刮除术联合胸腺五肽治疗尿道尖锐湿疣疗效观察

目的观察刮除术联合胸腺五肽治疗尿道尖锐湿疣的疗效。方法治疗组42例行刮除术后联合应用胸腺五肽注射液局部注射与肌肉注射,对照组35例只行刮除术治疗。两组分别于1、2、3、6个月时复诊观察复发情况和不良反应。结果治疗组复发率明显低于对照组,差异有统计学意义(P<0.001)。结论刮除术联合胸腺五肽局部注射加肌肉注射对治疗尿道尖锐湿疣及预防复发效果良好。     

液氮冷冻联合胸腺五肽局部注射治疗尖锐湿疣疗效观察

目的观察胸腺五肽联合液氮冷冻预防尖锐湿疣(CA)复发的疗效。方法选择347例CA患者随机分为两组,治疗组给予胸腺五肽皮损局部注射联合液氮冷冻,对照组给予液氮冷冻。结果治疗组复发率为12.9%(19例),对照组为47.9%(83例),两组复发率差异有显著性(P<0.05)。结论胸腺五肽联合液氮冷冻预防尖锐湿疣(CA)复发的效果良好。     

胸腺五肽与CO2激光联合治疗尖锐湿疣

尖锐湿疣(condyloma acuminatum,CA)是常见的性病之一,治疗方法虽然比较多,但易复发。我科从1999年8～12月对85例CA患者单用CO₂激光和CO₂激光与胸腺五肽联合治疗,后者取得较好的疗效,现报道如下。     

局部注射胸腺五肽配合微波和电离子手术治疗尖锐湿疣40例疗效观察

目的观察胸腺五肽配合微波和电离子手术治疗尖锐湿疣的疗效。方法将符合临床诊断的80例尖锐湿疣患者随机分为2组,治疗组40例采用局部注射胸腺五肽配合微波和电离子手术治疗,对照组40例采用微波和电离子手术治疗。结果随访12周,治疗组治愈率为72.5%,对照组治愈率为47.5%。差异有统计学意义(P﹤0.05)。结论采用局部注射胸腺五肽配合微波和电离子手术治疗尖锐湿疣较微波和电离子手术治疗的疗效更好。     

72例男性肛周尖锐湿疣临床分析

尖锐湿疣（condyloma acuminate，CA）是由人乳头瘤病毒（human papilloma virus，HPV）感染所致的性传播疾病。我们观察2005年6月-2007年4月我院皮肤性病科门诊72例男性肛周CA，比较其临床特点及总结治疗经验，现报道如下。     

男性肛周尖锐湿疣112例临床分析

尖锐湿疣 (ＣＡ)好发于男女外生殖器 ,也常见于肛周等部位。在临床治疗及控制复发上存在一定难度。为探讨男性肛周ＣＡ的发病特点及防治要点 ,现将我科近几年诊治的男性肛周ＣＡ资料作一临床分析。临床资料1.一般资料　 112例男性肛周ＣＡ均系 1996年～1999年本科性病门诊的患者 ,占同期门诊男性ＣＡ总数 595例的 18.8%。年龄 6～ 58岁 ,平均 34岁。病程 1周～ 12月 ,平均 2 .5月。已婚 59例 ,未婚 4 8例 ,离婚 3例 ,丧偶 2例。职业 :工人 2 9例 ,个体劳动者2 4例 ,干部、职员 17例 ,外地民工 14例 ,驾驶员 11例 ,教师 2例 ,学龄儿童 2例 ,…     

中西医结合治疗肛周尖锐湿疣30例疗效观察

目的:观察中西医结合治疗肛周尖锐湿疣的临床疗效。方法:将60例肛周尖锐湿疣患者分为两组,治疗组30例,采用龙胆泻肝汤加减内服、解毒除疣外洗方外洗,配合冷冻、胸腺五肽肌注治疗;对照组30例,采用CO2激光、百多邦外用治疗。结果:治疗组的总有效率分别为93.3%;对照组总有效率分别为66.7%,两组比较有显著性差异(P<0.05)。结论:中西医结合治疗肛周尖锐湿疣疗效显著,而且能明显降低复发率。     

胸腺五肽联合干扰素治疗尖锐湿疣临床疗效观察

尖锐湿疣(CA)是人类乳头瘤病毒(HPV)感染生殖器、会阴或肛门等部位引起的一种常见、易复发的性传播疾病,具有潜伏期长、传染性强、复发率高的特点,严重影响了患者身心健康。我科自2009年12月～2011年6月使用微波治疗仪去除可见的疣体     

中西医结合治疗肛周尖锐湿疣32例

尖锐湿疣是一种极为常见的性传播疾病.我院自1999年以来,用中西医结合治疗肛周尖锐湿疣,疗效良好,现报告如下.     

肛周尖锐湿疣的治疗

在我院性病门诊的诊疗中，我们遇到2例肛周尖锐湿疣患者。采用剪切术和电离子结合治疗的方法，取得了很好的效果，现将治疗方法报道如下。     

男性肛周尖锐湿疣392例流行病学调查

目的：了解沈阳市及周边地区发病的男性肛周尖锐湿疣患者流行病学特点,为今后针对高危因素及人群开展有效的预防干预工作提供经验和依据.方法：对我院及沈阳市肛肠医院392名符合标准的患者进行匿名问卷调查后,收集数据进行分析比较.结果：392名受访者平均年龄27.74岁,前卫职业人群集中,性安全自觉性差,对本病的了解程度不佳.具有男男性行为的同性恋或双性恋者是本病发病的高危人群,具有频繁肛交、多性伴侣、性病防护意识差等高危性行为特征,但改正不良生活习惯态度良好.公共浴池洗浴及公共卫浴用品的使用也是本病的发病危险因素之一.受访人群中艾滋病病毒（HIV）阳性率为7.14%,梅毒（USR）阳性率为5.61%,合并其他性传播疾病感染者占6.63%,HBsAg及抗-HCV阳性率分别为6.63%及2.04%.结论：针对中青年等高危人群应加强性健康教育普及,提高性安全意识,尤其针对男男性行为者应当予以广泛关注并采取良好有效的干预机制.     

宁波地区男性肛周尖锐湿疣的流行病学调查

目的:分析宁波地区男性肛周尖锐湿疣的临床与流行病学特征,以期为男性肛周尖锐湿疣的防治提供借鉴。方法:回顾自2011年6月到2012年6月宁波部分地区男性肛周尖锐湿疣患者的资料,采用个体匹配,调查每1个病例的同时,调查3个职业和年龄相同的的正常人作为对照。对患者的一般情况、个人社会行为、个人性行为、感染HPV病毒的亚型、复发的情况等,统计并分析其流行性特征。结果:我们发现男性肛周尖锐湿疣患者年龄平均(27.74±7.21)岁,受教育程度相对较高、易发生抑郁,肛交(OR=7.621,95%CI:2.610-22.256)、患有梅毒或艾滋病(OR=3.840,95%CI:2.079-7.093)、使用公共用品(OR=1.860,95%CI:0.721-3.027)、性病防护知识差(OR=1.649,95%CI:1.052-2.585)、多性伴侣(OR=1.109,95%CI:1.075-1.146)是男性患者发生肛周尖锐湿疣的危险因素,嗜酒、熬夜、吸烟、皮损HPV型别为16型、皮损HPV型别为复合型是男性患者发生肛周尖锐湿疣复发的主要促进因素。结论:针对高危人群应加强性健康教育普及,提高性安全意识,尤其针对男男性行为者应当予以广泛关注并采取良好有效的干预机制,对于男性肛周尖锐湿疣应注意禁止饮酒、不熬夜,以防止复发。     

Imiquimod 5% cream for external genital or perianal warts in human immunodeficiency virus-positive patients treated with highly active antiretroviral therapy: an open-label, noncomparative study

Background  Human immunodeficiency virus (HIV)+ patients have an increased risk of anogenital warts. High-risk (HR) human papillomaviruses (HPVs), especially types 16 and 18, are major risk factors for precancerous and cancerous lesions of the anogenital tract, while low-risk (LR) HPVs are associated with benign lesions. Cure of genital warts with ablative techniques, surgical excision, podophyllotoxin or trichloroacetic acid is frequently difficult. Treatment with imiquimod cream showed a total clearance of external genital or perianal warts in about 50% of immunocompetent subjects. However, total clearance was reduced in HIV+ subjects not treated with highly active antiretroviral therapy (HAART).
Objectives  To assess clinically and by monitoring HPV content the efficacy of 5% topical imiquimod to treat anogenital warts in HIV+ subjects with at least partially restored immune functions.
Methods  Fifty HIV+ patients successfully treated with HAART (total CD4+ cells ≥ 200 cells mm⁻³ and plasma HIV RNA load < 10⁴ copies mL⁻¹) with anogenital warts were included. Imiquimod 5% cream was applied on external genital or perianal warts three times weekly for up to 16 weeks. Warts were tested at entry and after treatment for human LR- and HR-HPV DNA.
Results  Total wart clearance was observed in 16 of 50 (32%) patients at week 16. At enrolment, HPV DNA was present in more than 90% of lesions with a majority of lesions co-infected by HR- and LR-HPV. At study end, the HPV load decreased or became undetectable in 40% of cases studied.
Conclusions  Imiquimod 5% cream did not show safety concerns and is suitable for use in HIV+ subjects with anogenital warts and successful HAART treatment.     

胸腺五肽联合干扰素治疗复发性尖锐湿疣疗效分析及对T细胞亚群影响的研究

目的：探讨胸腺五肽治疗复发性尖锐湿疣的临床疗效及对T淋巴细胞亚群水平的影响。方法：选取皮肤性病科门诊的复发性尖锐湿疣患者74名,随机分成治疗组与对照组,用微波将疣体彻底去除,并予以肌注干扰素（100万u/d）治疗,治疗组加用胸腺五肽（1mg/d）肌注,疗程30d。两组均于治疗前及治疗结束3个月后用流式细胞术检测外周血T淋巴细胞亚群含量。结果：治疗组总有效率为86.8％,对照组总有效率为63.9％,两组差异有统计学意义（P＜0.05）。治疗组治疗后CD3＋T淋巴细胞、CD4＋T淋巴细胞及CD4＋/CD8＋T淋巴细胞比值上升,CD8＋T淋巴细胞降低,与治疗前比较差异均有统计学意义（P＜0.05）;对照组治疗后CD3＋T淋巴细胞、CD4＋T淋巴细胞及CD4＋/CD8＋T淋巴细胞比值较治疗前有所上升,CD8＋T淋巴细胞有所下降,但差异均无统计学意义（P＞0.05）;治疗后比较,治疗组CD3＋T淋巴细胞、CD4＋T淋巴细胞及CD4＋/CD8＋T淋巴细胞比值均较对照组高（P＜0.05）,CD8＋T淋巴细胞较对照组低（P＜0.05）,差异均有统计学意义。结论：胸腺五肽能调节T淋巴细胞亚型的动态平衡,提升复发性尖锐湿疣患者T淋巴细胞免疫功能,临床效果显著,且无明显不良反应,安全性好,值得临床推广应用。     

5-氨基酮戊酸光动力疗法治疗面部扁平疣疗效评价

目的：评价5-氨基酮戊酸光动力（5-ALA—PDT）治疗面部扁平疣的疗效。方法：面部扁平疣患者48例,治疗组24例,采用5-氨基酮戊酸光动力疗法每周1次。对照组24例,用波长532nm的Q开关Nd：YAG激光照射皮损每周1次。疗程均为3周。治疗结束后判定两组疗效。末次观察后3个月判定两组复发率。结果：治疗组痊愈率为91．67％。3个月后随访,复发l例,复发率为4．17％;对照组痊愈率为83．33％,复发5例,复发率为20．83％,两组复发率有显著性差异（P〈0．05）。结论：5-ALA—PDT治疗扁平疣有效、复发率低。     

钝性剥离手术联合高频双极电凝治疗跖疣临床疗效观察

我科自2010年6月至2011年12月采用钝性剥离手术联合高频双极电凝治疗跖疣,取得明显疗效,现报告如下. 一、资料和方法 1.临床资料:60例跖疣患者均为我院门诊确诊患者,皮损数目1～5个.其中男37例,女23例,年龄13～62岁,病程平均1个月至10年,疣体数目总计146个,面积最大25 mm×25mm,最小0.5 mm× 0.5 mm.     

Successful treatment of periungual warts with topical cidofovir

Periungual warts represent a treatment challenge because of its high recurrence rate and recalcitrance. These are benign lesions produced by the human papilloma virus (HPV) that often do not respond to habitual treatment. Cidofovir is a potent antiviral drug that acts inactivating viral DNA polymerase. Topical cidofovir for the treatment of HPV‐related cutaneous and mucous lesions is becoming increasingly common. Our aim was to assess the efficacy and safety of cidofovir cream for the treatment of viral periungual warts. We undertook a retrospective observational study of patients with periungual warts who received treatment with topical cidofovir between January 2010 and December 2013 at the Dermatology Service of the Hospital Costa del Sol, Marbella, Spain. Data were recorded about the rate of treatment response, the adverse effects and recurrences, as well as the characteristics of the patient cohort. We identified 41 patients who had received some previous treatment. The concentration of cidofovir was 3% in all cases, usually applied twice a day (in 37 of the 41 cases). A greater or lesser response was noted in 35 cases. There were six recurrences in the follow‐up period. Topical cidofovir seems to be a useful alternative for the therapeutic management of recalcitrant periungual common warts that fail to respond to usual treatment. Our experience with the use of this antiviral agent has been satisfactory, although in our opinion, it should be reserved for specific cases as its economical cost represents an important limitation.     

中药联合咪喹莫特乳膏治疗尖锐湿疣患者临床疗效观察及对免疫功能的影响

目的:探讨中药联合咪喹莫特乳膏治疗尖锐湿疣患者临床疗效观察及对免疫功能的影响。方法:按照随机数字表法将本组纳入的107例尖锐湿疣患者随机分为观察组(n=55)和对照组(n=52)。观察组采用中药联合咪喹莫特乳膏治疗,对照组单用咪喹莫特乳膏治疗,两组疗程均为8周。对比分析两组治疗8周后临床疗效、伤口感染率及伤口平均愈合时间、治疗前后免疫功能水平变化及随访6个月复发情况。结果:观察组治疗8周后总有效率(96.36%)显著高于对照组(82.69%)(P0.05);两组伤口感染率无显著性意义(P0.05);观察组伤口平均愈合时间显著快于对照组(P0.05);治疗后,观察组CD3、CD4+、CD4+/CD8+明显高于对照组(P0.05),CD8+明显低于对照组(P0.05);观察组随访6个月复发率(3.64%)显著低于对照组(19.23%)(P0.05)。结论:中药联合咪喹莫特乳膏治疗尖锐湿疣患者临床疗效显著,可明显改善患者免疫功能,复发率低,具有重要临床意义。     

Possible role of interleukin 21 and interleukin 33 in patients with genital warts

Genital warts (GWs) are most prevalent sexually transmitted infections, presenting especially among the sexually active young population of both sexes. Efficient cell‐mediated immunity is needed for regression of GWs. To clarify the reactivity of cellular immunity among patients with GWs by means of measurements of their levels of serum interleukin (IL)‐21 and IL‐33, hence, to identify the possible role of IL‐21 and IL‐33 in GWs, this study aimed to evaluate serum levels of IL‐21 and IL‐33 among patients with GWs in comparison with the results of the controls. Levels of serum IL‐21 and IL‐33 were assayed utilizing commercially enzyme‐linked immune‐sorbent assay kits in 45 patients with GWs and 45 healthy control subjects. Levels of serum IL‐21 and IL‐33 were significantly decreased among patients with GWs in comparison with the controls (p < .0001). There was a highly significant positive correlation between IL‐21 and IL‐33 (r = .73, p < .0001). Low levels of serum IL‐21 and IL‐33 could have a contributive role in development, persistence, severity, and recurrence of GWs which rely basically on the defectiveness of cell‐mediated immunity. This could receive new light on nonconventional strategies for the prospective medical therapies of GWs by means of regulation of IL‐21 and IL‐33.     

Imiquimod cream 5% for recalcitrant cutaneous warts in immunosuppressed individuals

BACKGROUND: Viral warts may cause significant morbidity in individuals unable to mount an adequate T-helper 1 cell-mediated immune response to human papillomavirus. Imiquimod is a potent inducer of antiviral cytokine activity which has shown significant efficacy in the treatment of genital warts. Similar efficacy in cutaneous warts is not yet established. OBJECTIVES: To assess the response of persistent cutaneous warts to 5% imiquimod cream in immunosuppressed individuals. METHODS: Fifteen immunosuppressed patients with warts on the hands and/or feet present for more than 18 months, which had failed to respond to a minimum of 12 weeks of topical salicylic acid and four cycles of cryotherapy, were recruited. Imiquimod 5% cream was applied in an open label, right vs. left comparison study for 24 weeks (three times weekly for 8 weeks, daily for 8 weeks, then daily with occlusion for 8 weeks). RESULTS: Twelve (80%) patients completed the study protocol. Benefit was seen in five patients [36% in the intent-to-treat analysis (14 patients)], including more than 30% clearance of warts in three patients and reduction in overall size of warts in two further cases. Local skin reactions occurred in four (29%) patients and were usually mild. A transient rise in creatinine (11-29% above baseline) was measured in three renal transplant recipients, but we did not consider that this was related to imiquimod exposure. CONCLUSIONS: This is the first controlled study to assess therapeutic efficacy of topical 5% imiquimod cream in persistent warts associated with immunosuppression. It provides preliminary evidence that topical imiquimod may benefit a subgroup of immunosuppressed patients with recalcitrant cutaneous warts.