Research Article
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Analysis of the relationship between clinical features, treatment options and recurrence of patients diagnosed with anogenital warts

Year 2023, Volume: 6 Issue: 4, 745 - 750, 30.07.2023
https://doi.org/10.32322/jhsm.1297519

Abstract

Aims: Our study aimed to describe the demographic and clinical characteristics of patients with anogenital warts and to investigate the relationship between treatment options and recurrence.
Methods: The data of patients who were admitted to the dermatology, urology, and gynecology outpatient clinics between 2010 and 2021, and diagnosed with anogenital warts were retrospectively analyzed. Demographic characteristics of the patients, presence of other sexually transmitted diseases, anatomical distribution of warts, number of anatomical regions and warts, frequency of recurrence, type of treatment before the first recurrence, and follow-up periods were documented. Statistical analysis was performed and the results were evaluated at a 95% confidence interval and p<0.05.
Results: A total of 201 patients, 181 (90%) male and 20 (10%) female, who met the study criteria, were included in the study. The ages of the patients vary between 20-67 years; the median was 31 years. The rate of the number of warts of 10 or more in patients with recurrence was found to be statistically significantly higher than in cases without recurrence (p=0.013). The recurrence rate was statistically significantly higher in patients with pubic localization (p=0.001). There was a significant difference between the number of localization regions according to recurrence status (p=0.003). The recurrence rate of patients who received cryotherapy was statistically significantly higher (p=0.002). According to the logistic regression analysis; the number of 10 or more warts increases the risk of recurrence to 2.665 times (95% CI: 1.225-5.799) (p=0.013). Cryotherapy increases the risk of recurrence to 6.243 times (95% CI: 1.786-21.828) (p=0.004). Male sex increases the risk of recurrence to 3.034 times (95% CI: 1.029-8.940) (p=0.044).
Conclusion: Anogenital warts often recur even if they disappear completely after treatment. It has been observed that the recurrence is more common when the number of warts is more than 10. Recurrence may be observed more frequently in the male gender. Recurrence occurs more frequently with cryotherapy than electrocauterization. The importance of prophylactic human papillomavirus vaccination in preventing anogenital warts is emerging once again due to the high recurrence rate and prolonged treatment period.

Supporting Institution

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References

  • Leslie SW, Sajjad H, Kumar S. Genital Warts. [Updated 2023 Mar 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  • Clanner-Engelshofen BM, Marsela E, Engelsberger N, et al. Condylomata acuminata: A retrospective analysis on clinical characteristics and treatment options. Heliyon. 2020;6(3):e03547.
  • Scheinfeld N, Lehman DS. An evidence-based review of medical and surgical treatments of genital warts. Dermatol Online J. 2006;12:5.
  • Svare EI, Kjaer SK, Worm AM, et al. Risk factors for genital HPV DNA in men resemble those found in women: A study of male attendees at a Danish STD clinic. Sex Transm Infect. 2002;78:215–218.
  • Tyros G, Mastraftsi S, Gregoriou S, Nicolaidou E. Incidence of anogenital warts: epidemiological risk factors and real-life impact of human papillomavirus vaccination. Int J STD AIDS. 2021;32(1):4-13.
  • Tamer E, Cakmak SK, Ilhan MN, Artuz F. Demographic characteristics and risk factors in Turkish patients with anogenital warts. J Infect Public Health. 2016;9(5):661-666.
  • Kaderli R, Schnüriger B, Brügger LE. The impact of smoking on HPV infection and the development of anogenital warts. Int J Colorectal Dis. 2014;29(8):899-908.
  • Banura C, Mirembe FM, Orem J, Mbonye AK, Kasasa S, Mbidde EK. Prevalence, incidence and risk factors for anogenital warts in Sub Saharan Africa: a systematic review and metaanalysis. Infect Agent Cancer. 2013;8(1):27.
  • Thomas R, Steben M, Greenwald Z, et al. Recurrence of Human Papillomavirus External Genital Wart Infection Among High-Risk Adults in Montréal, Canada. Sex Transm Dis. 2017;44(11):700-706.
  • Habel LA, Van Den Eeden SK, Sherman KJ, McKnight B, Stergachis A, Daling JR. Risk factors for incident and recurrent condylomata acuminata among women. A population-based study. Sex Transm Dis. 1998;25(6):285-292.
  • Zhan M, Tong Z, Chen S, Miao Y, Yang Y. Establishing a prediction model for recurrence of condyloma acuminatum. Eur J Med Res. 2022;27(1):183.
  • Giuliano AR, Sirak B, Abrahamsen M, et al. Genital Wart Recurrence Among Men Residing in Brazil, Mexico, and the United States. J Infect Dis. 2019;219(5):703-710.
  • Widschwendter A, Böttcher B, Riedl D, et al. Recurrence of genitals warts in pre-HPV vaccine era after laser treatment. Arch Gynecol Obstet. 2019;300(3):661-668.
  • Demir A, Guder S. The effects of vitamin B12, vitamin D, ferritin level, neutrophil/monocyte ratio and some blood parameters on genital warts presence, the number of lesions, and recurrence rates. Andrologia. 2021;53(4):e14006.
  • Lacey CJ, Woodhall SC, Wikstrom A, Ross J. 2012 European guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol. 2013;27(3):263-270.
  • Stone KM, Becker TM, Hadgu A, Kraus SJ. Treatment of external genital warts: a randomised clinical trial comparing podophyllin, cryotherapy, and electrodesiccation. Genitourin Med. 1990;66(1):16-19.
  • Baker DA, Ferris DG, Martens MG, et al. Imiquimod 3.75% cream applied daily to treat anogenital warts: combined results from women in two randomized, placebo-controlled studies. Infect Dis Obstet Gynecol. 2011;2011:806105.
Year 2023, Volume: 6 Issue: 4, 745 - 750, 30.07.2023
https://doi.org/10.32322/jhsm.1297519

Abstract

References

  • Leslie SW, Sajjad H, Kumar S. Genital Warts. [Updated 2023 Mar 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  • Clanner-Engelshofen BM, Marsela E, Engelsberger N, et al. Condylomata acuminata: A retrospective analysis on clinical characteristics and treatment options. Heliyon. 2020;6(3):e03547.
  • Scheinfeld N, Lehman DS. An evidence-based review of medical and surgical treatments of genital warts. Dermatol Online J. 2006;12:5.
  • Svare EI, Kjaer SK, Worm AM, et al. Risk factors for genital HPV DNA in men resemble those found in women: A study of male attendees at a Danish STD clinic. Sex Transm Infect. 2002;78:215–218.
  • Tyros G, Mastraftsi S, Gregoriou S, Nicolaidou E. Incidence of anogenital warts: epidemiological risk factors and real-life impact of human papillomavirus vaccination. Int J STD AIDS. 2021;32(1):4-13.
  • Tamer E, Cakmak SK, Ilhan MN, Artuz F. Demographic characteristics and risk factors in Turkish patients with anogenital warts. J Infect Public Health. 2016;9(5):661-666.
  • Kaderli R, Schnüriger B, Brügger LE. The impact of smoking on HPV infection and the development of anogenital warts. Int J Colorectal Dis. 2014;29(8):899-908.
  • Banura C, Mirembe FM, Orem J, Mbonye AK, Kasasa S, Mbidde EK. Prevalence, incidence and risk factors for anogenital warts in Sub Saharan Africa: a systematic review and metaanalysis. Infect Agent Cancer. 2013;8(1):27.
  • Thomas R, Steben M, Greenwald Z, et al. Recurrence of Human Papillomavirus External Genital Wart Infection Among High-Risk Adults in Montréal, Canada. Sex Transm Dis. 2017;44(11):700-706.
  • Habel LA, Van Den Eeden SK, Sherman KJ, McKnight B, Stergachis A, Daling JR. Risk factors for incident and recurrent condylomata acuminata among women. A population-based study. Sex Transm Dis. 1998;25(6):285-292.
  • Zhan M, Tong Z, Chen S, Miao Y, Yang Y. Establishing a prediction model for recurrence of condyloma acuminatum. Eur J Med Res. 2022;27(1):183.
  • Giuliano AR, Sirak B, Abrahamsen M, et al. Genital Wart Recurrence Among Men Residing in Brazil, Mexico, and the United States. J Infect Dis. 2019;219(5):703-710.
  • Widschwendter A, Böttcher B, Riedl D, et al. Recurrence of genitals warts in pre-HPV vaccine era after laser treatment. Arch Gynecol Obstet. 2019;300(3):661-668.
  • Demir A, Guder S. The effects of vitamin B12, vitamin D, ferritin level, neutrophil/monocyte ratio and some blood parameters on genital warts presence, the number of lesions, and recurrence rates. Andrologia. 2021;53(4):e14006.
  • Lacey CJ, Woodhall SC, Wikstrom A, Ross J. 2012 European guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol. 2013;27(3):263-270.
  • Stone KM, Becker TM, Hadgu A, Kraus SJ. Treatment of external genital warts: a randomised clinical trial comparing podophyllin, cryotherapy, and electrodesiccation. Genitourin Med. 1990;66(1):16-19.
  • Baker DA, Ferris DG, Martens MG, et al. Imiquimod 3.75% cream applied daily to treat anogenital warts: combined results from women in two randomized, placebo-controlled studies. Infect Dis Obstet Gynecol. 2011;2011:806105.
There are 17 citations in total.

Details

Primary Language English
Subjects Dermatology, Health Care Administration
Journal Section Original Article
Authors

Elif Demirci Saadet 0000-0001-7449-7951

Halil Gürdal İnal This is me 0000-0001-9838-9189

Bedreddin Seçkin 0009-0005-7799-5637

Süleyman Akarsu 0000-0001-6571-6403

Early Pub Date July 28, 2023
Publication Date July 30, 2023
Published in Issue Year 2023 Volume: 6 Issue: 4

Cite

AMA Demirci Saadet E, İnal HG, Seçkin B, Akarsu S. Analysis of the relationship between clinical features, treatment options and recurrence of patients diagnosed with anogenital warts. J Health Sci Med / JHSM. July 2023;6(4):745-750. doi:10.32322/jhsm.1297519

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