免疫功能正常及受损的寻常疣患者中具有相同的人类乳头瘤病毒类型

至今,从皮肤及粘膜损害中已分离到67种以上不同的人类乳头瘤病毒(HPV),但寻常疣(包括跖疣)中最常见的为HPV1、2、4、7型。新近发表的HPV感染的流行病学资料主要着眼于免疫缺陷患者,因为后者更易患寻常疣、扁平疣及疣状表皮发育不良样损害。该研究旨在分析免疫功能正常患者中寻常疣的HPV类型,并与免疫缺陷患者进行比较。     

皮肤疣中人类乳头瘤病毒的特征及分析

目前,人类乳头瘤病毒(HPV)至少已发现有60型。HPV的型别,在一定程度上决定了其感染部位,病理特征,临床表现及相应的病程。该作者对台湾人皮肤疣患者中的HPV感染进行了分析。 61份临床标本取自跖疣、寻常疣、扁平疣患者手术切除的疣体。用Southern印迹杂交     

四种疣患者外周血淋巴细胞免疫表型的比较研究

作者对80例4种类型疣患者外周血淋巴细胞免疲表型进行了分析。结果OKT_(11)~+、OKT_4~+细胞百分比及OKT_4~+/OKT_8~+此率在寻常疣,扁平疣及尖锐湿疣较正常对照显著降低,仅尖锐湿疣OKT_8~+细胞百分比显著升高。寻常疣及尖锐湿疣OKT_(11)~+、OKT_4~+细胞绝对值显著降低,OKT_8~+细胞绝对值在跖疣和扁平疣显著增加。不同类型疣患者对HPV感染的细胞免疫应答的这种差异可能系HPV抗原异质性所致。     

人免疫缺陷病毒阳性人群人乳头状瘤病毒感染的型别分析

目的 了解人免疫缺陷病毒（HIV）阳性人群人乳头状瘤病毒（HPV）感染状况、型别分布特征及与HIV阴性人群的差异。 方法 选择门诊患有尖锐湿疣或主诉近期与可疑尖锐湿疣患者有性接触者作为研究对象,包括HIV阳性组62例和HIV阴性组2 716例,采用基因芯片技术对外生殖器部位皮肤黏膜样本进行HPV检测,采用SPSS 19.0统计软件进行χ2检验。 结果 HIV阳性组中,HPV总感染率74.19%（46/62）,高危型HPV感染率67.74%（42/62）,低危型HPV感染率58.06%（36/62）;HIV阴性组三者感染率分别为42.30%、29.57%、24.71%,两组比较,差异有统计学意义（均P < 0.01）。HIV阳性组男性HPV检出率高达92.11%（35/38）,和HIV阴性组男性检出率相比（37.38%,382/1 022）差异有统计学意义（χ2 = 45.98,P < 0.01）。低危型HPV在HIV阳性组检出率前3位为HPV6（37.10%,23/62）、43和11型,在HPV阴性组检出率排序相同但HPV6的检出率仅11.12%（302/2 716）。高危型HPV在HIV阳性组检出率前5位依次是HPV16（22.58%,14/62）、52、66、58和18型,在HIV阴性组前5位依次为HPV16（7.77%,211/2 716）、58、56、66和52型。HPV亚型重叠感染情况,HIV阳性组最多八重,HIV阴性组最多九重,三重及以上感染者,HIV阳性组65.21%（30/46）,HIV阴性组16.71%（192/1 149）,差异有统计学意义。 结论 HIV阳性人群HPV总感染率、高危型HPV感染率、低危型HPV感染率、男性HPV感染率以及HPV多重感染率均明显高出HIV阴性组,值得临床高度重视。     

电离子手术加外用5-Fu霜治疗皮肤疣疗效观察

皮肤疣常见有寻常疣、扁平疣、跖疣等。临床上诊断不难，可采取多种方法治疗，但治愈率不高，作者采用电离子手术加外用5－Fu霜治疗30例皮肤疣取得满意疗效，报告如下。病例与方法：59例门诊皮肤疣病人，随机分为两组，治疗组30例，其中扁平疣3例，寻常疣17例，跖疣10例；对照组29例，其中扁平疣3例，寻常疣18例，跖疣8例。所有病人均用2％利多卡因局麻后用电离子手术治疗机等离子火焰烧灼疣体，范围比疣体稍宽，创面深度以稍低于皮肤表面为限。治疗组术毕即嘱病人用2．5％5－Fu霜外涂创面，每日2次，连续用3－5天；对照组不用。术后如创面…     

寻常疣630例临床特点及治疗分析

正疣是人乳头瘤病毒(HPVs)感染引起的皮肤黏膜良性肿瘤~([1])。HPVs在人类中的感染十分常见,且皮损表现广谱多样,从良性增生疣到肿瘤。疣在黏膜和皮肤的分类主要依赖于它们的形态特征和分布部位~([2]),有寻常疣、跖疣、扁平疣、尖锐湿疣、     

浙江丽水地区男性肛门生殖器疣患者人乳头瘤病毒基因型研究

【摘要】 目的 了解浙江丽水地区男性肛门生殖器疣患者感染人乳头瘤病毒（HPV）基因型的分布状况。方法 PCR-反向斑点杂交技术对150例男性肛门生殖器疣患者标本进行HPV基因分型,包括3种低危型HPV-6、11、43和16种中高危型HPV-16、18、31、33、35、39、45、51、52、53、56、58、59、66、68、CP8304。 结果 150例男性肛门生殖器疣患者中91例（60.67%）检出HPV,其中有74例（81.32%）为低危型HPV-6、11、43的单一或多重感染,另有17例（18.68%）为中高危型的单一或多重感染。31例（34.07%）为多重感染（包括2 ～ 5种基因型混合感染）,其中低危型合并中高危型的多重感染20例占64.52%,低危型之间的二重感染6例占19.35%;HPV-6、11合并中高危型感染分别为13例（41.94%）和6例（19.35%）。各HPV基因型感染136例,感染率从高到低依次为：HPV-6（39例,28.68%）、11（36例,26.47%）、16（11例,8.09%）、52（7例,5.15%）、53（7例,5.15%）、51（6例,4.41%）、58（6例,4.41%）和43（6例,4.41%）。 结论 男性生殖器疣患者HPV基因型感染中,低危型HPV感染占绝对优势,多重感染及各基因型的分布状况差异较大。     

重庆地区尖锐湿疣患者HPV检测及基因分型分析

目的探讨重庆地区人类乳头瘤病毒(HPV)感染的分子流行病学特点,从而为本地区尖锐湿疣(CA)患者的监测及临床治疗、预防提供一定的临床依据。方法采用基因芯片法对重庆地区401例CA患者的皮损组织进行HPV检测及分型。结果 401例患者中384例检测出HPV阳性,共发现23种HPV亚型,其中HPV6型感染占46. 88%(180/384),HPV11感染占40. 89%(157/384)。其中单一感染226例,占比58. 85%(226/384)。158例存在2~6种亚型多重感染,多重感染率为41. 15%(158/384),其中三重感染占9. 38%(36/384),以HPV6+11+43感染多见;四重感染者共有16例,占4. 17%(16/384);五、六重感染者全为男性,占1. 56%(6/384)。多重感染中以高低危型HPV混合感染为主。结论重庆地区尖锐湿疣以低危型HPV6、11感染为主,高危型HPV感染发生率高,并多以高低危混合感染形式存在。     

埋植术治疗扁平疣、寻常疣、跖疣的疗效观察

扁平疣、寻常疣、跖疣均为人类乳头瘤病毒（HPV）感染皮肤黏膜所致的增生性皮肤疾病，人为HPV唯一宿主，主要通过直接接触传染，外伤常为重要因素，HPV通过皮肤黏膜细微破损进入细胞内复制、增殖，导致上皮细胞的异常分化和增生，形成赘生物。发病高峰16—30岁，免疫功能低下及外伤者易患此病。疣的发生与机体免疫状态有着重要关系，特别是细胞免疫防御机制起重要作用。过去治疗不外乎激光、冷冻、外科手术、药物腐蚀、内用药物治疗、抗病毒制剂和免疫增强剂等治疗，效果不佳。我科自开展埋植术治疗以来，     

~(32)磷治疗皮肤疣疗效观察

目的针对皮肤疣的特征,采用32磷局部注射及32磷局部敷贴治疗,观察临床疗效。方法分别采用32磷胶体局部注射和32磷敷贴治疗扁平疣、寻常疣、跖疣及尖锐湿疣四种皮肤疣。结果寻常疣治愈率84.31%,有效率94.12%;扁平疣治愈率81.82%,有效率93.94%;跖疣治愈率为78.95%,有效率89.47%;尖锐湿疣治愈率65.38%,有效率84.62%。结论32磷治疗皮肤疣方法简便、安全、痛苦小、疗效显著、复发率低、副作用少,是一种有效的治疗方法。     

Characterization and analysis of human papillomaviruses of skin warts

We analysed human papillomavirus (HPV) infections in 61 tissue specimens of skin warts of Taiwanese patients by DNA hybridization. The prevalence of HPV infection was 69% by Southern blot hybridization. The typing of HPVs was performed by dot blot hybridization under highly stringent conditions with each probe separately. The prevalence of HPV-1, 2/3, 4, 5, 8, 11, 16 and 18 in skin warts was 13, 7, 16, 2, 0, 5, 2 and 8%, respectively. Chi-squared analysis revealed that there was a correlation between HPV type and copy number. Most HPV-4-induced warts were verruca vulgaris. HPV-1 DNA was detected in verruca plantaris and verruca vulgaris. No specific histopathological features were found to be indicative of the presence or absence of HPV, or of the various types of HPV infection.     

Detection of Human Papillomavirus infection in trichilemmomas and verrucae using in situ hybridization

Background: It is hypothesized that trichilemmomas are 'burned out' verrucae. By performing in situ hybridization using HPV type-specific probes, we explored this concept.
Methods: Verrucae vulgaris and plantaris were positive controls, and inverted follicular keratoses (IFKs) were negative controls. Additionally, all lesions were tested for HPV genital types (low and high risk).
Results: We analyzed 9 trichilemmomas, 20 verrucae vulgaris, 8 verrucae plana, 3 verrucae plantaris and 6 IFKs. All trichilemmomas were negative for HPV types 1, 2 and genital types. Conversely, 9/20 verrucae vulgaris, 2 verrucae plantaris, and 1 verruca plana were positive for HPV type 2. Among HPV-2 positive lesions, 2/2 verrucae plantaris and 1 verruca vulgaris (chin) were strongly positive for genital-type HPV. One verruca plana (shin) was positive for genital-type HPV only. All 6 IFKs were HPV negative.
Conclusions: Using HPV type 1 and 2-specific probes and mixed genital-type probes, we were unable to detect HPV in trichilemmomas. This suggests that HPV-1, HPV-2 and low and high risk genital-type HPVs are not involved in the histogenesis of trichilemmoma. We also showed that genital HPV types could be present in non-genital verrucae.     

人乳头瘤病毒型别及载量与寻常疣临床特征相关性研究

目的 探讨人乳头瘤病毒型别、载量与寻常疣临床特征的相关性。 方法 提取48例寻常疣组织DNA;正反向测序通用引物PCR扩增片段,通过blast比对分型,并通过型别特异性引物PCR来验证和补充测序结果;实时荧光定量PCR相对定量ΔCt法检测HPV病毒载量;HE染色法观察病理变化。 结果 35例HPV PCR检测阳性的标本中HPV 7型32例;HPV 57型1例,为四肢末端多发;HPV 2和HPV 7混合感染2例,为头面部、躯干多发病例。单发组与多发组、病程 ＜ 6个月组与病程6个月至1年组病毒载量、空泡化细胞数目无明显差异,1年后病毒载量有下降趋势,病程 ＞ 2年的皮损,角化过度更明显,空泡化细胞减少。 结论 寻常疣的HPV感染型别主要是HPV 7;HPV 7型感染好发于头面部;对于病程1年内的寻常疣,HPV病毒载量及空泡化细胞数目与其数目、病程长短无明显相关性。     

Preliminary study of analyzing mucosal human papillomaviruses in cutaneous warts by restriction fragment mass polymorphism

Cutaneous human papillomavirus (HPV) types 1, 2, 4, 7 and 57 are reportedly found in cutaneous warts. However, there are few reports that have investigated the prevalence of mucosal HPV types in cutaneous warts. The aim of this study is to investigate the prevalence of mucosal HPV types in patients with cutaneous warts and to determine any association between HPV types and patient characteristics. We analyzed 62 wart samples that were taken from patients who were diagnosed with cutaneous warts, and 30 normal skin samples were used as negative control. We recorded the following characteristics: sex, age, type of warts, duration of warts, number of warts and patient's immune status. A matrix‐assisted laser desorption ionization time‐of‐flight (MALDI‐TOF) mass spectrometry (MS)‐based restriction fragment mass polymorphism (RFMP) assay was used for HPV genotyping. Of the total 62 wart samples, 50 samples (81.6%) were positive for HPV genotypes. All of the negative controls (30 samples) using normal skin showed negative reaction. Mucosal HPV types (49 samples, 84.4%) were highly detected, and high‐ or probable high‐risk HPV types (39 samples, 67.2%) were more common than lower risk HPV types (10 samples, 17.2%). A statistically significant association was observed between sex, age, duration of warts and the risk of HPV types. To the best of our knowledge, this is the first study to use the RFMP assay to analyze cutaneous wart‐associated mucosal HPV types. The high prevalence of high‐risk and probable high‐risk HPV in this study is of great significance.     

Expression of PCNA is associated with the presence of HPV DNA in skin warts

A series of 90 excised cutaneous warts (verrucae vulgaris) were studied for the presence of HPV (human papillomavirus) DNA using in situ hybridization (ISH) with biotinylated full genomic DNA probes of HPV types 1, 2, 3 and 4. The expression of PCNA (proliferating cell nuclear antigen) was examined using conventional immunohistochemistry. The aim was to test the hypothesis that HPV can reactivate PCNA, including in the host replication machinery. HPV DNA of the above types was detected in 60 of 90 verruca biopsies studied (66.7%): HPV 2 in 56 cases, HPV 1 in 2 cases, and HPV 3 in 2 cases. PCNA was expressed in all samples except two. The signal distribution of HPV DNA markedly differed from that of PCNA expression. ISH revealed strong HPV DNA signals in both the granular and the upper spinous cell layers, the most intense signals being detected in the upper epidermis. On the other hand, nuclear PCNA staining was present in the majority of parabasal and basal cells. Although strong PCNA signals within the wart lesions were found in the areas where HPV DNA was present, the PCNA positivity was almost invariably localized in the differentiated cells of the spinous cell layers, just below the HPV DNA-expressing cells. At the margins of the lesions, PCNA expression was still strong but disappeared abruptly towards the normal epidermis. HPV DNA-positive warts showed more intense expression of PCNA than did the HPV DNA-negative ones in this study. Our results indicate that PCNA induction is associated with the presence of HPV DNA, suggesting that HPV can reactivate PCNA, thus interfering with the host cell DNA replication machinery. Received: 8 May 1996     

寻常疣和跖疣患者外周血T淋巴细胞亚群及共刺激分子CD28,CD40的检测

目的探讨寻常疣和跖疣患者外周血T淋巴细胞亚群的变化及共刺激分子CD28,CD40的表达情况。方法采用流式细胞仪检测实验组60例(寻常疣、跖疣患者各30例)和健康对照组30例的外周血T淋巴细胞亚群和CD28,CD40分子在淋巴细胞上的表达水平。结果寻常疣组、跖疣组与健康对照组相比:外周血CD4+T淋巴细胞(34.57%,35.39%,42.02%)明显减少,差异有统计学意义(P<0.01);CD4+/CD8+比值(1.38,1.44,1.72)降低,差异有统计学意义(P<0.05);淋巴细胞上CD28的表达(52.80%,51.87%,37.41%)明显增加,差异有统计学意义(P<0.01),CD40的表达(12.88%,11.94%,15.82%)减少,差异有统计学意义(P<0.05)。而寻常疣和跖疣两组间,外周血T淋巴细胞亚群及共刺激分子CD28,CD40的表达,差异无统计学意义(P>0.05)。实验组患者的疣体数量和外周血T淋巴细胞亚群及共刺激分子CD28,CD40的变化均无相关性(P>0.05)。结论寻常疣和跖疣患者体内存在T淋巴细胞亚群改变和共刺激分子CD28,CD40表达异常,可能与其免疫功能紊乱和病程慢性化有关。     

Human papillomavirus typing of warts and response to cryotherapy

Background Cutaneous warts are common and caused by a number of different types of human papillomaviruses (HPVs). Objective The aim of this study was to investigate the HPV types causing common warts and to determine any association between the HPV type and the duration of warts and response to cryotherapy. Methods Eighty wart samples from 76 immunocompetent patients were taken from warts by paring prior to cryotherapy and analysed by in situ hybridization (ISH) with HPV probes specific to HPV 1, 2, 3, 4, 7, 10 and 57 and PCR analysis using degenerate cutaneous HPV primers with subsequent DNA sequencing. Each patient's details, including site, duration and response of the wart to cryotherapy were recorded. Cryotherapy was performed at 2 week intervals for a maximum of 12 weeks. Results An HPV type was identified in 65 samples. The majority of warts (58 samples) were typed as HPV 2/27/57 by ISH and/or PCR. Three of the 18 samples that were HPV negative with ISH were HPV positive by PCR. Response to treatment did not correlate with HPV type, duration or location. In the 21 wart parings taken from patients aged 16 and under, response to treatment did not correlate with HPV type but warts of shorter duration were more likely to resolve with cryotherapy treatment than longer standing lesions. Conclusion This study demonstrates that HPV type can be determined from wart parings. HPV‐2 related viruses are the prevalent HPV types causing common warts on the hands and feet in this population.     

Topical garlic treatment for verruca plana triggers Koebner phenomenon: A case report

Background

Verruca plana is a benign proliferation of the skin caused by human papilloma virus (HPV) infection. Fresh garlic can serve as an alternative therapy, and it has shown considerable effectiveness as a topical treatment for verruca plana. However, topical garlic treatment for verruca plana triggered Koebner phenomenon (KP), which has not been previously reported.

Aim

The aim of our report is to explore the possible causes of this adverse reaction.

Method

We here describe a 20-year-old female patient who developed a beaded rash after garlic treatment for facial wart plana, known as autoinoculation or KP.

Results

Garlic may have caused damage to the surrounding normal skin through primary irritation or allergic reactions. Then, the HPV virus on the primary verruca plana took the opportunity to spread to the surrounding skin injured by garlic stimulation, triggering the KP.

Conclusion

When using garlic to treat verruca plana, the operator needs to precisely apply the mashed garlic to the warts, and this treatment is strictly prohibited for patients who are allergic to garlic. Avoid such adverse reactions.     

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.     

Intralesional recombinant alpha-2 interferon for the treatment of patients with condyloma acuminatum or verruca plantaris

We conducted a multicenter double-blind study comparing human recombinant intralesional alpha-2 interferon (IFN) and placebo in 237 patients with the clinical diagnosis of condyloma acuminatum or verruca plantaris. A single wart on each patient was injected with 0.1 mL containing 10(6) IU of IFN, 10(5) IU of IFN, or placebo three times weekly for three weeks, and the response to treatment was followed up for 12 weeks. Among 91 of the 114 patients with condyloma acuminatum who completed the study, complete clearing of the treated wart occurred in 16 (53%) of 30 patients receiving 10(6) IU of IFN compared with six (19%) of 32 receiving 10(5) IU of IFN and four (14%) of 29 receiving placebo. In the group of 100 patients with plantar warts, there was no apparent benefit associated with interferon administration. Seven patients (3%) had treatment discontinued due to adverse reactions. Intralesional alpha-2 IFN is of benefit in the treatment of a single condyloma; its role in the treatment of multiple lesions remains to be clarified. Its role in the treatment of verruca plantaris, where no response was seen, also remains to be clarified.