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Poppens M, Ruci A, Davis J. Cutaneous Applications of the Antiviral Drug Cidofovir: A Review. J Clin Med 2024; 13:2462. [PMID: 38730991 PMCID: PMC11084884 DOI: 10.3390/jcm13092462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/11/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Background/Objectives: Cidofovir, an antiviral drug approved for cytomegalovirus retinitis, has emerged as an alternative treatment option for virally induced cutaneous and mucocutaneous conditions, as well as being trialed as a treatment for select neoplasms. In this review, we highlight the existing evidence, clinical uses, and rationale of using cidofovir for the treatment of cutaneous pathologies. Methods: A PubMed database literature search was conducted to identify relevant articles for inclusion in this review. Results: Cidofovir has several cutaneous applications in various formulations including intravenous, topical, and subcutaneous administrations. Primarily through case reports, case series, and retrospective reviews, cidofovir has demonstrated efficacy in treating a variety of virally induced conditions-verruca vulgaris, herpes simplex virus, molluscum contagiosum-as well as in adjuvant treatment for select neoplasms. The drug has shown efficacy in immunocompromised and immunocompetent adults and children alike. Conclusions: The body of literature supports the use of cidofovir as an effective and well-tolerated treatment for many viral cutaneous pathologies, and encourages further study for its use as an adjuvant therapy for neoplastic disease.
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Affiliation(s)
- McKayla Poppens
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90404, USA
| | - Amanda Ruci
- David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90404, USA
| | - Jeremy Davis
- Division of Dermatologic Surgery, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, 2020 Santa Monica Blvd #510, Los Angeles, CA 90404, USA
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Leerunyakul K, Thammarucha S, Suchonwanit P, Rutnin S. A comprehensive review of treatment options for recalcitrant nongenital cutaneous warts. J DERMATOL TREAT 2020; 33:23-40. [PMID: 32116076 DOI: 10.1080/09546634.2020.1737635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: The treatment of recalcitrant nongenital cutaneous warts has always been challenging for dermatologists as they often recur and relapse. Multiple treatment options have been investigated to improve the outcome. This review provides an overview of the current treatment modalities and summarizes the efficacy and side effects of each treatment option for recalcitrant nongenital cutaneous warts.Methods: A PubMed search was performed through July 2019 to include all English language reports investigating the treatment for recalcitrant nongenital cutaneous warts, regardless of design.Results: A total of 144 studies were included in this review. The treatment options for recalcitrant nongenital cutaneous warts can be divided into three groups: destructive treatment, immunotherapy, and cytotoxic agents. Although both destructive therapies and cytotoxic agents demonstrated high complete response rates, immunotherapy, which is a minimally invasive method, was superior in terms of the clearance of distant warts. Intralesional mumps-measles-rubella injections and purified protein derivatives currently demonstrate high efficacy with well-established clinical evidence.Conclusions: Many upcoming treatment modalities, especially immunotherapy, are promising. However, more comparative studies are required to verify the efficacy and safety profile.
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Affiliation(s)
- Kanchana Leerunyakul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasima Thammarucha
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Boroujeni NH, Handjani F. Cryotherapy versus CO 2 laser in the treatment of plantar warts: a randomized controlled trial. Dermatol Pract Concept 2018; 8:168-173. [PMID: 30116657 PMCID: PMC6092077 DOI: 10.5826/dpc.0803a03] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 04/10/2018] [Indexed: 12/05/2022] Open
Abstract
Background Warts are one of the most common infections in humans. Plantar warts are a subtype of non-genital warts, and several procedures and topical treatments have been used in its treatment. Cryotherapy is one of the most popular modalities, but it is time-consuming and remission rates vary in different studies. CO2 laser was the first laser used for treating warts. To date, no clinical trial has been done to compare CO2 laser with cryotherapy in the treatment of plantar warts. Patients and Methods This randomized controlled trial was performed in order to compare the efficacy and number of sessions needed to treat plantar warts in 60 patients who had received no previous treatment in the previous 3 months. They were randomly allocated to the cryotherapy or CO2 laser group. The number of sessions needed for response and the recurrence rate after a 3-month follow-up was compared in the 2 groups. Results Sixty patients with plantar warts were randomly allocated to either the CO2 laser or cryotherapy groups. Median age was 25 (range=18–53) and 27 (range= 18–75) years in the cryotherapy group and CO2 laser groups, respectively. Both groups were matched for age and sex (56% male and 44% female in the cryotherapy group and 34% male and 66% female in the CO2 laser group). The median number of sessions needed for complete resolution of the warts in the CO2 laser and cryotherapy groups were 1 (range=1–2) and 3 (range=1–12), respectively. The difference in the number of sessions was statistically significant between the 2 groups (P-value≤0.001). Recurrence rates after a 3-month follow-up was not statistically significant (P-value= 0.069). Conclusion The number of sessions needed to treat plantar warts was less using CO2 laser than cryotherapy; therefore, this modality can be a good addition to the already existing anti-wart armamentarium.
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Affiliation(s)
| | - Farhad Handjani
- Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran.,Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Blaizot R, Dutkiewicz AS, Guillet S, Pham-Ledard A, Beylot-Barry M. Intravenous cidofovir for diffuse genital warts in the setting of multifactorial immunosuppression. J Eur Acad Dermatol Venereol 2016; 31:e162-e163. [DOI: 10.1111/jdv.13880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Blaizot
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - A.-S. Dutkiewicz
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - S. Guillet
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - A. Pham-Ledard
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
| | - M. Beylot-Barry
- Dermatology Department; Oncodermatology Unit; CHU de Bordeaux; University of Bordeaux; Bordeaux France
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Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfield-Jones SE. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol 2014; 171:696-712. [PMID: 25273231 DOI: 10.1111/bjd.13310] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J C Sterling
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 OQQ, U.K
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6
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De Schutter T, Andrei G, Topalis D, Duraffour S, Mitera T, van den Oord J, Matthys P, Snoeck R. Reduced tumorigenicity and pathogenicity of cervical carcinoma SiHa cells selected for resistance to cidofovir. Mol Cancer 2013; 12:158. [PMID: 24325392 PMCID: PMC4029382 DOI: 10.1186/1476-4598-12-158] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 11/18/2013] [Indexed: 12/18/2022] Open
Abstract
Background Insights into the mechanisms associated with chemotherapy-resistance are important for implementation of therapeutic strategies and for unraveling the mode of action of chemotherapeutics. Although cidofovir (CDV) has proven efficacious in the treatment of human papillomavirus (HPV)-induced proliferation, no studies concerning the development of resistance to CDV in HPV-positive tumor cells have been performed yet. Methods From the cervical carcinoma SiHa cells (SiHaparental), which are HPV-16 positive, cidofovir-resistant cells (SiHaCDV) were selected, and differential gene expression profiles were analyzed by means of microarrays. We examined in vitro phenotyping of resistant cells compared to parental cells as well as tumorigenicity and pathogenicity in a mouse-xenograft model. Results SiHaCDV had a resistant phenotype and a reduced growth both in vitro and in vivo. A markedly diminished inflammatory response (as measured by production of host- and tumor-derived cytokines and number of neutrophils and macrophages in spleen) was induced by SiHaCDV than by SiHaparental in the xenograft model. Gene expression profiling identified several genes with differential expression upon acquisition of CDV-resistance and pointed to a diminished induction of inflammatory response in SiHaCDV compared to SiHaparental. Conclusions Our results indicate that acquisition of resistance to cidofovir in SiHa cells is linked to reduced pathogenicity. The present study contributes to our understanding on the antiproliferative effects of CDV and on the mechanisms involved, the inflammatory response playing a central role.
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Affiliation(s)
| | | | | | | | | | | | | | - Robert Snoeck
- Rega Institute, Laboratory of Virology and Chemotherapy, KU Leuven, Leuven, Belgium.
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Broganelli P, Chiaretta A, Fragnelli B, Bernengo MG. Intralesional cidofovir for the treatment of multiple and recalcitrant cutaneous viral warts. Dermatol Ther 2013; 25:468-71. [PMID: 23046027 DOI: 10.1111/j.1529-8019.2012.01477.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cidofovir is a nucleoside analog of deoxycytidine with a strong activity against a broad spectrum of DNA viruses, including human papillomavirus. The first objective was to evaluate efficacy of cidofovir for the treatment of cutaneous viral warts, recalcitrant after conventional therapies or where the surgery approach is difficult for their location or extension. Second, the present authors propose to point out possible local and systemic side effects consequent to treatment. Two-hundred eighty patients affected by recalcitrant cutaneous viral warts, were treated with intralesional cidofovir 15 mg/mL once a month. The present authors stated that candidates were those who had made before at least two other treatments reported in the guideline for management of cutaneous viral warts. In 276 cases, warts completely cleared: 158 of those have a follow-up period longer than 12 months and 118 have a follow-up of 6 months. On the average, 3,2 injections were enough to solve the problem. Local side effects consisted of pain and burning sensation during the injections; itching, erythema, and post-inflammatory hyperpigmentation were observed. No cases of systemic side effects were noted. The treatment was well tolerated, and the warts were completely cleared without relapses. Intralesional cidofovir is emerging as an effective therapeutic alternative for warts that are unresponsive to conventional treatments.
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Affiliation(s)
- Paolo Broganelli
- Department of Oncology and Dermatology, University of Turin, Turin, Italy
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De Schutter T, Andrei G, Topalis D, Duraffour S, Mitera T, Naesens L, van den Oord J, Matthys P, Snoeck R. Cidofovir treatment improves the pathology caused by the growth of human papillomavirus-positive cervical carcinoma xenografts in athymic nude mice. Cancer Lett 2013; 329:137-45. [DOI: 10.1016/j.canlet.2012.10.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 10/26/2012] [Accepted: 10/26/2012] [Indexed: 11/29/2022]
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9
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McAleer MA, Bourke J. Intravenous cidofovir for resistant cutaneous warts in a patient with psoriasis treated with monoclonal antibodies. Clin Exp Dermatol 2011; 36:638-40. [DOI: 10.1111/j.1365-2230.2011.04039.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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De Clercq E. Yet another ten stories on antiviral drug discovery (part D): paradigms, paradoxes, and paraductions. Med Res Rev 2010; 30:667-707. [PMID: 19626594 DOI: 10.1002/med.20173] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This review article presents the fourth part (part D) in the series of stories on antiviral drug discovery. The stories told in part D focus on: (i) the cyclotriazadisulfonamide compounds; (ii) the {5-[(4-bromophenylmethyl]-2-phenyl-5H-imidazo[4,5-c]pyridine} compounds; (iii) (1H,3H-thiazolo[3,4-a]benzimidazole) derivatives; (iv) T-705 (6-fluoro-3-hydroxy-2-pyrazinecarboxamide) and (v) its structurally closely related analogue pyrazine 2-carboxamide (pyrazinamide); (vi) new strategies for the treatment of hemorrhagic fever virus infections, including, as the most imminent, (vii) dengue fever, (viii) the veterinary use of acyclic nucleoside phosphonates; (ix) the potential (off-label) use of cidofovir in the treatment of papillomatosis, particularly RRP (recurrent respiratory papillomatosis); and (x) finally, the prophylactic use of tenofovir to prevent HIV infections.
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Affiliation(s)
- Erik De Clercq
- Rega Institute for Medical Research, K.U. Leuven, Minderbroedersstraat 10, B-3000 Leuven, Belgium.
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Oliveira WR, Ferreira GN, Rady PL, Festa C, Tyring SK. Epidermodysplasia Verruciformis Associated with Myelodysplastic Syndrome: An Intriguing Association. J Cutan Med Surg 2009; 13:317-20. [DOI: 10.2310/7750.2009.08049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Epidermodysplasia verruciformis (EV) is a rare genodermatosis characterized by massive infection with human papillomaviruses (HPVs) and development of skin cancer. Myelodysplastic syndromes (MDSs) are a group of chronic conditions that involve dysplastic hematopoiesis, peripheral blood cytopenias, and a high incidence of progression into leukemia. Methods: We describe the intriguing association of these two premalignant conditions (EV and MDS) in one patient. These diagnoses were confirmed by histopathologic examination and cytogenetic abnormalities of bone marrow cells. Results: The patient presented initially with clinical features typical of EV and impairment of cell-mediated immunity. In the skin lesions, HPVs 23 and 25 were identified by nested polymerase chain reaction. Six years later, he had recurrent episodes of mucosal bleeding with fever, weakness, and fatigue. At this time, severe refractory anemia and neutropenia were observed, and bone marrow smears showed hypercellularity with abnormal dysplastic megakaryocytes. The cytogenetic pattern showed abnormalities involving trisomy of chromosomes 8 and 21. The patient received a diagnosis of the indolent subtype of MDS. Conclusions: Through the observation of our patient and review of the literature, we hypothesized that the pathomechanisms, including the role of oncogenes and cytokines, are connected to the progression to malignancy in these settings.
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Affiliation(s)
- Walmar R. Oliveira
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Gustavo N. Ferreira
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Peter L. Rady
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Cyro Festa
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
| | - Stephen K. Tyring
- From the Department of Dermatology, University of São Paulo, São Paulo, Brazil, and the Department of Dermatology, The University of Texas M.D. Anderson Cancer Center and Medical School, Houston, TX
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Field S, Irvine AD, Kirby B. The treatment of viral warts with topical cidofovir 1%: our experience of seven paediatric patients. Br J Dermatol 2008; 160:223-4. [PMID: 19067689 DOI: 10.1111/j.1365-2133.2008.08947.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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De Socio GVL, Simonetti S, Rosignoli D, Minga P, Tomassini GM, Baldelli F. Topical cidofovir for severe warts in a patient affected by AIDS and Hodgkin's lymphoma. Int J STD AIDS 2008; 19:715-6. [DOI: 10.1258/ijsa.2008.008065] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We describe a 42-year-old man with AIDS and Hodgkin's lymphoma whose severe and recalcitrant cutaneous warts resolved following treatment with local 1% cidofovir. Clinically significant improvements were observed in a two-week period of therapy. In advanced HIV disease complicated by additional haematological malignancy, cutaneous warts may be difficult to treat and present a challenge for the attending physicians. In similar clinical condition topical anti-human papillomavirus therapy may prove to be safe and curative.
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Affiliation(s)
- G V L De Socio
- Department of Infectious Diseases, Clinical Immunology, ‘Santa Maria della Misericordia’ Hospital, University of Perugia, Piazzale Menghini, 1 – 06129 Perugia, Italy
| | - S Simonetti
- Department of Dermatology, Clinical Immunology, ‘Santa Maria della Misericordia’ Hospital, University of Perugia, Piazzale Menghini, 1 – 06129 Perugia, Italy
| | - D Rosignoli
- Department of Infectious Diseases, Clinical Immunology, ‘Santa Maria della Misericordia’ Hospital, University of Perugia, Piazzale Menghini, 1 – 06129 Perugia, Italy
| | - P Minga
- Department of Hematology and Clinical Immunology, ‘Santa Maria della Misericordia’ Hospital, University of Perugia, Piazzale Menghini, 1 – 06129 Perugia, Italy
| | - G M Tomassini
- Department of Dermatology, Clinical Immunology, ‘Santa Maria della Misericordia’ Hospital, University of Perugia, Piazzale Menghini, 1 – 06129 Perugia, Italy
| | - F Baldelli
- Department of Infectious Diseases, Clinical Immunology, ‘Santa Maria della Misericordia’ Hospital, University of Perugia, Piazzale Menghini, 1 – 06129 Perugia, Italy
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Cusack C, Fitzgerald D, Clayton TM, Irvine AD. Successful treatment of florid cutaneous warts with intravenous cidofovir in an 11-year-old girl. Pediatr Dermatol 2008; 25:387-9. [PMID: 18577053 DOI: 10.1111/j.1525-1470.2008.00689.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cutaneous warts, commonly seen in children and the immunosuppressed are socially distressing and are often resistant to traditional treatments. Here, we report an 11-year-old girl with bilateral florid verrucous lesions on her hands, feet and chin, which were refractory to a number of standard treatments including cryotherapy, cantharidin preparations, topical salicylic acid, surgical debulking techniques, oral Cimetidine, and topical and intralesional Cidofovir. As the disfiguring lesions had a marked adverse effect on her quality of life, a trial of IV Cidofovir was instituted. We administered five cycles of IV Cidofovir with a 1-week interval between the first and second treatment, followed by 2-week intervals thereafter. This regime was well tolerated and we report dramatic resolution of the lesions with persistent clearance 6 months after completion of the fifth infusion. Resolution of recalcitrant warts with IV Cidofovir has been reported in a limited number of cases. Our experience supports its efficacy in this setting, and to the best of our knowledge this is the first report of successful treatment of cutaneous warts with IV Cidofovir in a pediatric case.
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Affiliation(s)
- Caitriona Cusack
- Department of Paediatric Dermatology, Our Lady's Children's Hospital Crumlin, Dublin, Ireland.
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Bonnekoh B, Falk K, Reckling KF, Kenklies S, Nitsche A, Ghebremedhin B, Pokrywka A, Franke I, Thriene B, König W, Pauli G, Gollnick H. Cowpox infection transmitted from a domestic cat. J Dtsch Dermatol Ges 2008; 6:210-3. [DOI: 10.1111/j.1610-0387.2007.06546.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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16
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Mastrolorenzo A, Supuran CT, Zuccati G. The sexually transmitted papillomavirus infections: clinical manifestations, current and future therapies. Expert Opin Ther Pat 2007. [DOI: 10.1517/13543776.17.2.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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