Severe intractable common warts associated with human papillomavirus 2, 3 and 20

A 26-year-old male had had numerous common warts on the feet and hands since childhood. They had repeatedly undergone etretinate cryosurgery, always responding well to it. However, the warts reappeared. Human papillomavirus (HPV) 2, 3 and 20 were detected in the warts using Southern's blot hybridization technique with HPV DNA. Histologically, the warts showed swollen, clear keratinocytes with vacuolated degeneration not found in common warts. The findings are presented in this paper.     

Regression of flat warts and common warts

Wart (human papilloma) is such a common disease that even a child can make a diagnosis at a glance. Furthermore, from our long experience, we are aware that warts often disappear in a short period of time, spontaneously or after various magical rituals that are prevalent in different parts of the world. In Japan, we can find some shrines or temples in every district where ardent worshipers make pilgrimages in search of quick answers to their prayers to cure their warts.

Evaluation of clinical effectiveness of a new therapeutic modality is most difficult because of its high incidence of spontaneous wart resolution. The lesion can be cured even by hypnosis.

Recently, the phenomenon of spontaneous regression of warts was reviewed from the viewpoint of tumor immunology. We now know that in the body, tumors may be rejected by an immune “surveillance” mechanism analogous to resistance to microbial pathogens. Various modalities of immunization procedure or enhancement of host immunity can induce partial or complete resolution of established tumors in both experimental animals and humans. Even malignant tumors, such as melanoma or choriocarcinoma, may disappear spontaneously. Wart is one of the most common tumors in humans and probably the tumor that most commonly shows the phenomenon of spontaneous regression.

Advances in molecular biology and biotechnology have disclosed that, as there are various clinical types of wart, there are many distinct HPV types and that the distinct HPV types are associated with distinct cutaneous and mucosal papillomas.¹ Analogous to animals with the Shope papillomavirus or bovine papillomavirus infections, it is known that some human papillomavirus lesions may undergo malignant transformation.^2,3     

Cryotherapy of viral warts: a sustained 10-s freeze is more effective than the traditional method

BACKGROUND: Cryotherapy is a standard treatment for viral warts. Although textbooks recommend treating until there is a halo of ice around the wart (traditional freeze), many authors advocate more aggressive cryotherapy. There are no previously published studies assessing the efficacy of longer freezing times. OBJECTIVES: To compare the efficacy of the traditional freeze and a sustained 10-s freeze in the treatment of common viral warts with liquid nitrogen. METHODS: Patients attending a dedicated wart clinic were randomized to receive either a traditional freeze or a 10-s sustained freeze with liquid nitrogen delivered by a spray gun. Two hundred patients were recruited, 100 in each group. RESULTS: After five treatments, 49 patients in the 10-s freeze group were clear of warts (64% of non-defaulters) as compared with 31 (39%) of those in the traditional freeze group (chi2 = 6.7; P = 0.009). Seventy-four patients in the 10-s freeze group as compared with 59 in the traditional freeze group had either improved or cleared after five treatments (chi2 = 5.0; P = 0.02). Morbidity was significantly greater in the 10-s freeze group. Sixty-four patients suffered pain or blistering as compared with 44 in the traditional freeze group (chi2 = 10.8; P = 0.0045). Five patients were withdrawn from the 10-s freeze group because of pain as compared with one patient in the traditional freeze group. CONCLUSIONS: A 10-s sustained freeze is more effective in the cryotherapy of viral warts but carries a significantly greater morbidity in terms of pain and blistering.     

Cryotherapy versus electrocautery in the treatment of genital warts.

Forty-two male patients with ano-genital warts were randomly allocated to a single-blind study of cryotherapy versus electrocautery. There was no significant difference in the success rates of these two forms of treatment in patients followed for three months. Cryotherapy was qualitatively much more acceptable to the patients than electrocautery. It seems particularly suited to patients with widely scattered warts who are unable to attend for regular treatment.     

Eruptive viral warts of the burn area

Eruptive viral warts were observed in a second-to-third degree burn area in a 68-year-old woman; the warts healed spontaneously and completely after approximately 3 weeks. HPV-2-related DNA was demonstrated by Southern blot analysis.     

Interferon in the treatment of persistent viral warts

7 patients with a diagnosis of common and/or plantar warts present for at least 1 year and resistant to previous vigorous therapy were studied. All patients entered completed the study and during the trial period the warts of 4 patients receiving intralesional injections were completely cleared. 2 other patients demonstrated partial clearance of their warts.     

Characterization of two HPV-3 related papillomaviruses from common warts that are distinct clinically from flat warts or epidermodysplasia verruciformis

We have recently identified two unusual human papillomavirus (HPV) isolates while engaged in an ongoing study of wart disease in meat handlers and veterinarians. The papillomas from which these two viruses were isolated clinically resembled verruca vulgaris rather than either flat warts or epidermodysplasia verruciformis (EV). These two previously uncharacterized HPVs were molecularly cloned and characterized with respect to known HPVs. The genomes of the two viruses exhibited dramatically different restriction endonuclease cleavage patterns but were found to have significant sequence homology to each other, as well as to HPV-3 and a new virus isolated from a patient with EV. Neither of the two new HPV isolates exhibit detectable sequence homology under stringent conditions of hybridization or share similar restriction endonuclease cleavage patterns with previously characterized HPV types 1,2,4,5,6b, or a previously isolated HPV from meat handlers.     

p53 p21和PCNA在寻常疣中的过度表达

目的：研究寻常疣ｐ５３蛋白、ｐ２１蛋白和增殖细胞核抗原（ＰＣＮＡ）过度表达与人类乳头瘤病毒（ＨＰＶ）感染的关系。方法：采用免疫组化方法对石蜡包埋组织标本进行检测。结果：１５例寻常疣皮损中ｐ５３、ｐ２１以及ＰＣＮＡ阳性标本分别为６例（４０％）、５例（３３％）和９例（６６％）。ｐ５３阳性细胞多位于基底层，ｐ２１阳性细胞则多分布于棘细胞层的中下层，ＰＣＮＡ阳性细胞散在分布于整个增生的表皮。受ＨＰＶ感染的空泡样变性细胞核中均有ｐ５３、ｐ２１以及ＰＣＮＡ过度表达者４例。结论：证实了寻常疣中存在ｐ５３、ｐ２１和ＰＣＮＡ过度表达，并从原位上找到ＨＰＶ感染与ｐ５３、ｐ２１过度表达和细胞异常增生相关联的细胞学证据。