期刊
ARCHIVES OF DERMATOLOGICAL RESEARCH
卷 313, 期 10, 页码 815-827出版社
SPRINGER
DOI: 10.1007/s00403-020-02182-y
关键词
Cryotherapy; Low-dose oral isotretinoin; Anogenital warts; Condyloma; HPV; Papilloma
类别
The study found that low-dose oral isotretinoin as adjuvant treatment for anogenital warts did not show significant efficacy in Hispanic patients, but also did not have significant adverse reactions. Cryotherapy remains a first-line treatment and can improve patients' quality of life.
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.
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