I safety and antigenicity of TA-GW: a recombinant HPV6 L2E7 vaccine for the treatment of genital warts. A phase I double-blind, randomized, placebo-controlled study was carried out in healthy subjects to assess the safety and immunogenicity of TA-GW, a recombinant HPV6 L2E7 fusion protein vaccine for the treatment of genital warts. Forty-two healthy male volunteers were randomised to receive three intramuscular injections of either 0, 3, 30 or 300 microg of recombinant L2E7 adsorbed onto (...) and immunogenic. The results allow the selection of the 300-microg vaccine formulation and accelerated vaccination schedule for phase II trials in patients with genital warts.

1999 Vaccine Controlled trial quality: uncertain

1825. Efficacy and tolerability of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected persons. (Abstract)

Efficacy and tolerability of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected persons. Treatment options for anogenital warts in patients with HIV-1 are unsatisfactory because they fail to eradicate latent human papillomavirus.To determine tolerability and efficacy of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected patients.A randomized, placebo-controlled, single-blind, crossover pilot study of either 1 (...) % cidofovir cream or placebo applied once daily 5 days a week for 2 weeks followed by 2 weeks of observation was performed.Six patients were randomized to 1% cidofovir cream and six to placebo. The latter patients eventually received 1% cidofovir cream. Thus, 12 treatment rounds of cidofovir were compared with six rounds of placebo. A reduction of more than 50% in the total wart area achieved by seven cidofovir treatments (58%), as compared with no placebo regimen (P = 0.02). Local reactions occurred

2001 Sexually transmitted diseases Controlled trial quality: uncertain

1826. Oral zinc sulphate in the treatment of recalcitrant viral warts: randomized placebo-controlled clinical trial. (Abstract)

Oral zinc sulphate in the treatment of recalcitrant viral warts: randomized placebo-controlled clinical trial. Viral warts are common dermatological diseases; although the rate of spontaneous recovery is high, it usually takes a long time, and some patients might not show this spontaneous healing. Zinc has an important effect on the immune system and it has been used as an immunomodulator to treat a variety of skin disorders.To assess whether oral zinc was effective in treating viral warts (...) of patients evaluated between May 1999 and April 2000.This was a placebo-controlled clinical trial. Eighty patients with viral warts (common, plantar and plane) were all resistant to all forms of treatment. Each patient had > 15 warts. Forty patients were treated by oral zinc sulphate at a dose of 10 mg kg(-1) daily up to 600 mg day(-1) and followed-up for resolution of their warts and for any evidence of recurrence for 2-6 months. Another 40 patients were given a placebo oral treatment in the form

2002 The British journal of dermatology Controlled trial quality: uncertain

1827. External genital warts: diagnosis, treatment, and prevention. Full Text available with Trip Pro

External genital warts: diagnosis, treatment, and prevention. External genital warts (EGWs) are visible warts that occur in the perigenital and perianal regions. They are due primarily to non-oncogenic human papillomavirus (HPV) types, usually types 6 and 11. Physical examination assisted by bright light and magnification is the recommended approach for primary diagnosis. Biopsy is indicated when EGWs are fixed to underlying structures or discolored or when standard therapies are not effective (...) . Recurrences are common, and there is no single treatment that is superior to others. Among women with atypical squamous cells, molecular HPV testing may be useful in determining who should be referred for colposcopy. Condoms may provide some protection against HPV-related diseases and thus are recommended in new sexual relationships and when partnerships are not mutually monogamous. Because the efficacy of cesarean section in preventing vertical transmission of HPV infection from women with EGWs

2002 Clinical Infectious Diseases

1828. Genital and perianal warts: new treatment opportunities for human papillomavirus infection. (Abstract)

Genital and perianal warts: new treatment opportunities for human papillomavirus infection. Human papillomaviruses are among the most common sexually transmitted diseases in the United States. Genital warts are a common phenotypic expression of human papillomaviruses, affecting 1% of the population; therefore, the obstetrician/gynecologist will invariably be required to advise and treat patients with this clinical manifestation. Issues essential in the diagnosis, counseling, and management (...) of patients with genital warts will be examined, including epidemiology, transmission, molecular biology, and host immune response. This review will also provide the health care professional with a thorough examination of the new patient-applied treatment opportunities for anogenital condyloma, in addition to an overview of current provider-administered therapies, to assist in patient management.

2003 American Journal of Obstetrics and Gynecology

1829. Treatment of anogenital warts with imiquimod 5% cream followed by surgical excision of residual lesions. (Abstract)

Treatment of anogenital warts with imiquimod 5% cream followed by surgical excision of residual lesions. Cytodestructive or surgical therapy for patients with anogenital warts is frequently associated with recurrence. In February 1997, the US Food and Drug Administration approved imiquimod as a 5% cream for the treatment of anogenital warts. Activity of the drug results primarily from interferon alfa and other cytokine induction in the skin. These cytokines stimulate several other aspects (...) in comparison with those patients who were treated with surgery alone. Therefore, treatment with imiquimod followed by excision of residual lesions may provide long-term clearance of anogenital warts in those patients in whom imiquimod monotherapy is insufficient.

2002 Journal of American Academy of Dermatology

1830. An open label evaluation of the efficacy of imiquimod 5% cream in the treatment of recalcitrant subungual and periungual cutaneous warts. (Abstract)

An open label evaluation of the efficacy of imiquimod 5% cream in the treatment of recalcitrant subungual and periungual cutaneous warts. Periungual and subungual warts are very difficult to eradicate with current therapies. Most are destructive in nature (liquid nitrogen, cantharidin, vascular lesion laser) and inflammation, pain and pigment dyschromia are common side effects. Furthermore, failure to respond or appearance of new lesions often leads to even more destructive treatments (CO(2 (...) , burning and pain) were generally mild and well-tolerated. No relapses occurred during a 6-month follow-up.Topical imiquimod is an interesting novel treatment for multiple periungual and subungual warts. Tolerability is excellent when compared to other commonly used modalities and there are few side effects. This trial suggests a high clinical response rate. This treatment is applicable to patients who have failed conventional therapies before embarking on potentially scarring approaches

2003 Journal of Dermatological Treatment

1831. CO2 laser treatment of warts in immunosuppressed patients. (Abstract)

CO2 laser treatment of warts in immunosuppressed patients. A large proportion of chronically immunosuppressed patients suffer from recalcitrant viral warts. Furthermore, the incidence of nonmelanoma skin cancer is clearly elevated in this patient group and human papillomavirus is most likely to play a causal role in these neoplasms.To analyze the effectiveness of treatment of viral warts with the CO(2) laser in immunosuppressed patients.Multiple viral warts of 13 patients with immunosuppression (...) , a majority of them renal allograft recipients, were treated with CO(2) laser in local or regional anesthesia. In case of recurrences, the lesions were treated again after 3 months.12 of 13 patients experienced dramatic improvement after 1-3 treatment sessions, 6 of these patients showed full remission. Side effects such as postoperative pain or scarring were minimal.CO(2) laser treatment of recalcitrant warts in immunosuppressed patients shows promising results which are comparable to those

2003 Dermatology

1832. Successful treatment of multiple filiform facial warts with imiquimod 5% cream in a patient infected by human immunodeficiency virus. (Abstract)

Successful treatment of multiple filiform facial warts with imiquimod 5% cream in a patient infected by human immunodeficiency virus. Imiquimod, an imidazoquinoline amine, is approved for the topical treatment of external anogenital warts induced by human papilloma virus. Several clinical trials have shown imiquimod to be an effective and safe drug for treatment of anogenital warts. Consequently, it was considered that imiquimod might be effective on warts caused by the same aetiological agent (...) located on other skin areas. We describe the favourable outcome of a case of multiple facial verrucae in a human immunodeficiency virus (HIV)-infected patient treated with imiquimod 5% cream. This is a promising finding which supports those of two previous reports. We feel that imiquimod could be used in HIV-infected patients with multiple facial warts in whom conventional therapies are ineffective or produce significant side-effects.

2003 Clinical & Experimental Dermatology

1833. Successful treatment of butcher's warts with imiquimod 5% cream. (Abstract)

Successful treatment of butcher's warts with imiquimod 5% cream. A unique correlation has been shown to exist between frequent occupational handling of raw meat and development of warts on the hands, leading to the designation of 'butcher's warts'. Numerous treatments are available for warts including cryotherapy, laser therapy and surgical excision. We present a case of a 31-year-old-butcher with a 4-year history of warts on his fingers. Imiquimod 5% cream was applied once daily to the warts (...) for 3 months. Clinical improvement was noted after 1 month, with regression of the warts experienced after 3 months. During 12 months of follow-up, no recurrent lesions were observed.

2003 Clinical & Experimental Dermatology

1834. Topical treatment of common warts in an HIV-positive patient with imiquimod 5% cream. (Abstract)

Topical treatment of common warts in an HIV-positive patient with imiquimod 5% cream. Human immunodeficiency virus (HIV) infects and destroys crucial components of the immune system, leaving patients susceptible to a number of viral, bacterial and fungal diseases. Viral warts are caused by human papillomavirus infection and are a common skin disease that afflicts HIV-infected patients. Treatment modalities currently rely on destruction of the infected tissue or interruption of cell division (...) ; however, frequent recurrence is a particular challenge in HIV-infected patients. We report the case of a 41-year-old HIV-positive man with multiple common warts located on his hands and feet. Following 5 months of treatment with imiquimod, an immune response modifier, as a 5% cream, complete clearance of all warts was achieved. Mild erythma, itching and burning at the application site was observed in the early stages of treatment. The patient showed no relapse of warts at the 30-month follow-up visit.

2003 Clinical & Experimental Dermatology

1835. Warts are not merely blemishes on the skin: A study on the morbidity associated with having viral cutaneous warts. (Abstract)

Warts are not merely blemishes on the skin: A study on the morbidity associated with having viral cutaneous warts. Eighty-five people aged 2-76 years with 250 common and plantar warts were followed prospectively for 9 months. The majority (57; 67%) had one to two warts. Of the 54 subjects who had a past history of warts, 41 (75.9%) had sought treatment for them. Twenty-four (58.5%) said that treatment had been unsuccessful; 22 (53.7%) experienced pain during their treatment; 14 (34.1%) said (...) that treatment had been inconvenient; nine (22%) required multiple treatments; and eight (19.5%) said the treatment resulted in the development of scars. The quality-of-life assessment related to their current warts revealed that 81.2% were moderately to extremely embarrassed by them; 70.5% were moderately to extremely concerned about negative appraisal by others for having them; 24.7% said that it was moderately to extremely difficult to play sport because of their warts. Moderate to severe discomfort from

2003 Australasian Journal of Dermatology

1836. Topical immunomodulators for the treatment of external genital warts, cutaneous warts and molluscum contagiosum. (Abstract)

Topical immunomodulators for the treatment of external genital warts, cutaneous warts and molluscum contagiosum. Topical immunomodulators (TIMs) include both immunostimulatory and immunosuppressive agents. Newer immunostimulatory compounds such as imidazoquinolines (e.g. imiquimod) act by cytokine secretion from monocytes/macrophages (interferon-alpha, interleukin-12, tumour-necrosis factor-alpha), leading to a Th1-dominance and cell-mediated immunity. This immune milieu has been clinically (...) used to treat viral infections such as human papillomavirus (condyloma and common warts), herpes simplex virus and mollusca in immunocompetent and immunosuppressed patients.

2003 British Journal of Dermatology

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