Host control of human papillomavirus infection and disease

Most human papillomaviruses cause inapparent infections, subtly affecting epithelial homeostasis, to ensure genome persistence in the epithelial basal layer. As with conspicuous papillomas, these self-limiting lesions shed viral particles to ensure population level maintenance and depend on a balance between viral gene expression, immune cell stimulation and immune surveillance for persistence. The complex immune evasion strategies, characteristic of high-risk HPV types, also allow the deregulated viral gene expression that underlies neoplasia. Neoplasia occurs at particular epithelial sites where vulnerable cells such as the reserve or cuboidal cells of the cervical transformation zone are found. Beta papillomavirus infection can also predispose an individual with immune deficiencies to the development of cancers. The host control of HPV infections thus involves local interactions between keratinocytes and the adaptive immune response. Effective immune detection and surveillance limits overt disease, leading to HPV persistence as productive microlesions or in a true latent state.     

外用咪喹莫特治疗扁平疣的疗效观察

目的探讨外用5%咪喹莫特乳膏（艾达乐）治疗扁平疣的有效性和安全性。方法选择扁平疣患者64例,分成2组,分别给予单纯外用咪喹莫特、外用0.025%维甲酸软膏3个月,期间定期复诊,记录患者的药物反应、皮疹变化情况。结果各组患者有效率分别为79.4%、73.3%。各组治疗前与治疗后的皮损数量有统计学意义（P〈0.05）;两组疗效之间无统计学差异。无严重不良反应发生。结论外用5%咪喹莫特乳膏（艾达乐）治疗扁平疣安全有效。     

消疣安胃汤治疗隆起糜烂性胃炎对照观察

[目的]观察消疣安胃汤治疗隆起糜烂性胃炎疗效。[方法]将180例隆起糜烂性胃炎患者随机分为治疗组和对照组,每组90例。治疗组采用消疣安胃汤加减(药用白芍、柴胡、枳壳、大枣、生大黄、半枝莲、法半夏、乳香、甘草),1剂/d,煎汤服,早晚1次,空腹服用。对照组使用丽珠得乐+克拉霉素+雷尼替丁治疗。治疗1个月判定疗效。[结果]治疗组痊愈率56.67%,总有效率84.44%,HP阴性率83.33%;对照组痊愈率37.78%,总有效率71.11%,HP阴性率72.22%。治疗组痊愈率、总有效率、HP阴性率均优于对照组。[结论]消疣安胃汤治疗隆起糜烂性胃炎的疗效确切,HP转阴情况佳,值得在临床上推广应用。     

Lesional HPV types of cutaneous warts can be reliably identified by surface swabs

Background

Large numbers of HPV types infect the human skin and members from the HPV genera alpha, gamma and mu are associated with cutaneous warts.

Objectives

The aim of this study was to test if the HPV genotypes in swabs of the overlying skin are identical to the types present within these warts.

Study design

To this purpose, 25 persons being treated for persistent cutaneous warts were enrolled. Swabs of the overlying skin of the wart were collected from each participant. Additionally, scabs of the wart and deeper portions of the warts were surgically removed. HPV genotyping was performed on all samples using the novel HSL-PCR/MPG assay and the HPV genotyping results were compared.

Results

From the 25 wart biopsies one was HPV negative. 15 were positive for HPV27, 3 for HPV57, 2 for HPV2, 2 for HPV1, 1 for HPV3 and 1wart biopsy was positive for both HPV41 and HPV65. Scabs and swabs of the warts both showed identical typing results as the biopsies in 24 of the 25 cases (sensitivity: 96%).

Conclusions

There was an excellent agreement between HPV types in the swabs of the skin that overlies the warts and the biopsies of these warts validating the use of wart swabs for future studies of wart-associated HPV types. HPV27 was highly prevalent (70%) in the in adults of the investigated population of patients with persistent cutaneous warts.     

5-氨基酮戊酸光动力疗法联合CO_2激光治疗甲旁疣的临床疗效

目的观察5-氨基酮戊酸光动力疗法（5-aminolaevulinic acid-based photodynamic therapy,ALA-PDT）联合CO2激光治疗甲旁疣的疗效。方法 2012年1月至2013年12月,甲旁疣患者75例,根据患者选择的治疗方式,分为两组。治疗组患者35例,采用CO2激光清除疣体后,进行ALA-PDT治疗,2周1次,共治疗3次;对照组患者40例,单纯用CO2激光治疗,疗程同治疗组。两组患者治疗结束后,随访半年,比较两组的疗效和复发率。结果治疗组的痊愈率和3个月后的复发率分别为91.4%和8.57%。对照组的痊愈率和3个月后的复发率分别为62.5%和37.5%。治疗组的痊愈率明显高于对照组,而复发率显著低于对照组,两组比较差异有显著意义（P〈0.05）。结论应用5-氨基酮戊酸光动力疗法联合CO2激光治疗甲旁疣,能明显提高治愈率,降低复发率。     

A Two-week Interval Is Better Than a Three-week Interval for Reducing the Recurrence Rate of Hand-foot Viral Warts after Cryotherapy: A Retrospective Review of 560 Hand-foot Viral Warts Patients

Background

Viral warts are a common infectious disease and liquid nitrogen cryotherapy is one of the most common methods for treatment of these warts. Hand-foot viral warts frequently recur and reduce quality of life as well.

Objective

To find the ideal treatment interval between cryotherapy sessions that can influence not only the cure rate but also the recurrence rate for hand-foot viral warts.

Methods

A retrospective study was designed to compare a 2 week interval and a 3 week interval between cryotherapy sessions on hand-foot viral warts with respect to cure rate, recurrence rate, treatment number, duration of treatment, mean time to recurrence and adverse events.

Results

A total of 560 patients were enrolled. The overall cure rate was 75.7% and the recurrence rate was 19.6%. The mean time to recurrence was 7.8 months (range 1~26 months). For the 2-week and 3-week groups, cure rates were, respectively, 76.6% (196) and 75.0% (228); recurrence rates were 13.3% (26) and 25.0% (57). The mean time to recurrence was 9.8 months and 6.9 months, respectively. Adverse events were not statistically different.

Conclusion

We suggested that 2-week cryotherapy is optimal not only because of the rapid cure but also because of the lower recurrence rate and similar adverse events.     

Heterogeneous keratohyalin formation in warts

Summary The heterogenecity of keratohyalin (KH) has been demonstrated in rats, then in human warts where similar morphological features have been found and among them, dense homogeneous ovoïd single granules (SG) and composite granules (CG) apparently made up of single granules coated with a matrix. This work compares the ultrastructure of the KH of the tongue of newborn rats with that of common warts with and without post-fixation by OsO₄, after oxydation by H₂O₂ and after pepsin treatment. The osmiophily of the SG is confirmed as well as the absence of osmiophily of the matrix of the CG. In man, however, the SG are resistant to oxydation by H₂O₂ and the CG matrix is oxydation sensitive whereas the opposite is observed in the case of rats. These differences show that it is impossible to deduce the composition of the KH in human warts from that of the rat despite their close ultrastructural resemblance but that important modification of the keratogenesis and KH formation are induced in the cells parasited by the virus of common warts.This work was supported by INSERM, Contrat ATP 19-75-42     

CO2激光治疗丝状疣的临床疗效观察

目的观察CO2激光治疗丝状疣的疗效。方法将180例丝状疣患者随机分为治疗组95例,予CO2激光治疗,对照组85例予液氮冷冻治疗,4周后观察并评价疗效。结果治疗组痊愈率为97．89％,高于对照组的82．35％（P〈0．05）;治疗组不良反应发生率为2．1％,显著低于对照组的41．18％（P〈0．05）。结论CO2激光治疗丝状疣治愈率高,治疗次数少,不良反应少,效果优于液氮冷冻治疗,值得临床推广使用。     

光动力学疗法在难治性良性皮肤病中的应用进展

光动力学疗法（photodynamie therapy，PDT）是通过局部或系统给予光敏剂后以特定波长激光照射从而对靶组织产生选择性的光敏化作用，其特殊的作用机制使其具有美容效果好、可重复应用而无耐药性等优点。最初PDT在皮肤科主要用于肿瘤的治疗，新近研究者尝试将PDT拓展到某些难治性良性皮肤病，如病毒疣、真菌感染、慢性炎症性疾病的治疗，并取得初步疗效，为上述皮肤病的治疗提供了新的思路。然而，目前还尚需大量的比较性研究以及PDT治疗方案的优化以确定PDT在上述疾病治疗中的地位。