Intralesional Measles-Mumps-Rubella Vaccine for Genital Warts

Genital warts are caused by several strains of Human Papilloma Viruses. Although asymptomatic in most cases, they can be psychologically and physically distressing for patients. Recently, intralesional immunotherapy using different antigens—such as Bacille Calmette–Guerin vaccine, candida antigen and measles, mumps, and rubella (MMR) vaccine—have shown promising efficacy in the treatment of genital warts. We report two cases in Omani males who presented to the Dermatology Department at Barka Polyclinic with recalcitrant genital warts that resolved completely with intralesional injection of the MMR vaccine.

Genital condylomata in a patient receiving infliximab for Crohn's disease

Infliximab is a monoclonal antibody against tumour necrosis factor-alpha. Recent studies have shown that it is effective in treating patients with refractory Crohn's disease and in those with Crohn's fistulae. Though this drug is found to be safe in clinical trials, sporadic reports of serious complications have been recorded in the literature. The case of a patient who developed profuse genital warts after infliximab treatment is reported. The literature is reviewed and information is presented on side effects and complications as a result of infliximab therapy.

Development of human papillomavirus-associated Buschke-Löwenstein penile carcinoma during cyclosporine therapy for generalized pustular psoriasis

Buschke-Löwenstein-type giant penile condyloma developed in a human immunodeficiency virus-negative, 25-year-old man after 4 years of intermittent cyclosporine therapy (5 mg/kg/day) for pustular psoriasis. Microscopic examination showed multifocal areas of invasive squamous cell carcinoma. Dot blot analysis of amplified polymerase chain reaction products with primers directed at the L1 region demonstrated signals for several human papillomavirus genotypes, including human papillomavirus type 16, that correlated with different histologic patterns consisting of verrucous and bowenoid changes and invasive carcinoma. This case conforms to the enhanced risk of cutaneous carcinogenesis from either papillomavirus infection or chronic actinic damage that has become evident in patients with organ allografts and cyclosporine therapy.

Oral contraceptives and human papillomavirus infection in cervical intraepithelial neoplasia

We report about 142 patients from whom colposcopically directed cervical punch biopsies were taken which showed condylomatous lesions with or without cervical intraepithelial neoplasia (CIN). Fifty-six (39.4%) of these women used oral contraceptives (OC) for at least two years before examination. We used DNA in situ hybridization on all biopsies for detection of human papillomavirus (HPV)-DNA. Among OC users a significant trend towards higher HPV infection rates in high grade CIN (odds ratio 2.9, P less than 0.05) was found, whereas non-users of oral contraceptives had the highest HPV infection rate in condylomatous lesions without CIN (odds ratio 0.5, P less than 0.05). Thus in OC users HPV infection was about 24 times more likely in CIN III as in condyloma, while among non-users the trend was the other way round (7-fold likelihood of HPV positivity in condyloma compared to CIN III). Other known risk factors for cervical carcinoma did not influence HPV infection rates in either group.

The physical state of human papillomavirus type 16 DNA in benign and malignant genital tumours

Cloned DNA from human papillomavirus (HPV) type 16 was subjected to restriction enzyme analysis. A genome size of 7.8 +/- 0.1 kb was determined and restriction maps were prepared. Fragments of HPV 16 DNA were nick-translated and hybridized with fragments of HPV 6b DNA. The two genomes appeared to be colinear. The physical state of HPV 16 DNA in genital tumours was analysed. In each of six benign tumours the viral DNA was detected exclusively as 8 kb circles. In four malignant tumours the viral DNA appeared to be integrated within the host genome but one cervical carcinoma and one case of Bowen's disease also contained oligomeric episomal molecules of viral DNA. One cervical carcinoma (WV 2965), containing only integrated viral DNA, was examined in detail. HPV 16 DNA was integrated as head-to-tail tandem repeats at more than one site. Three virus/cell junction fragments from this tumour were cloned. Two contained lengths of repetitive cellular DNA and one a length of apparently single copy cellular DNA.