Genital warts

Coexistence of condyloma acuminatum and extramammary Paget's disease on penis and scrotum: A rare case report

RATIONALE

Extramammary Paget's disease (EMPD) is a rare skin cancer that commonly occurs in sites rich in apocrine glands, such as perineum, vulva, axilla, scrotum, and penis. On the other hand, condyloma acuminatum (CA; also referred to as anogenital warts) is a common benign neoplasm caused by human papillomavirus. Few cases of coexistent EMPD and CA have been reported because of the rarity of the condition.

PATIENT CONCERNS AND DIAGNOSIS

A 72-year-old man with a genital mass, which appeared to be composed of multiple papillomatous masses, was referred for surgical resection. The lesion was first noticed 6 months previously and grew rapidly. CO2 ablative laser therapy was performed twice at a primary clinic, but the mass recurred.

INTERVENTION AND OUTCOMES

Excisional biopsy revealed the presence of coexistent EMPD and CA. Additional wide excision was performed, and postoperative biopsy confirmed no residual tumor. Two years after surgery, no recurrence had occurred.

LESSONS

CA can co-occur with several types of skin malignancies, and a skin malignancy coexisting with CA is difficult to diagnose visually. Therefore, even if a skin lesion in the genital region is considered to be CA, we recommend punch biopsy before treatment because it can benefit prognosiss.

Establishing a prediction model for recurrence of condyloma acuminatum

We collected the clinical data of 156 patients diagnosed with condyloma acuminatum (CA), including age, gender, marriage, education level, stay up late, smoking, drinking, number of sexual partners, HPV infection status of sexual partners, genitourinary and anal diseases, condom use, other diseases of HPV infection, location and number of warts, HPV typing, etc. Analyze the risk factors affecting the recurrence of CA, explore the influencing factors and independent influencing factors of CA recurrence, establish the prediction model of CA recurrence, and evaluate its prediction value. Univariate analysis showed that stay up late, HPV infection status of sexual partners, urogenital diseases, condom use, other diseases of HPV infection and the number of CA were the influencing factors of CA recurrence. Multivariate analysis showed that condom use (OR = 0.166), HPV infection status of sexual partners (OR = 4.848), number of warts (OR = 1.212) and urogenital diseases (OR = 3.179) were independent factors affecting the recurrence of CA (P < 0.05). Therefore, the prediction model of CA recurrence can be established, and the area under the curve AUC of the prediction model was calculated to be 0.867 (95% CI 0.812–0.923). The model established in this study has certain prediction value for the recurrence of CA and can be used to preliminarily predict the recurrence of CA.

5-aminolevulinic acid photodynamic therapy and holmium laser treatment for intraurethral condylomata acuminata in a renal transplant patient

Condylomata acuminata (CA) caused by human papillomavirus, often involves the external genitalia, perianal skin, and other moist mucous membranes. Urethral involvement is uncommon and little recognized, and usually limited to the distal 3 cm of the meatus. It is difficult to treat CA involving the urethra because of the anatomical location, risk of complications and recurrence. One effective method for the treatment of CA located at the urinary meatus is 5-aminolevulinic acid photodynamic therapy (ALA-PDT). However, experience of using this method for the treatment of whole urethral CA is still very limited. Herein, we treated a whole urethral CA successfully with photodynamic and holmium laser therapies. The case of a 25-year-old patient who underwent kidney transplant effected by intraurethral CA is presented and discussed. Catheter implantation and (or) immunosuppression treatment increases the risk of urethral condyloma acuminatum. The ALA-PDT is a safe, straightforward, effective, and well-tolerated treatment procedure for intraurethral CA. ALA-PDT combined with holmium laser treatment can successfully treat kidney transplant patients with intraurethral CA.

The effects of vitamin B12, vitamin D, ferritin level, neutrophil/monocyte ratio and some blood parameters on genital warts presence, the number of lesions, and recurrence rates

The relationships between cancer caused by HPV and some vitamins, as well as leucocytes and their ratios, have been investigated in the literature. Our aim is to evaluate these relationships at the level of genital wart in terms of the investigated parameters and lesion numbers. Data were obtained from 98 and 94 patients for groups one and two, including warts patients and healthy people respectively. The Neutrophil/Monocyte ratio and lesion numbers in the warts patients were reported and analysed in terms of vitamin B12 and D, ferritin and leucocytes. A correlation was established between lesion numbers, age and midcorpuscular volume (p <0.05). There was no correlation between lesion numbers and recurrence. According to the comparative analysis, there were differences in terms of ferritin, neutrophil, monocyte, haemoglobin, midcorpuscular volume and neutrophil/monocyte ratio between groups. The cut-off values for neutrophil, monocyte and N/M ratios were 56.45, 4.91 and 7.825 respectively. While our study showed that wart development may be affected by blood ferritin levels and in this situation, midcorpuscular volume, neutrophil, monocyte and N/M ratios may change, a relation was found between lesion numbers and age and mean midcorpsucular volume values only. However, further studies are needed to clarify this issue.

Determinants of high-risk human papillomavirus infection in anogenital warts

Introduction

Genital warts are benign epithelial tumours caused by human papilloma viruses (HPV), and are sexually transmitted. Genotyping of genital HPV bears great clinical significance in terms of treatment planning, follow-up, and prevention strategies.

Aim

To evaluate the distribution of high-risk HPV infection types in patients diagnosed with anogenital warts.

Material and methods

A total of 66 patients with anogenital warts were enrolled. Punch biopsy samples were obtained from the lesions of each patient. After nucleic acid purification and DNA extraction, the presence of HPV DNA was ascertained using the PCR method, followed by HPV DNA genotyping. The relationship between HPV type distribution and age, gender, clinical location, and number of sexual partners was investigated.

Results

Genotyping was performed and HPV genome was detected in 50 tissue samples (75.8%). Low-risk genotypes predominated with a prevalence of 62.1% (42/66). The most prevalent genotypes were HPV-6 (47%), and HPV-11 (13.6%). Other types detected included HPV-18 and HPV-3.

Conclusions

Genotyping of HPV provides significant clinical information regarding this family of viruses that play a role in the aetiology of a variety of genital cancers, as some of these malignancies are now considered preventable due to recent development of vaccines. We believe that our results may provide guidance on future vaccination programs in our country.

Effectiveness of physically ablative and pharmacological treatments for anal condyloma in HIV-infected men

BACKGROUND

There is limited information on the effectiveness of available treatments for anal condyloma acuminata in HIV-1-infected men.

AIM

To provide data on the effectiveness of electrosurgical excision, infrared coagulation and pharmacological (imiquimod) treatments for anal condyloma acuminata (peri-anal and/or intra-anal) in HIV-1-infected men based on authors' practice.

METHODS

Single-center, retrospective descriptive analysis of HIV-1-infected men, 18 years or older treated for anal condyloma acuminata. Standard treatments were offered: electrosurgery excision, infrared coagulation and topical imiquimod. Effectiveness was evaluated by the recurrence rate at 1 year after treatment. Recurrence was defined as any anal condyloma acuminata diagnosed after 3 months of condyloma-free survival post-treatment. Anal cytology and human-papillomavirus-infection (HPV) was assessed.

RESULTS

Between January 2005 and May 2009, 101 men were treated for anal condyloma acuminata: 65 (64%) with electrosurgery, 27 (27%) with infrared coagulation and 9 (9%) with imiquimod. At 1 year after treatment, the cumulative recurrence rate was 8% (4/65, 95%CI: 2-15%) with electrosurgery excision, 11% (3/27, 95%CI: 4-28%) with infrared coagulation and 11% (1/9, 95%CI: 2-44%) with imiquimod treatment. No predictive factors were associated with recurrence. Anal HPV-6 or HPV-11 was detectable in 98 (97%) patients and all had high-risk HPV genotypes, and 89 (88%) patients had abnormal anal canal cytology. Limitations: this was a retrospective descriptive analysis; limited to a single center; it cannot know if the recurrence is related to new infection.

CONCLUSION

Recurrence of anal condyloma after any treatment was common. Abnormal anal cytology and high-risk HPV-infection were highly prevalent in this population, therefore at high-risk of anal cancer, and warrants careful follow-up.

Condyloma Acuminata of the Urethra in a Male Renal Transplant Recipient: A Case Report

BACKGROUND

Condyloma acuminatum (CA) is a common sexually transmitted disease associated with human papilloma virus (HPV). CA occurring in the urethra is rare and has not been reported in male renal transplant recipients. In addition, despite immunosuppressive conditions and increased risk of HPV-related malignant neoplasms in transplant recipients, HPV testing in male transplant recipients has been uncommon. Here we report a case of urethral CA in a male deceased donor renal transplantation recipient and discuss the importance of HPV testing in male transplant recipients.

CASE PRESENTATION

A 33-year-old male deceased donor renal transplant recipient presented with miction pain 5 years after the transplantation. He reported repeated urinary tract infections with no sexual contact since the renal transplantation. Multiple papillary tumors in his penile urethra were detected by cystoscopy, and a biopsy sample was pathologically diagnosed with CA. Transurethral tumor resection was performed, and the tumors were completely resected. Additional HPV risk type screening with a urethral smear sample showed the prevalence of low-risk HPV. Although tacrolimus was switched to everolimus and imiquimod cream was administered, the tumors recurred 6 months after the resection, and a second resection was performed. No further recurrence has been observed for 1 year to date.

CONCLUSION

As the urethral CA was possibly related to immunosuppressive conditions and a risk for HPV-related malignant neoplasm, the case required careful diagnosis, including HPV risk type. The methodology of sampling for HPV testing in men has not been established. This case suggests the necessity for further discussion about HPV testing in male transplant recipients.

[Genital warts in HIV-infected individuals]

Anogenital warts (condylomata acuminata) are much more frequent in human immunodeficiency (HIV)-positive patients compared to HIV-negative individuals. Anogenital warts of HIV-infected patients differ from those of HIV-negative individuals with respect to their spread, occurrence on more unusual anatomical sites, human papillomavirus (HPV)-type spectrum, tendency to recur, and risk of malignant transformation. Between 18 and 56% of anogenital warts of HIV-positive patients harbor high-grade dysplasia. Therefore, anogenital warts of HIV-infected patients should be preferentially treated with ablative methods and should be evaluated histopathologically. Gender-neutral prophylactic HPV vaccination of HPV-naive boys and girls could also lead to a significant reduction of anogenital warts in this patient group in the future.

Podophyllotoxin-Loaded Nanostructured Lipid Carriers for Skin Targeting: In Vitro and In Vivo Studies

Nanostructured lipid carriers (NLC) exhibit high skin targeting efficiency and good safety. They are promising vehicles for topical drug delivery. This study aims to increase the skin distribution of podophyllotoxin (POD) by incorporating it into NLCs. Two kinds of POD-loaded NLCs (POD-NLCs)—POD-NLC_{formulation 1} and POD-NLC_{formulation 2}—were prepared and characterized. Their skin targeting efficiencies were compared by conducting in vitro and in vivo experiments. Obviously smaller mean particle size was observed for POD-NLC_{formulation 1} (106 nm) than POD-NLC_{formulation 2} (219 nm), whereas relatively low POD loadings (less than 0.5%) were observed for both POD-NLC_{formulation 1} (0.33%) and POD-NLC_{formulation 2} (0.49%). Significantly higher in vitro and in vivo rat skin deposit amounts of POD (p ˂ 0.01) were detected after the topical application of POD-NLC_{formulation 1} compared to POD-NLC_{formulation 2}. To visualize the skin distribution behavior of hydrophobic active pharmaceutical ingredients (APIs) when NLCs were used as carriers, POD was replaced with Nile red (NR—a hydrophobic fluorescent probe), and the distribution behavior of NR-NLC_{formulation 1} and NR-NLC_{formulation 2} in rat skin in vivo was observed using confocal laser scanning microscopy (CLSM). Higher fluorescent intensity was observed in rat skin after the topical application of NR-NLC_{formulation 1} than NR-NLC_{formulation 2}, suggesting that higher skin targeting efficiency might be obtained when NLCs with smaller mean particle size were used as carriers for hydrophobic APIs. This result was in accordance with those of skin distribution evaluation experiments of POD-NLCs. Skin irritation property of POD-NLC_{formulation 1} was investigated and no irritation was observed in intact or damaged rabbit skin, suggesting it is safe for topical use. Our results validated the safety of NLCs when applied topically. More importantly, mean particle size might be an important parameter for formulation optimization when NLCs are used as carriers for hydrophobic APIs for topical application, considering that their loading is relatively low.

A rare cause of acute urinary retention in women: meatal condyloma accuminata, a case report

Acute urinary retention in women is a rarely seen phenomenon due to pharmacological, neuromuscular, anatomical, functional and infectious causes. Human papillomaviruses causing condyloma acuminata is one of the rarely reported viral infectious cause of acute urinary retention in case reports. A 45-year-old woman with acute urinary retention was found to have a round solid lesion on external urethral meatus. Histopathological examination revealed as condyloma acuminata. Urethral condyloma can be treated by local excision as an effective method for early improvement of voiding function. Even if the genital condyloma can be locally excised, patients should be referred to the gynecologists for cervical cancer screening.

Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV-infected men

BACKGROUND

Genital infections with low-risk (LR) and high-risk (HR) human papillomavirus (HPV) genotypes are associated with ano-genital condylomata and anal squamous cell cancer. HPV-related pathologies in HIV-infected men are a serious concern. In this study, the prevalence of anal condylomata and their association with cytological abnormalities and HPV infection in the anal canal in HIV-infected men [men who have sex with men (MSM) and heterosexuals] were estimated.

METHODS

This was a cross-sectional study based on the first visits of patients in the Can Ruti HIV-positive Men (CARH·MEN) cohort. Anal condylomata were assessed by clinical and proctological examination. Samples from the anal canal were collected for HPV genotyping and cytological diagnoses.

RESULTS

A total of 640 HIV-infected men (473 MSM and 167 heterosexuals) were included in the study. The overall prevalence of anal condylomata was 25% [157 of 640; 95% confidence interval (CI) 21-28%]; in MSM it was 28% and in heterosexuals it was 15% [odds ratio (OR) 2.2; 95% CI 1.4-3.5]. In patients with anal condylomata, HPV infection in the anal canal was more prevalent (92% vs. 67% in those without anal condylomata; OR 8.5; 95% CI 3.2-22). This higher HPV prevalence involved at least two HPV genotypes (OR 4.0; 95% CI 2.2-7.1), mainly HR genotypes (OR 3.3; 95% CI 1.7-6.4). Similarly, the cumulative prevalence of HPV-6 and HPV-11 was higher in patients with anal condylomata (63% vs. 19% in those without anal condylomata). Having anal condylomata was associated with higher prevalences of cytological abnormalities (83% vs. 32% in those without anal condylomata; OR 6.9; 95% CI 3.8-12.7) and high-grade squamous intraepithelial lesions (HSILs) (9% vs. 3% in those without anal condylomata; OR 9.0; 95% CI 2.9-28.4) in the anal canal.

CONCLUSIONS

HIV-infected men with anal condylomata were at risk of presenting HSILs and harbouring multiple HR HPV infections in the anal canal. Although MSM presented the highest prevalence of anal condylomata, heterosexual men also had a clinically important prevalence. Our findings emphasize the importance of screening and follow-up for condylomata in the anal canal in HIV-infected men.

Low dosages: new chemotherapeutic weapons on the battlefield of immune-related disease

Chemotherapeutic drugs eliminate tumor cells at relatively high doses and are considered weapons against tumors in clinics and hospitals. However, despite their ability to induce cellular apoptosis, chemotherapeutic drugs should probably be regarded more as a class of cell regulators than cell killers, if the dosage used and the fact that their targets are involved in basic molecular events are considered. Unfortunately, the regulatory properties of chemotherapeutic drugs are usually hidden or masked by the massive cell death induced by high doses. Recent evidence has begun to suggest that low dosages of chemotherapeutic drugs might profoundly regulate various intracellular aspects of normal cells, especially immune cells. Here, we discuss the immune regulatory roles of three kinds of chemotherapeutic drugs under low-dose conditions and propose low dosages as potential new chemotherapeutic weapons on the battlefield of immune-related disease.

CD4+FOXP3+ regulatory T cell depletion by low-dose cyclophosphamide prevents recurrence in patients with large condylomata acuminata after laser therapy

Condylomata acuminata (CA) caused by human papillomavirus (HPV) is a common sexually transmitted disease with half a million new cases diagnosed in the United States per year and the annual increase in incidence in China. Recurrence is a major challenge for CA treatment. Recently, we demonstrated that FOXP3(+) regulatory T (Treg) cells mediate the immunosuppression in large genital warts. Here, we further report that low-dose cyclophosphamide (CY), a conventional chemotherapy drug, can effectively prevent the recurrence of large CA in clinical patients after laser therapy. Surprisingly, although 9 out of 52 patients recur six weeks after the combination treatment, the re-administration of low-dose CY alone completely eliminates most recurred lesions. We provide evidence that low-dose CY not only depletes patients' Treg cells and enhances function of HPV-specific T cells and NK cells in the periphery, but also ameliorates the immune milieu of the lesion site, leading to the elimination of remnant viruses. These findings have important clinical significance, and potentially lead to a therapeutic breakthrough for the treatment of CA.

The location of endogenous wild-type p53 protein in 293T and HEK293 cells expressing low-risk HPV-6E6 fusion protein with GFP

The mechanism underlining human papillomaviruses (HPVs) causing cancer has been studied extensively, and it was concluded that the high-risk HPVs' E6 targeted and degraded tumor suppressor protein p53, leading to infected cells malignant transformation. In contrast, the low-risk HPVs only cause proliferative but non-invasive lesions of infected epithelia. Therefore, we hypothesized that low-risk HPVs' E6 might interact with p53 in a different pattern. We used a mammalian green fluorescent protein (GFP) expression system to express HPV-18E6 and HPV-6E6 fusion proteins in wild-type (wt) p53 cell lines, 293T and HEK293 cells, to investigate the traffic and location of E6s and p53. The results indicated GFP-18E6 was mainly expressed in nucleus, whereas GFP-6E6 was expressed exclusively in cytoplasm. Endogenous wt p53 was shown to be localized in the nuclei of cells transfected with GFP- 18E6. Interestingly, for the first time, we observed that p53 was trapped in the cytoplasm and never translocated into the cell nuclei transfected with GFP-6E6. In conclusion, HPV-6E6 was responsible for the cytoplasmic localization of p53. Therefore, our experiments provide a new insight into the pathogenesis of HPV.

Genital warts: New approaches to the treatment / Genitalne bradavice - novi pristupi u lečenju

Genital warts are one of the most common sexually transmitted infections caused by the human papilloma virus. Persons with genital warts may be infected by several types of human papilloma viruses: various types may have antagonistic or synergistic interactions, causing regression or recurrence of the existing lesions. No specific antiviral therapy is currently available. The treatment includes removal of symptomatic lesions on the skin and mucous surfaces. Apart from classical surgical procedures, local destruction of lesions is performed using various chemical and physical agents, whereas systemic therapy includes administration of agents promoting the immune system. The efficacy of treatment is not identical in all cases, and relapses are still inevitable. Combination therapy is often an alternative to monotherapy, while vaccine has an important role in prevention of genital warts.

Sexually transmitted papillomavirus infections: epidemiology pathogenesis, clinic, morphology, important differential diagnostic aspects, current diagnostic and treatment options

The family of human papilloma viruses (HPV) comprises more than 100 genotypes. Approximately 30 of the genotypes are responsible for infections in the human anogenital area. A precisely defined algorithm with the goal of diagnosing and removing HPV for a prolonged or indefinite length of time, as well as to protect the patient from any malignant ransformation, does not currently exist. The identification of HPV strains by PCR or DNA hybridization in lesional tissue provides higher security for the patients. In high-risk patients additional colposcopy, rectoscopy, and rethroscopy/cystoscopy increase the probability of proper diagnosis and the application of a reliable therapeutic strategy. Removal of lesions by means of invasive methods, such as electrodessication, cryosurgery, and/or laser therapy, may be successful and could be combined pre- and postoperatively with the local application of podophyllotoxin, Trichloroacetic acid, 5-fluorouracil epinephrine gel, imiquimod, cidofovir or interferon. The administration of vaccine to young patients prevents to a significant extent the clinical manifestation of the most frequent viral strains, being HPV-6,-11 and -18. The different therapeutic methods must be applied in accordance with the clinical picture, taking into account the patient's general status, the presence of concomitant diseases, as well as the local and systematic compatibility of the side effects of each remedy. The review focuses on the diagnosis and treatment options of sexually transmitted HPV-infections and includes synopsis of the most recent literature regarding new data of epidemiology, pathogenesis, ifferential diagnosis and morphology of HPV infections in humans.

Molecular epidemiology of sexually transmitted human papillomavirus in a self referred group of women in Ireland

Background

Human papillomavirus (HPV) causes cervical cancer and external genital warts. The purpose of this study is to document the genotype distribution of HPV in females aged between 18 and 34 who self-referred to an STI clinic with visible external genital warts (EGW). Scrapings were taken from visible external genital warts (EGW). These scrapings were analysed by PCR for the presence of HPV DNA. Positive samples were then genotyped by means of a commercially available assay (LiPA). A comparison of genotyping results determined by the LiPA assay and direct amplicon DNA sequencing was also performed.

Results

Ninety-two patients out of 105 samples (88%) had detectable levels of HPV DNA. The majority of individuals with EGW (66%) showed the presence of two or more genotypes. The most common HPV genotypes present in the study population were HPV-6, HPV-11, HPV-16, HPV-18, HPV-33 and HPV-53. Potential effects of vaccination on HPV molecular epidemiology indicate that 40% of the patients could have been protected from the high risk genotypes HPV-16 and HPV-18.

Conclusion

This is the first report of the molecular epidemiology of external genital warts in women aged between 18 and 34 from Ireland based on results from a LiPA assay. The study shows that most individuals are infected with multiple genotypes including those with high oncogenic potential and that the newly available HPV vaccines could have a significant impact on prevalence of the most common HPV genotypes in this study population.

Benign masses of the female periurethral tissues and anterior vaginal wall

Due to their rarity, benign masses of the periurethral tissues and anterior vaginal wall are poorly understood. Arriving at the proper evaluation and treatment is challenging because many of these masses have similar presenting signs and symptoms, as well as overlapping differential diagnoses. The literature regarding these lesions mainly consists of level III evidence, mostly involving case reports and series. Clinical management has traditionally been based on established surgical principles and expert opinion. This review presents the pertinent embryologic and anatomic background for these benign masses, as well as other pertinent etiological processes. Furthermore, the most current evidence is reviewed regarding the differential diagnosis, evaluation, and treatment for each mass.

Distinctive features of foreskin condylomata acuminata associated with diabetes mellitus

The aim of this study was to test the hypothesis that particular clinical features of foreskin condylomata acuminata in Chinese male patients are associated with diabetes. A prospective study enrolled 126 men presenting with foreskin condylomata acuminata from 2001 to 2006. Mean age was 46 years (age range 25-74 years) and mean duration of disease was 4.8 months (range 1-18 months). Patients were divided into two groups according to clinical features. In group 1, 42 men had distinctive signs such as redundant prepuce, crown warts circling the entire preputial ring, maceration, fissures, phimosis and balanitis, and 37 of 42 (88%) patients were found to have concurrent type 2 diabetes, furthermore 32 of these 37 patients had an insidious onset and were previously undiagnosed. In group 2, 84 male patients did not have those distinctive clinical features and type 2 diabetes was found in only 10 cases (11.9%, p<0.0001, Fisher's exact test). These clinical features strongly suggest the presence of diabetes. Therapy should address diabetes and condylomata concurrently.

Local accumulation of FOXP3+ regulatory T cells: evidence for an immune evasion mechanism in patients with large condylomata acuminata

Condylomata acuminata derived from the infection of human papillomavirus is a common sexually transmitted disease. Although T cell-mediated cellular immunity is considered as the main arm against such infection, the regulation of T cell immune responses in genital condylomata is unclear to date. In this study, we analyzed FOXP3(+) regulatory T cells in genital condylomata of patients. The results show that FOXP3(+) regulatory T cells with suppressive function accumulated in large warts. Consistently, the immunosuppressive milieu in large warts was characterized by high expression of IL-10 and TGF-beta1 and low expression of IL-2 and IFN-gamma. The responsiveness of wart-infiltrating T cells both in vitro and in vivo can be increased by depleting FOXP3(+) T cells. The accumulation of FOXP3(+) regulatory T cells in large warts can be partly ascribed to the chemotaxis of CCL17 and CCL22, derived from Langerhans cells and macrophages in wart. Although such accumulation favors the local immunosuppression, it seems not to influence the systemic immunity. In conclusion, these findings demonstrate that FOXP3(+) regulatory T cells play an important role in genital condylomata, which has multiple implications in the comprehensive treatment of condylomata acuminata.

Significance of SHP-1 and SHP-2 expression in human papillomavirus infected Condyloma acuminatum and cervical cancer

Human papillomaviruses (HPVs) are a group of DNA viruses that infect the skin and mucous membranes. Type HPV6/11 is closely related to Condyloma acuminatum, while HPV16/18 is the principal cause of cervical cancer. In this study, we examined the expression of protein tyrosine phosphatases SHP-1 and SHP-2 in Condyloma acuminatum, cervical cancer and the relationship between SHP-1/SHP2 expression and HPV infection. Forty Condyloma acuminatum cases, 20 cervical cancer cases and 20 normal human foreskins were examined for HPV infection by in situ hybridization and the expression of SHP-1 and SHP-2 were examined by immunohistochemistry. Results demonstrated that positive expression rates of HPV6/11, HPV16/18, and HPV31/33 were 98%, 10%, and 7.5% in Condyloma acuminatum, 10%, 85%, and 25% in cervical cancer. Only one normal foreskin demonstrated positive staining for HPV16/18. Positive expression rates of SHP-1 and SHP-2 were 80% and 85% in Condyloma acuminatum, 85% and 90% in cervical cancer. The SHP-1 and SHP-2 expressions were mainly distributed in the prickle layer of Condyloma acuminatum and were diffusely distributed in cervical cancer cells. Only 35% and 30% of foreskins demonstrated weak staining in the basal layer cells. There were statistically significant correlations among the infection of HPV and the expression of SHP-1 and SHP-2 in both Condyloma acuminatum and cervical cancer (P < 0.05). SHP-1 expression has a positive correlation with SHP-2 expression. Our results demonstrate putative roles of SHP-1 and SHP-2 in the progression of both Condyloma acuminatum and cervical cancer after HPV infection.

Condylomata acuminata of external urethral meatus causing infravesical obstruction

Condyloma acuminata is one of the most common virally transmitted diseases. The most common sites for condyloma in males are the balanopreputial sulcus, frenulum and the glans' mucosa. Condylomata in the urethra is rarely seen occur and most often situated in the distal part of the urethra. A 24-year-male admitted to our clinic with complaint of papillary lesion at the urethral meatus and urinary retention. Physical examination revealed that multiple papillary lesions along the anterior urethra until 1 cm distance from the urethral meatus. Under the clinical diagnosis of condyloma acuminata, he was treated conservatively with radical local excision of the lesion and condyloma acuminatum was verified by histopathological examination. Four months after surgery, there has been no local or remote recurrence.