1
|
Salado-Rasmussen K, Alsing KK, Mårtensson NL, Burian EA, Larsen HK. Penile Pyoderma Gangrenosum, a Rare Encounter in STI Healthcare: A Case Report and a Review of the Literature. Acta Derm Venereol 2024; 104:adv32160. [PMID: 38551377 PMCID: PMC11000657 DOI: 10.2340/actadv.v104.32160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/27/2024] [Indexed: 04/02/2024] Open
Abstract
Abstract is missing (Short communication)
Collapse
Affiliation(s)
- Kirsten Salado-Rasmussen
- Department of Dermato-Venereology, Bispebjerg University Hospital, Copenhagen, Denmark;Department of Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Køhler Alsing
- Copenhagen Wound Healing Center, Department of Dermato-Venereology, Bispebjerg University Hospital, Copenhagen, Denmark.
| | - Nina Løth Mårtensson
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Department of Pathology, Rigshospitalet University Hospital, Copenhagen, Denmark
| | - Ewa Anna Burian
- Department of Dermato-Venereology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Helle Kiellberg Larsen
- Department of Dermato-Venereology, Bispebjerg University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Ring LL, Larsen HK, Frederiksen K, Hædersdal M, Sørensen SS, Bonde JH, Thomsen LT, Kjær SK. Incidence and clearance of cervical and anal high-risk human papillomavirus in kidney transplant recipients: Results from a Danish prospective clinical study. Am J Transplant 2024:S1600-6135(24)00200-4. [PMID: 38458364 DOI: 10.1016/j.ajt.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/10/2024]
Abstract
This study investigates the incidence and clearance of cervical and anal high-risk human papillomavirus (hrHPV) infection in kidney transplant recipients (KTRs) compared to immunocompetent controls. During 2016-2017, we enrolled 125 female KTRs and 125 female controls. Liquid-based cervical and anal cytology samples collected at enrollment and follow-up were tested for human papillomavirus (HPV) DNA using the CLART HPV2 test. All participants answered a questionnaire on lifestyle and sexual behavior at both examinations. KTRs had an increased age-adjusted risk of incident cervical hrHPV infection compared to controls (hazard ratio [HR] = 3.6, 95% CI = 1.2-11.2). Probability of cervical hrHPV clearance at 18 months was lower among KTRs (8.3%) than controls (66.7%). There was no statistically significant difference in anal hrHPV incidence between KTRs and controls (HR = 0.9, 95% CI = 0.4-2.0). Clearance of anal hrHPV was similar between KTRs and controls at 18 months. During the total follow-up, a lower anal hrHPV clearance, although not statistically significant, was observed among KTRs (HR = 0.3, 95% CI = 0.06-1.2). KTRs had higher incidence of cervical hrHPV and lower probability of clearance, especially of cervical hrHPV infections, than controls. Our findings support that KTRs are at increased risk of HPV infection and point to the need for targeted HPV prevention strategies, such as cervical cancer screening.
Collapse
Affiliation(s)
- Linea Landgrebe Ring
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Helle Kiellberg Larsen
- Department of Dermatology and Venereology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Merete Hædersdal
- Department of Dermatology and Venereology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Søren Schwartz Sørensen
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Jesper Hansen Bonde
- Department of Pathology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | | | - Susanne K Kjær
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| |
Collapse
|
3
|
Larsen HK, Hædersdal M, Kjær SK. [Not Available]. Ugeskr Laeger 2023; 185:V10220616. [PMID: 36896618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Anal cancer risk is increased in certain risk groups including people living with HIV (PLWH), especially in men who have sex with men, but also in organ transplant recipients and women with a history of cervical or vulva dysplasia or cancer. High-resolution anoscopy (HRA) is a tool to diagnose anal high-grade squamous intraepithelial lesions (HSIL), and HRA-guided treatment of anal HSIL has been shown to reduce the risk of anal cancer in PLWH. The purpose of this review is to increase the awareness of HRA but also of tertiary prevention by digital anal rectal examination.
Collapse
Affiliation(s)
| | - Merete Hædersdal
- Dermato-venerologisk Afdeling D, Københavns Universitetshospital - Bispebjerg Hospital
| | - Susanne Krüger Kjær
- Afdeling for Virus, Livsstil og Gener, Kræftens Bekæmpelses Center for Kræftforskning
- Gynækologisk Afdeling, Juliane Marie Centret, Københavns Universitetshospital - Rigshospitalet
| |
Collapse
|
4
|
Larsen HK, Kjaer SK, Haedersdal M, Kjaer AK, Bonde JH, Sørensen SS, Thomsen LT. Anal Human Papillomavirus Infection in Kidney Transplant Recipients Compared With Immunocompetent Controls. Clin Infect Dis 2022; 75:1993-1999. [PMID: 35438132 DOI: 10.1093/cid/ciac285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Kidney transplant recipients (KTRs) have increased risk of human papillomavirus (HPV)-related anogenital (pre)cancers, including anal high-grade intraepithelial lesions and cancer. Previous studies on anal high-risk HPV (hrHPV) among KTRs are sparse. METHODS In a cross-sectional study, we included 247 KTRs and 248 controls from a dermatology department and 5 nephrology departments in Denmark during 2016-2017. All participants provided an anal cytobrush sample that was tested for HPV DNA. Participants completed a questionnaire on lifestyle and sexual habits. We used logistic regression to estimate odds ratios (ORs) of anal hrHPV in KTRs compared with controls and risk factors for anal hrHPV in KTRs. RESULTS The anal hrHPV prevalence was higher in female KTRs (45.5%) than in controls (27.2%). Female KTRs had almost 3-fold higher adjusted odds of anal hrHPV than controls (adjusted OR, 2.87 [95% confidence interval, 1.57-5.22]). In contrast, among men we did not observe increased prevalence or odds of anal hrHPV in KTRs compared with controls (prevalence, 19.4% vs 23.6%; adjusted OR, 0.85 [95% 95% confidence interval, .44-1.64]). Among hrHPV-positive KTRs, 63% and 52% of men and women, respectively, were infected with hrHPV types covered by the nonavalent HPV vaccine (type 16, 18, 31, 33, 45, 52, or 58). Current smoking, >10 lifetime sexual partners, history of genital warts, and among men having had receptive anal sex were risk factors for anal hrHPV in KTRs. CONCLUSIONS Female KTRs had an increased risk of anal hrHPV compared with immunocompetent controls. Our findings indicate that pretransplant HPV vaccination should be considered to prevent anal high-grade intraepithelial lesions and cancer caused by anal hrHPV infection in KTRs. CLINICAL TRIALS REGISTRATION NCT03018327.
Collapse
Affiliation(s)
- Helle Kiellberg Larsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Dermatology and Venereology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermatology and Venereology, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark
| | - Alexander K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jesper Hansen Bonde
- Department of Pathology, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Søren Schwartz Sørensen
- Department of Nephrology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| |
Collapse
|
5
|
Larsen HK, Grim SE, Salado-Rasmussen K, Danielsen AG. [Neurosyphilis]. Ugeskr Laeger 2022; 184:V05210418. [PMID: 35499222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This review focuses on typical and atypical manifestations of neurosyphilis. The manifestations of neurosyphilis are manyfold and may involve many specialties. Today, clinicians have limited experience with the well-described manifestations of neurosyphilis. Many screening opportunities for men who have sex with men might catch the majority of cases of syphilis in this group. However, a concern could be if disclosure about heterosexuality or, in general, monosymptomatic neurosyphilis constitute a risk for delayed diagnosis.
Collapse
Affiliation(s)
- Helle Kiellberg Larsen
- Dermato-Venerologisk Afdeling og Videncenter for Sårheling, Københavns Universitetshospital - Bispebjerg Hospital
| | - Simone Elisabeth Grim
- Dermato-Venerologisk Afdeling og Videncenter for Sårheling, Københavns Universitetshospital - Bispebjerg Hospital
| | - Kirsten Salado-Rasmussen
- Dermato-Venerologisk Afdeling og Videncenter for Sårheling, Københavns Universitetshospital - Bispebjerg Hospital
- Hudklinikken Panoptikon
| | | |
Collapse
|
6
|
Opstrup MS, Puchner M, Larsen HK. [Verrukøst karcinom udgående fra et kondylom]. Ugeskr Laeger 2020; 182:V71014. [PMID: 32829750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
|
7
|
Larsen HK, Thomsen LT, Haedersdal M, Dehlendorff C, Schwartz Sørensen S, Kjaer SK. Risk of genital warts in renal transplant recipients-A registry-based, prospective cohort study. Am J Transplant 2019; 19:156-165. [PMID: 30080315 DOI: 10.1111/ajt.15056] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/08/2018] [Accepted: 07/25/2018] [Indexed: 01/25/2023]
Abstract
Genital warts (GWs) are a risk factor for subsequent human papillomavirus (HPV)-related anogenital cancers. In this register-based, prospective cohort study, we estimated the risk of GWs in renal transplant recipients (RTRs) compared with a nontransplanted cohort. In a nationwide database, we identified first-time RTRs in Denmark during 1996 to 2015. For each RTR, 50 age- and sex-matched nontransplanted individuals were selected from the population registry. Information on GWs, sociodemographic characteristics, HPV vaccination, and other causes of immunosuppression was retrieved from registries. We estimated the cumulative incidence of GWs and used Cox regression to estimate hazard ratios (HR) of GWs in RTRs vs non-RTRs. We included 3268 RTRs and 162 910 non-RTRs without GWs 1 year before baseline. RTRs had higher hazard of GWs than non-RTRs (HR = 3.30; 95% confidence interval, 2.76-3.93, adjusted for sex, age, education, and income). The increased hazard of GWs compared with non-RTRs was more pronounced in female than in male RTRs. Although not statistically significant, the hazard tended to be higher in RTRs with functioning grafts compared with RTRs on dialysis after graft failure. The hazard of GWs was increased <1 year after transplantation and remained increased during ≥10 years. In conclusion, RTRs had substantially higher risk of GWs than non-RTRs.
Collapse
Affiliation(s)
- Helle Kiellberg Larsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Louise T Thomsen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Merete Haedersdal
- Department of Dermato-Venereology, Bispebjerg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Christian Dehlendorff
- Unit of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Søren Schwartz Sørensen
- Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| |
Collapse
|
8
|
Larsen HK, Kofoed K. [Ano-genital warts are more than benign lesions]. Ugeskr Laeger 2018; 180:V01180031. [PMID: 29798751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Ano-genital warts are in general considered as benign lesions, as they are mostly caused by the non-oncogenic HPV types 6 and 11. In this review, there is a focus on the problematic issues, that these lesions and their treatments can cause. Both topical and ablative treatments are associated with side effects, and the varying effect of the treatments combined with an uncertain timeline to clearance are known to cause psychological distress. Vaccination against HPV-6 and -11 has been shown to reduce the incidence of this troublesome infection substantially in both women and men in countries with high vaccine coverage.
Collapse
|
9
|
Terkelsen D, Tolstrup J, Johnsen CH, Lund O, Larsen HK, Worning P, Unemo M, Westh H. Multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and intermediate resistance to azithromycin, Denmark, 2017. ACTA ACUST UNITED AC 2018; 22. [PMID: 29067905 PMCID: PMC5710115 DOI: 10.2807/1560-7917.es.2017.22.42.17-00659] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe a multidrug-resistant Neisseria gonorrhoeae infection with ceftriaxone resistance and azithromycin intermediate resistance in a heterosexual man in Denmark, 2017. Whole genome sequencing of the strain GK124 identified MSLT ST1903, NG-MAST ST1614 and all relevant resistance determinants including similar penA resistance mutations previously described in ceftriaxone-resistant gonococcal strains. Although treatment with ceftriaxone 0.5 g plus azithromycin 2 g was successful, increased awareness of spread of gonococcal strains threatening the recommended dual therapy is crucial.
Collapse
Affiliation(s)
- David Terkelsen
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark.,These authors contributed equally to the work
| | - Jacob Tolstrup
- These authors contributed equally to the work.,Department of Dermatovenerology, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Ole Lund
- Department of Bio and Health Informatics, Technical University of Denmark, Lyngby, Denmark
| | | | - Peder Worning
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark
| | - Magnus Unemo
- WHO Collaborating Centre for Gonorrhoea and other Sexually Transmitted Infections, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,These authors share last authorship
| | - Henrik Westh
- Department of Clinical Microbiology, Hvidovre Hospital, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,These authors share last authorship
| |
Collapse
|
10
|
Larsen HK, Banzhaf CA, Thomsen SF, Gormsen M, Schopf RE, Haedersdal M. An exploratory, prospective, open-label trial of ingenol mebutate gel 0.05% for the treatment of external anogenital warts. J Eur Acad Dermatol Venereol 2018; 32:825-831. [PMID: 29024025 DOI: 10.1111/jdv.14625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/20/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Anogenital warts (AGW) can cause physical discomfort and decreased quality of life. Recent case reports suggest that ingenol mebutate gel might be an effective treatment of AGW. OBJECTIVE To explore primarily the safety, and secondarily the efficacy of ingenol mebutate gel 0.05% in patients with AGW. METHODS This was an exploratory, open-label, 1-arm trial of ingenol mebutate gel 0.05% administered up to three times to patients with AGW. Safety was assessed by occurrence and severity of local skin reactions (LSRs) and treatment-related adverse events (AEs). Efficacy was assessed by complete clearance and reduction in AGW count 14 days after last treatment, and recurrence 12 weeks after clearance. RESULTS Of 41 patients enrolled, 40 received treatment and 26 completed the trial. Patients had a median AGW count of 11.0 and AGW duration of 3.0 years at baseline. All patients experienced transient LSRs following treatment with a maximum composite LSR score of 7.5 (on a scale from 0 to 18). A total of 93% of patients reported treatment-related AEs, most frequently pain (85%) and procedural complications (35%) due to smearing of the gel. 78% of patients took mild analgesics for the pain, typically for 1-2 days following treatment. The majority of AEs were of moderate-to-severe intensity. Seventeen of 39 patients (43.6%) had complete clearance 14 days after last treatment, and AGW count was reduced by 90.9%. There was a tendency towards lower clearance rate in patients with longer duration of AGW. Eight of 14 patients (57.1%) had AGW recurrence 12 weeks after clearance. CONCLUSION Ingenol mebutate gel was associated with a high number of AEs and withdrawals due to painful local and adjacent skin reactions. Furthermore, it showed promising efficacy in reducing AGW despite a difficult-to-treat population. Optimization of the formulation is warranted to improve the safety profile of the treatment.
Collapse
Affiliation(s)
- H K Larsen
- Department of Dermato-Venereology, University Hospital of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| | - C A Banzhaf
- Department of Dermato-Venereology, University Hospital of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| | - S F Thomsen
- Department of Dermato-Venereology, University Hospital of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - R E Schopf
- Department of Dermatology, Johannes Gutenberg University, Mainz, Germany
| | - M Haedersdal
- Department of Dermato-Venereology, University Hospital of Copenhagen, Bispebjerg Hospital, Copenhagen, Denmark
| |
Collapse
|
11
|
Taudorf EH, Larsen HK. [Gonorrhea cases on the rise]. Ugeskr Laeger 2016; 178:V68284. [PMID: 27745575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
|
12
|
Salado-Rasmussen K, Cowan S, Gerstoft J, Larsen HK, Hoffmann S, Knudsen TB, Katzenstein TL, Jensen JS. Molecular Typing of Treponema pallidum in Denmark: A Nationwide Study of Syphilis. Acta Derm Venereol 2016; 96:202-6. [PMID: 26122912 DOI: 10.2340/00015555-2190] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this nationwide study is to determine the strain type diversity among patients diagnosed with syphilis by PCR during a 4-year period in Denmark. Epidemiological data, including HIV status, for all patients were obtained from the Danish national syphilis registration system. Molecular strain typing was based on characterization of 3 variable treponemal genes, arp, tpr and tp0548. A total of 278 specimens from 269 patients were included. Among the fully typeable specimens (n = 197), 22 strain types were identified, with 1 type, 14d/g, accounting for 54%. The majority (93%) of the patients reported acquiring syphilis in Denmark. Among patients with concurrent HIV, 9 full strain types were identified and no difference in strain type was found by HIV status (p = 0.197). In conclusion, the majority of patients were infected in Denmark and the HIV-infected syphilis patients were diagnosed with a wide spectrum of different strain types of Treponema pallidum.
Collapse
Affiliation(s)
- Kirsten Salado-Rasmussen
- Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Carlsen BC, Larsen HK, Hædersdal M. [Ablative laser treatment of rhinophyma]. Ugeskr Laeger 2016; 178:V66927. [PMID: 26815717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
14
|
Kiellberg Larsen H. [Uncertainty about the duration of HPV vaccine immunogenicity in boys]. Ugeskr Laeger 2013; 175:1817. [PMID: 23923133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
|
15
|
Kiellberg Larsen H. [Screening for anal intra-epithelial neoplasia among men, who have sex with men]. Ugeskr Laeger 2013; 175:345-349. [PMID: 23402240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Anal intra-epithelial neoplasia is of high incidence in the post-highly active antiretroviral treatment era especially among men, who have sex with men (MSM). This article focuses on the relation between infection with oncogenic HPV types and anal intra-epithelial neoplasia, and the potential progression to anal cancer. Vaccine studies with the quadrivalent HPV vaccine in HIV-negative MSM shows promising results regarding preventing development of HGAIN.
Collapse
Affiliation(s)
- Helle Kiellberg Larsen
- Dermato-venerologisk Afdeling D, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 København NV, Denmark.
| |
Collapse
|
16
|
Kiellberg Larsen H, Kofoed K, Sand C. [The disease burden of human papillomavirus in men is substantial and can potentially be prevented]. Ugeskr Laeger 2013; 175:349-353. [PMID: 23402241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Human papillomavirus (HPV) is a highly prevalent sexually transmitted infection. High-risk HPV causes penile cancer and a substantial proportion of oropharyngeal and anal malignancy in men. Low-risk types of HPV cause anogenital warts. The incidence of oropharyngeal and anal cancers is increasing in Denmark. Prevention of penile, anal and oropharyngeal cancers and anogenital warts represents potential benefits of the HPV vaccine; and vaccination of men is now recommended by the Australian and the North American health authorities. Thus, we recommend that the Danish HPV vaccination program should include men.
Collapse
Affiliation(s)
- Helle Kiellberg Larsen
- Dermato-venerologisk Afdeling D, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 København NV, Denmark.
| | | | | |
Collapse
|
17
|
Olsen J, Jørgensen TR, Kofoed K, Larsen HK. Incidence and cost of anal, penile, vaginal and vulvar cancer in Denmark. BMC Public Health 2012; 12:1082. [PMID: 23244352 PMCID: PMC3546065 DOI: 10.1186/1471-2458-12-1082] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 12/13/2012] [Indexed: 11/27/2022] Open
Abstract
Background Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer. Methods New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis. Results The annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs. Conclusions Anogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current HPV vaccination program will markedly reduce this burden.
Collapse
Affiliation(s)
- Jens Olsen
- Centre for Applied Health Services Research and Technology Assessment (CAST), University of Southern Denmark, J, B, Winslows Vej 9B, 5000, Odense C, Denmark.
| | | | | | | |
Collapse
|
18
|
Gyldenløve M, Baumgartner-Nielsen J, Larsen HK. [Venereological examination]. Ugeskr Laeger 2012; 174:2701-2703. [PMID: 23121906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Mette Gyldenløve
- Dermato-allergologisk Afdeling K, Gentofte Hospital, Niels Andersens Vej 65, 2900 Hellerup.
| | | | | |
Collapse
|
19
|
Danielsen PL, Schønning K, Larsen HK. [Herpes simplex virus type 1 in a patient with herpes zoster]. Ugeskr Laeger 2012; 174:425-426. [PMID: 22331046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this case report we present an otherwise healthy 63 year-old male patient with herpes zoster corresponding to the 2nd left branch of the trigeminal nerve. Real time-polymerase chain reaction analyses were positive for both herpes simplex virus (HSV) type 1 and varicella zoster virus (VZV). The most probable explanation is that this reflects asymptomatic, latent expression of HSV-1 in a herpes zoster patient with no clinical relevance. Another hypothesis is that reactivation of a neurotropic herpes virus can reactivate another neurotropic virus if both types are present in the same ganglion. If co-infection with HSV/VZV is suspected the treatment regimen for herpes zoster will sufficiently treat a possible HSV infection also.
Collapse
|
20
|
Skovgaard S, Larsen HK, Sand C, Friis-Møller A, Schønning K, Jensen JS, Westh H. Genital and extra-genital screening for gonorrhoea using the BD Probetec ET system with an in-house PCR method targeting the porA pseudogene as confirmatory test. Acta Derm Venereol 2012; 92:45-9. [PMID: 22002460 DOI: 10.2340/00015555-1192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Diagnosing gonorrhoea from extra-genital as well as genital sites is important in managing this sexually transmitted disease. In this study we evaluated a screening procedure for Neisseria gonorrhoeae (GC) from all sample sites in a low-prevalence setting. A total of 69,252 specimens submitted for Chlamydia trachomatis testing were also examined for GC on the BD Viper™ platform using the BD Probetec ET system. In order to avoid false-positive results all GC BD reactive samples were re-tested using a PCR method with the porA pseudogene as target. Using this method we screened 170% more samples for GC than in the previous year, in the same population, and diagnosed more than twice as many GC-positive episodes. The BD system can be used successfully to screen extra-genital as well as genital specimen types for GC in a low-prevalence area if it is combined with a validated confirmatory PCR test.
Collapse
|
21
|
Thomsen SF, Larsen HK, Hagen K. [Diagnostics and treatment of pruritus ani]. Ugeskr Laeger 2009; 171:3791-3794. [PMID: 20018156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Pruritus ani is defined as an intense itching sensation affecting the perianal skin. The condition affects up to 5% of the population, and occurs four times more commonly in men than in women. Pruritus ani occurs in a primary form caused by overt but insufficient cleansing of the perianal skin, and in a secondary form caused by underlying pathology, often of proctological or dermatological/infectious origin. Causes and treatment are reviewed, and it is concluded that the condition, even in its chronic refractory form, has a favourable prognosis.
Collapse
|
22
|
Mortensen GL, Larsen HK. [The quality of life of male homosexual patients with condyloma]. Ugeskr Laeger 2009; 171:2561-2565. [PMID: 19732547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
INTRODUCTION A recent qualitative study shows that genital warts can reduce the quality of life of heterosexual patients considerably. This follow-up study seeks to elucidate the illness perception among men who have sex with men (MSM). The aim is to examine the extent to which minority cultural conditions and factors affect the experiences of these patients. MATERIAL AND METHODS This study was based on qualitative interviews with six Danish MSM. Along with the study among heterosexual patients, a literature review identified the important questions to be presented to the participants. RESULTS Many MSM worry about being stigmatized in the homosexual "scene" and thereby losing their affiliation to a significant social group as well as their chances of finding sex and love. Most participants had suffered from genital warts for several years - which added to the negative psycho-sexual and social effects of the disease. These participants' fears of developing anal cancer corresponded to the concerns of female genital warts patients about cervical cancer. CONCLUSION Ano-genital HPV infection is common among MSM. However, these men will not benefit to the same extent as heterosexual men from the herd immunity effect of HPV vaccination of girls. MSM may have particular pathological pictures as well as concerns that should be addressed when communicating with these patients and taken into account when considering HPV vaccination of boys.
Collapse
|
23
|
Larsen HK. [Health-related quality of life among patients with condyloma]. Ugeskr Laeger 2009; 171:2557-2561. [PMID: 19732546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
|
24
|
Mortensen GL, Larsen HK. [Quality of life of patients with condyloma]. Ugeskr Laeger 2008; 170:3858-3862. [PMID: 19014739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION The new quadrivalent vaccine against human papillomavirus (HPV) can prevent a large number of cervical cancer cases and most cases of genital warts. Genital warts are among the most common sexually transmitted diseases in Denmark and constitute a considerable burden to the health care system as well as to the individual patient. The aim of this study is to examine the ways in which genital warts may affect the patient's quality of life. The results are important in relation to treatment as well as counselling of patients suffering from genital warts. The results are particularly relevant to decisions concerning the introduction of HPV vaccination of men as well as women. MATERIAL AND METHODS A qualitative research design was applied using focus group interviews with male and female genital wart patients aged 18-30 years. The study was based on a literature review which identified the important issues and questions presented to the participants. RESULTS The participants in the study have a significantly lowered quality of life due to their genital warts. The disease negatively affects them psychologically, socially and in their sex and love life in particular. The course of treatment is a burden because of the uncertain time-line and the varying effectiveness. There is much need for more information and communication about the disease and its psycho-sexual aspects. CONCLUSION The development of a quadrivalent HPV vaccine is a milestone in the prevention of both cervical cancer and genital warts. The knowledge of genital warts is limited despite the prevalence of the disease and its severe effects on the patient's quality of life. This study indicates that HPV vaccination of both sexes would have a marked positive effect on the mental burden associated with the disease.
Collapse
|
25
|
Penninga EI, Larsen HK, Andersen SE. [Impotence caused by Methotrexate treatment]. Ugeskr Laeger 2008; 170:354. [PMID: 18252170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Methotrexate (MTX) is used in the treatment of malignant and non-malignant diseases. This case report describes impotence as a seldom but possible overlooked adverse effect to MTX treatment. A 58 year-old man was treated for erythrodermia with a weekly dose of 7.5 mg MTX. He developed erective impotence nine months after initiation of treatment. Two weeks after discontinuation of MTX the impotence subsided, but when MTX treatment was reintroduced, the impotence returned after two months. Only a few other cases of impotence associated with MTX have been described previously.
Collapse
|
26
|
Abstract
The referral pattern of acute dermatologic conditions is not well described in either outpatients or hospitalized patients. The aim of this study is to describe in more detail the skin diseases that were referred for evaluation in an acute outpatient clinic at Bispebjerg Hospital, Copenhagen. In a 3-month period in 2003 a total of 428 consecutive new patients were referred for various skin diseases that needed subacute and acute dermatological evaluation in a university hospital setting. Referral pattern, age ratio and sex ratio were examined retrospectively. Two hundred and twenty-five (53%) of the 428 patients were referred from other hospital clinics in the local area. Sixty-six (15%) were referred from private practising dermatologists and 64 (15%) from general practitioners in the City of Copenhagen. Referral information was not noted in 35 (8%) of the 428 patients. The most prevalent diagnoses were: unspecified eczema (10.7%), drug eruptions (6.3 %), psoriasis (6.3%), atopic dermatitis (5.6%), bacterial skin infections (4.0%), inflammatory skin disorders (3.7%), seborrhoeic dermatitis (3.5%), urticaria (3.0%), seborrhoeic keratosis (3.0%), toxic contact dermatitis (2.8%), ulcus cruris (2.8%), autoimmune diseases (2.8%), malignant skin tumours (2.5%), candidiasis (2.5%), pruritus/prurigo (2.5%) and viral skin infections (2.5%). The fact that drug eruptions are one of the leading causes of acute referral conditions probably reflects the proximity to other hospital settings, where a large number of patients receive several systemic medicaments for various conditions.
Collapse
|
27
|
Abstract
Neutrophil dermatosis of the dorsal hands (NDDH) is a recently described skin manifestation regarded as a subset of acute febrile neutrophilic dermatotis (Sweet syndrome). We describe 5 cases with pustular and ulcerative plaques and/or bullae and vesicles of the dorsal hands. Three of the patients also had skin changes at sides other than the hands. Associated conditions were found in two patients, one patient treated with hemo-dialysis for chronic glomerulonephritis, and one patient had suffered from a streptococcal tonsillitis prior to the eruption. Two of the patients had fever, two had neutrophil leucocytosis in peripheral blood and two had elevated sedimentation rates. Histological findings showed signs of vasculitis in biopsies from two of the patients. NDDH is discussed on the basis of prior case reports concerning the subject, and it is concluded that Neutrophil dermatosis of the dorsal hands should be regarded as a localized variety of Sweet syndrome.
Collapse
Affiliation(s)
- H K Larsen
- Department of Dermatology D40, University Hospital of Copenhagen, Bispebjerg Hospital, 2400 Copenhagen NV, Denmark.
| | | | | | | |
Collapse
|
28
|
Selmer RM, Kristiansen IS, Haglerod A, Graff-Iversen S, Larsen HK, Meyer HE, Bonaa KH, Thelle DS. Cost and health consequences of reducing the population intake of salt. J Epidemiol Community Health 2000; 54:697-702. [PMID: 10942450 PMCID: PMC1731748 DOI: 10.1136/jech.54.9.697] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
STUDY OBJECTIVE The aim was to estimate health and economic consequences of interventions aimed at reducing the daily intake of salt (sodium chloride) by 6 g per person in the Norwegian population. Health promotion (information campaigns), development of new industry food recipes, declaration of salt content in food and taxes on salty food/subsidies of products with less salt, were possible interventions. DESIGN The study was a simulation model based on present age and sex specific mortality in Norway and estimated impact of blood pressure reductions on the risks of myocardial infarction and stroke as observed in Norwegian follow up studies. A reduction of 2 mm Hg systolic blood pressure (range 1-4) was assumed through the actual interventions. The cost of the interventions in themselves, welfare losses from taxation of salty food/subsidising of food products with little salt, cost of avoided myocardial infarction and stroke treatment, cost of avoided antihypertensive treatment, hospital costs in additional life years and productivity gains from reduced morbidity and mortality were included. RESULTS The estimated increase in life expectancy was 1.8 months in men and 1.4 in women. The net discounted (5%) cost of the interventions was minus $118 millions (that is, cost saving) in the base case. Sensitivity analyses indicate that the interventions would be cost saving unless the systolic blood pressure reduction were less than 2 mm Hg, productivity gains were disregarded or the welfare losses from price interventions were high. CONCLUSION Population interventions to reduce the intake of salt are likely to improve the population's health and save costs to society.
Collapse
Affiliation(s)
- R M Selmer
- National Health Screening Service, PO Box 8155 Dep, N-0033 Oslo, Norway.
| | | | | | | | | | | | | | | |
Collapse
|