Irving Llibran Reyna-Rodríguez1, Sonia Chavez-Alvarez1, Veronica Garza-Rodríguez1, Rodolfo Franco-Marquez2, Gerardo Gonzalez-Martinez1, Jorge Ocampo-Candiani1, Alejandra Villarreal-Martinez3. 1. Dermatology Department, Facultad de Medicina Y Hospital Universitario "Dr. José Eleuterio Gonzalez", Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero Y Avenida Gonzalitos S/N Colonia Mitras Centro, 64460, Monterrey, Nuevo Leon, Mexico. 2. Pathology Department, Facultad de Medicina Y Hospital Universitario "Dr. José Eleuterio Gonzalez", Universidad Autónoma de Nuevo León, Monterrey, Mexico. 3. Dermatology Department, Facultad de Medicina Y Hospital Universitario "Dr. José Eleuterio Gonzalez", Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero Y Avenida Gonzalitos S/N Colonia Mitras Centro, 64460, Monterrey, Nuevo Leon, Mexico. dravillarrealmtz@yahoo.com.mx.
Abstract
BACKGROUND: Anogenital warts are a common human papillomavirus infection. They cause emotional distress, especially when they are in the anogenital region. Cryotherapy is a first-line treatment. Previous clinical trials and case series have reported variable results with retinoids (isotretinoin) as adjuvant therapy. OBJECTIVE: To determine the safety and efficacy of low-dose oral isotretinoin as adjuvant treatment of anogenital warts. METHODS: Forty-six patients with anogenital warts were randomly assigned to isotretinoin + cryotherapy (n = 23) or only cryotherapy (n = 23). Patients were allocated via an interactive web-based randomization system. Evaluators were blinded to treatments. Isotretinoin 20 mg/daily + cryotherapy or cryotherapy were prescribed for 6 weeks. Patients were followed for 4 months. Genotyping of lesions was performed before treatment started. Dermatology Life Quality Index (DLQI) and Columbia-Suicide Severity Rating Scale (C-SSRS) were measured at the beginning and end of therapy. All patients completed the study. RESULTS: Both Groups had 50% clearance at the end of treatment. Recurrence in the combined group was not significantly lower than in the cryotherapy group (P = 0.59). Improvement was observed in the DLQI of all patients in both groups (P = 0.001). No suicidal intention was detected with the C-SSRS. Two patients (one in each group) had liver function test abnormalities after treatment. CONCLUSION: Combined therapy showed a slight not significant efficacy for anogenital warts in Hispanic patients. Low-dose isotretinoin seems to be safe even when it is used with cryotherapy on anogenital warts. TRIAL REGISTRATION: On April 25, 2019 with registration number DE19-00004, CONBIOÉTICA-19-CEI-001-20160404. Prospectively registered.
BACKGROUND: Anogenital warts are a common human papillomavirus infection. They cause emotional distress, especially when they are in the anogenital region. Cryotherapy is a first-line treatment. Previous clinical trials and case series have reported variable results with retinoids (isotretinoin) as adjuvant therapy. OBJECTIVE: To determine the safety and efficacy of low-dose oral isotretinoin as adjuvant treatment of anogenital warts. METHODS: Forty-six patients with anogenital warts were randomly assigned to isotretinoin + cryotherapy (n = 23) or only cryotherapy (n = 23). Patients were allocated via an interactive web-based randomization system. Evaluators were blinded to treatments. Isotretinoin 20 mg/daily + cryotherapy or cryotherapy were prescribed for 6 weeks. Patients were followed for 4 months. Genotyping of lesions was performed before treatment started. Dermatology Life Quality Index (DLQI) and Columbia-Suicide Severity Rating Scale (C-SSRS) were measured at the beginning and end of therapy. All patients completed the study. RESULTS: Both Groups had 50% clearance at the end of treatment. Recurrence in the combined group was not significantly lower than in the cryotherapy group (P = 0.59). Improvement was observed in the DLQI of all patients in both groups (P = 0.001). No suicidal intention was detected with the C-SSRS. Two patients (one in each group) had liver function test abnormalities after treatment. CONCLUSION: Combined therapy showed a slight not significant efficacy for anogenital warts in Hispanic patients. Low-dose isotretinoin seems to be safe even when it is used with cryotherapy on anogenital warts. TRIAL REGISTRATION: On April 25, 2019 with registration number DE19-00004, CONBIOÉTICA-19-CEI-001-20160404. Prospectively registered.
Authors: Janine Jason; Lennox K Archibald; Okey C Nwanyanwu; Anne L Sowell; Ian Buchanan; Joshua Larned; Michael Bell; Peter N Kazembe; Hamish Dobbie; William R Jarvis Journal: Clin Diagn Lab Immunol Date: 2002-05
Authors: Zsolt Faluhelyi; Imre Rodler; Andras Csejtey; Stephen K Tyring; Istvan A Ember; Istvan Arany Journal: Anticancer Res Date: 2004 Mar-Apr Impact factor: 2.480