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Laser Therapy of Human Papilloma Virus Associated Genital Warts
Authors:Ute Mü  ller, Carsten M. Philipp,H.-Peter Berlien
Affiliation:1. Laserklinik, Klinikum Neukölln, eine Einrichtung der Vivantes GmbH, Berlin, Germany;1. Centre d''Investigation Clinique Antilles-Guyane, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique;2. Antilles-Guyane University, Fort-de-France, Martinique;3. Department of Dermatology, Cochin Hospital, Paris-Descartes University, Paris, France;4. Department of Dermatology, Bichat Hospital, Paris-Diderot University, Paris, France;5. Department of Dermatology and Pediatric Dermatology, National Centre for Rare Skin Disorders, Saint-André and Pellegrin Hospitals, Bordeaux, France;6. Délégation à la Recherche Clinique et à l''Innovation, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique;7. Department of Dermatology, Centre Hospitalier Universitaire de Martinique, Fort-de-France, Martinique;1. Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan;2. Sasaki Dentistry-Oral Oral and Maxillofacial Care Clinic, Chiba, Japan;1. Centre national de référence des papillomavirus humains, Institut Pasteur, 25-28, rue du Dr Roux, 75724 Paris cedex 15, France;2. Groupe hospitalier Pitié-Salpétrière, 75013 Paris, France;1. Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy;2. Department of Plastic Surgery, University of Campania Luigi Vanvitelli, Naples, Italy;3. Department of Anesthesiology, Surgery and Emergency, University of Campania Luigi Vanvitelli, Naples, Italy
Abstract:Introduction: Condylomata acuminata are caused by the Human Papilloma Virus Types 6 and 11. This sexually transferred disease is one of the most widespread diseases in the world and its incidence is growing. Many different treatments exist, but the results are not satisfactory because of the high relapse rate.Patients and methods:During the past five years we treated 437 patients with genital warts with either a CO2 laser or a Nd:YAG laser, depending on the localisation. A detailed examination preceded every treatment. In cases where the lesions could not be clearly recognised as condomylata, we carried out an ALA-D-Light diagnosis and took biopsies.Results:We treated 280 males and 157 females. 80% of the males and 30% of the females suffered from intraanal lesions. Three males and one female had deep internal urethral lesions and 22% of all patients displayed genital warts at the urethral ostium. 12% of the women had portio lesions and in 4% of the females and in three men we detected dysplasias using the ALA-D-Light diagnosis system. The total relapse rate was of 7%.Discussion:The widespread nature and high infection rate of genital warts together with their possible complications make a reliable and adequate treatment essential. Because of the many phenotypes of condylomata, diseases like dysplasias have to be excluded.Summary:The use of lasers in the treatment of genital warts has helped to reduce the rate of relapse. Appropriate and discriminatory diagnostics prior to treatment lead to better results. Patient's acceptance is high because they often can be treated as outpatients, suffer only minor inconvenience and good cosmetic results are achieved.
Keywords:HPV   Condylomata acuminata   ALA-D-Light fluorescence diagnosis   CO2-laser   Nd:YAG-laser
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