Conventional therapy for genital herpesvirus and remission of HPV-related lesions: a case series.

This report covers the case of 7 women affected by pathologies related to genital Herpesvirus and Papillomavirus. They were referred to the gynaecology outpatient clinic for colposcopic examination, and received pharmacological antiviral treatment. The patients presented clinical signs of genital Herpesvirus infections in the cervix and vulva. Cervical lesions and condylomatosis, which are characteristic of Papillomavirus infections were also detected, and patients underwent cervical cancer screening. Patients received oral and topical treatment with Acyclovir or oral treatment with Valacyclovir. During weekly or biweekly gynaecological follow-up visits, patients showed different times of remission of genital Herpesvirus. During the antiviral treatments, the vulvar and cervical Papillomavirus lesions also showed complete resolution with restitutio ad integrum of the tissues, and no recurrence at follow-up visits. Herpesvirus and Papillomavirus infections are often associated in genital infections and, as sexual transmitted infections, share the same risk factors. In the cases presented, the observed remission of HPV-related pathologies during Acyclovir and Valaciclovir treatments may suggest that antivirals are also effective in the treatment of HPV lesions. The cases described could pave the way for further investigations and clinical studies.

Photodynamic therapy combined with surgical management of extensive anogenital condylomatosis in a patient with systemic lupus erythematosus.

Infections with human papillomavirus in the anogenital area result in warty, papillary, and condylomatous lesions. The giant anogenital wart is relatively uncommon. Treatment of giant wart is challenging, especially in the immunosuppressive population. Here, a patient with systemic lupus erythematosis had extensive, fast-growing, recurrent anogenital condylomatosis shaped as giant cauliflowers. We reported this case and the successful treatment of photodynamic therapy combined with surgical management. It provided the feasibility for surgical ablation combined with ALA-PDT performed for these kinds of challenging cases.

Case of giant vulvar condyloma acuminata successfully treated with imiquimod 3.75% cream: A case report.

Condyloma acuminata, also known as anogenital warts, represent a cutaneous infection caused by sexual transmission of the human papilloma virus. We present a case of overwhelming condyloma acuminata that was treated successfully without surgery using only topical imiquimod 3.75% cream. The patient, a 66-year-old female, was referred to Dermatology for large protruding verrucous plaques that covered the entire surface of her external vulva, perineum and perianal area. These lesions developed after being treated for genital warts with cantharidin. Four other cases treated with imiquimod were identified in the literature but either required surgery, higher doses or longer duration of treatment or involved pediatric populations. In patients who are not amenable to surgery, topical imiquimod may be a novel standalone or an adjunctive therapy for giant condyloma acuminata.

Condilomatosis genital en embarazadas, experiencia del manejo y tratamiento en la Maternidad Mariana de Jesús / Genital condylomatosis in pregnants, experienceof handling and treatment in Maternity Mariana de Jesus

Introducción: La condilomatosisgenital o verruga genital es una de las manifestaciones clínicas más común de infección del virus del papiloma humano (VPH), predominantemente causadas por los genotipos VPH-6 y -11. Durante el embarazo, el incremento en los niveles de las hormonas esteroides modifica el sistema inmune de la madre contribuyendo a la "tolerancia" del feto, pero disminuye la capacidad de eliminar infecciones, incluido el VPH. El presente estudio plantea determinar el comportamiento de la condilomatosis genital en gestantes atendidas en la Maternidad Mariana de Jesús desde 2016 a 2017. Materiales y métodos: Es un estudio longitudinal, observacional, retrospectivo, en 84 gestantes que fueron atendidas entre el 1 de enero de 2016 al 30 de septiembre de 2017. Resultados: En las 84 gestantes analizadas se pudo observar quela mayoría de las pacientes con condilomas tiene de 20 a 25 años de edad; su primera relación sexual fue entre los 17 a 19 años; existiendo mayor número de gestantes multíparas, y que han tenido más de 2 parejassexuales.

Introduction: Genital condylomatosisor genital wart is one of the most common clinical manifestations of human papilloma virus (HPV) infection, predominantly caused by HPV-6 and -11 genotypes. During pregnancy, increased levels of steroid hormones modify the mother's immune system contributing to the "tolerance" of the fetus, but decrease the ability to eliminate infections, including HPV. The present study proposes to determine the behavior of genital condilomatosis in pregnant women attended in the Mariana de Jesus Maternity from 2016 to 2017. Materials and Methods: It is a longitudinal, observational, retrospective study in 84 pregnant women who were attended between January 1, 2016 to September 30, 2017. Results: In the 84 pregnant women analyzed it was possible to observe that the majority of patients with condylomas are between 20 and 25 years of age; her first sexual relationship was between 17 and 19 years old; There is a greater number of multiparous pregnant women, and they have had more than 2 sexual partners. The condylomas were presented individually, preferably being accumulated, predominantly in the second trimester of pregnancy. Conclusion: Although the greatest effort of studies is carried out in high-risk HPV, it is important to carry out studies that show the reality of the condylomas caused by low-risk HPV, mainly focusing on avoiding maternal-neonatal transmission.

Transmisión materno fetal del VPH. Evolución clínica y nasofibroscópica

A nivel mundial, se estima 630 millones de individuos infectados en el área ano-genital y 190 millones con enfermedad clínica por el virus papiloma humano (VPH), siendo la primera infección de transmisión sexual. En Venezuela se estima que entre el 11 % y 12 % de las mujeres embarazadas pueden están infectadas, con riesgo de transmisión al recién nacido por mecanismo vertical/ perinatal pudiendo llevar a infección crónica en el niño. Objetivo: determinar el porcentaje de transmisibilidad materno fetal del VPH, la persistencia y tipo del mismo en faringe, y los hallazgos nasofibroscópicos en los veinticuatro primeros meses de vida, en pacientes que acuden al servicio de infectología y neumonología del Hospital Pediátrico Dr. Jorge Lizárraga, Valencia, Edo. Carabobo. Metodología: Trabajo descriptivo, longitudinal, retro y prospectivo en hijos de madre con VPH, período junio 2010 a marzo 2016, a quienes se les realizó evaluación clínica y nasofibroscópica, antes del primer año y entre el primer y segundo año de vida, con toma de muestra laríngea para PCR VPH. Resultados: Se evaluaron 12 niños. El 58 % de las madres eran menores de 25 años, el 40,6 % habían tenido más de 4 parejas sexuales; en su mayoría presentaron arrugas vulvares. Los niños fueron en su mayoría a términos, y 75 % parto vaginal; 2/3 presentaron el virus en laringe antes del primer año, predominando el tipo 6, pero persistiendo solo en uno durante el segundo año (tipo 11), con lesión vegetante. CONCLUSIONES: El inicio de actividad sexual es precoz, con una tasa importante de madres embarazadas conVPH. Transmisión vertical/ perinatal aproximada del 75 % pero con una lisis viral mayor al 90 % en el segundo año de vida.

Globally, an estimated 630 million individuals are infected in the ano-genital area and 190 million with clinical disease from the Human Papillomavirus (HPV), being the first sexually transmitted infection in the world. In Venezuela, it is estimated that between 11 and 12 % of pregnant women may be infected, with risk of transmission to the newborn by vertical or perinatal mescanism, leading to complications due to chronic infection in the child. Objective: To determine the percentage of maternal fetal transmissibility of HPV, the persistence and type of the pharynx, as well as the nasofibroscopic findings in the first 24 months of life, in patients attending the infectious and pneumonology department of the Pediatric Hospital Dr. Jorge Lizárraga, Valencia, Edo. Carabobo. Methods: Descriptive, longitudinal, retrospective and prospective work in children of HPV mothers during the period June 2010 to March 2016, who underwent clinical and nasofibroscopic evaluation, before the first year and between the first and second year of life, with laryngeal sampling for HPV PCR. Results: Twelve children were evaluated. 58 % of the mothers were under 25 years old, where 40.6 % had had more than 4 sexual partners; most of them had vulvar wrinkles. In terms of children were mostly terms, 75 % vaginal delivery. Two-thirds of the children presented the virus in the larynx before the first year, predominating type 6, but persisting only in one child during the second year of life (type 11), with a persistent vegetative lesion. Conclusions: The onset of sexual activity is precocious in our population, with an important rate of pregnant mothers important for HPV. There is approximately 75 % vertical / perinatal transmission but viral lysis greater than 90 % in the second year of life.