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     

132例皮肤疣组织人乳头瘤病毒分型检测

目的 探讨皮肤疣组织中人乳头瘤病毒（HPV）的感染率和病毒型别。方法 门诊皮肤疣患者132例中寻常疣46例,跖疣38例,扁平疣48例。以特异性DNA序列为模板设计引物,进行PCR扩增,电泳,对结果进行分析。 结果 132例皮肤疣中,HPV阳性128例,感染率为97.0%,其中HPV2型阳性111例,感染率为84.1%。寻常疣、跖疣感染主要为HPV2、HPV1型,扁平疣感染主要为HPV2、HPV10、HPV3、HPV1型。89例为多重感染,感染率为67.4%,其中二重感染率为41.7%（55例）,三重感染率为21.2%（28例）,四重感染率为4.6%（6例）;寻常疣多重感染率为50.0%（23/46）,跖疣为76.3%（29/38）,扁平疣77.1%（37/48）。多重感染中,以HPV1 + 2型最多,有35例（39.3%）,其次为HPV1 + 2 + 10型,有12例（13.5%）。 结论 遵义皮肤疣感染以HPV2型为主,其次为1型;2型与多种皮肤疣感染有关;皮肤疣中多重感染率较高,其中扁平疣多重感染率最高;新发现HPV3、10型感染寻常疣,HPV10型感染跖疣,HPV1、7型感染扁平疣。     

男性尖锐湿疣患者疣体和手指人乳头瘤病毒6/11型DNA的检测

目的：确定男性尖锐湿疣患者疣体和手指人乳头瘤病毒6/11型的感染。方法：采用PCR荧光法对46例男性尖锐湿疣患者疣体和手指进行HPV6/11型核酸定性、定量检测,同时以20名无尖锐湿疣的男性手指作对照。结果：尖锐湿疣患者39例疣体(39/46＝84.78％)阳性,手指25例(25/46＝54.35％)阳性。无尖锐湿疣患者的手指仅2人阳性,差异有显著性意义( P<0.05)。 HPV6/11型疣体病毒载量为6.60×107±3.77×108,病毒载量与病程长短无相关性;尖锐湿疣患者的手指病毒载量为5.72×103±1.75×104,低于疣体的病毒载量(P<0.05)。结论：男性尖锐湿疣患者的手指携带HPV6/11型,其在尖锐湿疣的传播意义有待研究。     

多发性跖疣患者治疗前后外周血T细胞亚群的比较

<正>为了解细胞免疫功能在多发性跖疣复发机制中的作用。本文检测了67例多发性跖疣患者的外周血T细胞亚群,同时应用卡介菌多糖核酸(BCG-PSN)进行治疗。现报道如下。1资料与方法1.1临床资料所有病例均来自我科门诊。入选标准:临床检查及聚合酶链反应(PCR)法检测人乳头瘤病毒(HPV)DNA呈阳性确诊为多发性跖疣,年龄18~60岁;病程2年内初发;疣体数目≥15个;皮     

微波联合CO2激光治疗跖疣193例疗效观察

1一般资料193例均为2005年10月-2010年12月本科门诊跖疣患者,符合跖疣的诊断标准[1],男103例,女90例,年龄18 ～56岁,平均(35.40±11.09)岁,病程3～12个月.患者皮损不伴有炎症或溃疡,半年内未接受过跖疣的任何治疗,不伴有自身免疫性疾病,无严重肝肾功障碍及高血压、糖尿病史(非器官移植患者),哺乳期和妊娠妇女除外.疣体直径2～ 7mm,疣体数目1～10个.将入选的193例患者按就诊顺序分为CO2激光治疗组(A组)、微波治疗组(B组)和微波联合CO2激光治疗组(C组),三组患者的性别、年龄和病程均有可比性(P均＞0.05).见表1.     

荧光定量PCR检测人类乳头瘤病毒在尖锐湿疣中的应用

目的　对尖锐湿疣 (CA)患者进行乳头瘤病毒 (HPV )DNA定量测定。方法　用聚合酶链反应 (PCR )测定HPVDNA的载量及HPV分型。结果　 2 0 0例尖锐湿疣患者中 198例疣体组织HPV测定阳性 ,2例阴性。在 84例疣体组织HPV6、11阳性者中有 12例合并HPV16、18阳性。 5例疣体组织及宫颈分泌物同时阳性。定量测定结果显示 :HPV6、11患者最高 2 .0× 10 8copy/ml ,最低 3 .0× 10 4copy/ml,HPV16、18患者最高 1.75× 10 7copy/ml,最低 3 .0× 10 5copy/ml。 结论　尖锐湿疣患者应用荧光定量PCR检测HPV阳性率高 ,并可快速区分致癌型及致疣型HPV感染 ,对尖锐湿疣复发及癌变作出可能性预测     

点阵激光联合派特灵外用治疗多发性跖疣疗效观察

<正>多发性跖疣系人乳头瘤病毒(human papillomavirus,HPV)感染,是皮肤科常见病,多为HPV-1、HPV-2、HPV-4等亚型所致,可发生于足跖任何部位~([1])。激光是治疗多发性跖疣的常用方法,虽然能迅速清除疣体,但临床效果不佳,易复发~([2])。派特灵近年来被广泛应用于跖疣的临床治疗中,能够有效提高治疗HPV的临床效果,降低复发率,减轻患者痛苦~([3])。我院通过采     

HPV疫苗在性病控制中的作用

流行病学研究显示在性活跃成人中20％～80％有人类乳头瘤病毒(HPV)感染史,绝大部分为无症状感染。HPV疫苗也许能预防生殖器疣,与HPV相关的宫颈癌以及其它少见的肛门生殖器癌的发生。生殖器疣通常由HPV6和HPV11感染引起,还有10多种HPV型别较少引起该病。可见疣的患病率在成人一般为1％～5％;宫颈癌90％～95％与HPV相关,从HPV感染至发现癌症估计潜伏期为5～25年。     

不同病程尖锐湿疣患者HPV感染与T细胞亚群表达情况的关系

目的探讨不同病程尖锐湿疣(CA)患者人乳头状瘤病毒(HPV)感染与T细胞亚群表达情况的关系。方法选择2012年1月—2015年2月我院收治的151例CA患者,根据病程长短分为A、B组,A组病程≤3个月,B组病程3个月,A组97例,B组54例,另选同期体检健康的51例作为对照组。采集3组患者外周血,并使用流式细胞术检测T淋巴细胞亚群的表达情况。取脱落疣体细胞,并使用核酸快速杂交分型法检测HPV-DNA。结果 B组患者CD4~+、CD4~+/CD8~+水平显著低于A组和对照组,CD8~+水平显著高于对照组及A组患者,差异均有统计学意义(P0.05)。HPV阳性患者151例,其中包括单纯HPV6/11~+、HPV16/18~+型感染各45例、49例,HPV6/11、16/18~+混合型感染57例。HPV6/11~+、HPV16/18~+、(HPV6/11~+、16/18~+)各组患者CD3~+、CD4~+、CD4~+/CD8~+水平均低于健康组,差异有统计学意义(P0.05);而3组间CD3~+、CD4~+、CD8~+、CD4~+/CD8~+水平比较,差异均无统计学意义(P0.05)。结论病程3个月以上CA患者细胞免疫功能明显降低,且各型HPV感染患者细胞免疫功能差异无统计学意义。     

1619例尖锐湿疣患者人乳头瘤病毒基因型检测及分析

目的探讨深圳地区尖锐湿疣(condyloma acuminatum,CA)组织中人乳头瘤病毒(human papillomavirus,HPV)基因型分布情况。方法采用反向点杂交技术,检测1 619例CA患者疣体脱落细胞中的HPV基因型。结果 1 619例CA患者中低危型阳性率为68.6%,高危型阳性率为57.3%;主要HPV型别:6型(35.8%)、11型(25.1%)、43型(14.8%)、16型(14.5%)、52型(10.1%)、58型(8.3%)、18型(5.7%)。男性和女性高危型HPV感染阳性率比较差异有统计学意义(P0.01)。单一HPV感染占63.9%,多重感染占36.1%,高危型多重感染比例为89.7%(524/584)。男、女性多重感染的比例差异有统计学意义(P0.001)。结论深圳地区CA感染HPV型别主要为低危型,高危型比例明显上升,主要流行型别是HPV6、11、43、16、52、58、18。高危型多存在混合感染,女性多重感染比例最高。     

Two anatomoclinical types of warts with plantar localization: Specific cytopathogenic effects of papillomavirus

Summary In this study, the clinical and histopathological aspects of 50 plantar warts are reported in relation to the type of papillomavirus present in the lesions, as detected by immunofluorescence tests, using specific guinea pig fluorescein-labelled IgG. Warts of plantar localization are not caused by the same human papillomavirus (HPV) since they are found to be associated with both HPV type 1 (HPV-1) and HPV type 2 (HPV-2). HPV-1 is always associated with deep and painful plantar warts (myrmecia), whereas HPV-2 is found to be associated with superficial, painless plantar warts (vulgaris or often mosaic type). Histologically, these two types of plantar warts are quite different. In myrmecia (HPV-1), characterized by an endophytic growth, large eosinophilic, keratohyaline-like granules are observed in the cytoplasm and nucleus of infected, often vacuolated cells. These granules appear early in stratum spinosum and are very numerous in stratum granulosum. In the mosaic type (HPV-2), the histopathological aspect is not different from that of common warts; these lesions have an exophytic growth and are characterized by foci of clear vacuolized cells which are found in stratum granulosum. Their cytoplasm contains round, basophilic keratohyalin granules which often have a heterogenous aspect. These differences are observed in other localizations of morphologically related warts associated with HPV-1 and HPV-2 and seem to be related to a specific cytopathogenic effect of HPV-1 and HPV-2 in human papillomas.This work was supported by Grant ATP 67.78-99 from the Institut National de la Santé et de la Recherche Médicale (INSERM). J. L. Kienzler was Chargé de Recherches as equivalent title to Interne des Hôpitaux at the INSERMThis work is dedicated to Professor Paul Laugier for his 70th birthday     

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.     

Clinical and histopathological characterization and typing of the human papillomavirus in common warts of kidney transplant recipients

The prevalence of skin lesions caused by the human papillomavirus (HPV) is high in kidney transplant patients. Twenty recipients of kidney transplants with a diagnosis of common warts were evaluated. HPV detection was performed by polymerase chain reaction (PCR) using the MY09/MY11 and RK91 primers. HPV typing was performed by restriction fragment length polymorphism analysis and direct sequencing. The presence of HPV was identified in 10 patients (50%) and the types identified were HPV-2, 27, 29, 34 and 57.     

Klinischer Algorithmus zur Therapie von kutanen, extragenitalen HPV-induzierten Warzen

Various human papillomavirus of the genera α-, β-, γ-, μ- and η-papillomavirus induce type-specific extragenital warts. Plantar, common and plane warts are the most common types. The closely related Alpha-papillomaviruses HPV 2, 27 and 57 are responsible for the majority of therapy-resistant common warts. A wide armamentarium of surgical, physical, chemical or drug therapies is available but no modality cures all patients. In order to avoid overtreatment it is mandatory to differentiate between indolent warts which will spontaneously resolve, warts which cause acute discomfort and warts without any tendency to heal spontaneously. HPV type, wart type, localization, size, disease duration as well as age and immune status are parameters influencing self-healing and should be considered when choosing the appropriate wart therapy.     

Topical 5% imiquimod long-term treatment of cutaneous warts resistant to standard therapy modalities

BACKGROUND: Long-lasting cutaneous warts may represent an unbearable stigma to patients and therefore pose a singular challenge for the physician. Generally, these warts are induced by human papillomavirus (HPV) 2, HPV-27 or HPV-57. OBJECTIVES: The present study was conducted to evaluate the efficacy and safety of long-term treatment with imiquimod 5% cream applied to long-lasting (mean duration 6.3 years) common warts, which had been resistant to previous therapeutic interventions. PATIENTS AND METHODS: Imiquimod cream was self-applied by the patients twice daily. Assessment of response and occurrence of side-effects was performed every 4 weeks until clinical cure or up to a maximum of 24 weeks. A total of 37 patients were recruited. RESULTS: 31 out of 37 patients completed the treatment. 10 out of 37 patients experienced a total clearance of their warts (27%). The mean duration to clearance was 19.2 weeks. 18 patients (49%) showed a reduction of more than 50% and 5 patients (14%) a reduction of less than 50%. CONCLUSION: Our data demonstrate that the long-term topical application of imiquimod 5% cream is an effective treatment for otherwise therapy-resistant cutaneous warts without causing any meaningful side-effects.     

Detection and typing of human papillomavirus in cutaneous warts of patients infected with human immunodeficiency virus type 1

BACKGROUND: Cutaneous warts are caused by human papillomavirus (HPV). To date, more than 120 different types of HPV are known, of which 80 have been completely characterized. Prevalence studies on types of HPV present in cutaneous warts have been carried out in immunocompetent individuals and immunosuppressed organ allograft recipients, but not in human immunodeficiency virus (HIV)-positive patients. OBJECTIVES: To determine the HPV types present in cutaneous warts of HIV-infected patients. METHODS: Twenty-five biopsies of cutaneous warts from HIV-infected patients and 14 samples from control non-HIV-infected patients were studied. HPV detection was performed by polymerase chain reaction using two sets of primers: MY09/MY11 and RK91. The type of HPV was determined by restriction fragment length polymorphism analysis and direct sequencing of the amplified products. RESULTS: HPV DNA was detected in 64% of cutaneous warts from HIV-infected patients and in 79% of samples from the control group. The HPV types identified in HIV-infected patients were: HPV 2 (38%), 57 (31%), 27 (12%), 6 (12%) and 7 (6%). HPV 2/27/57 predominated in both groups, being present in 81% of lesions from HIV-infected patients and 82% of samples from non-HIV-infected patients. HPV 6, a genital HPV type rarely found in cutaneous lesions, was detected in two warts from HIV-infected patients and in one lesion of the immunocompetent group. HPV 7, characteristically associated with butcher's warts, and recently detected in oral and perioral lesions of HIV-infected patients, was found for the first time in a non-facial lesion of an HIV-infected patient. CONCLUSIONS: This is the first study evaluating the prevalence of HPV types in cutaneous warts of HIV-infected patients and immunocompetent individuals in Brazil.     

Plantar warts treated with an immune response modifier: a report of two cases

Summary Viral warts are the most common disease of the skin and are caused by human papillomavirus (HPV). Plantar warts, a manifestation of infection by HPV-1, -2 and -4, tend to be smoother and flatter than common warts and can also be painful when pressure is applied. A variety of local treatments, including topical salicyclic acid, cryotherapy, topical 5-fluorouracil, intralesional interferons and photodynamic therapy, are available to treat plantar warts. Here we report two cases of plantar warts, which had been previously treated without success. Total clearance of the warts was observed in both cases after treatment with imiquimod 5% cream over a period of 12 weeks. No evidence of local skin reactions was observed in either case during the treatment period. Recurrent lesions were not evident in the follow-up period for each patient.     

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.