PubMed · 4610588
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M Lord. 1974. Day case surgery.. https://pubmed.ncbi.nlm.nih.gov/4610588/
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The natural history of human papillomavirus (HPV) genital tract lesions is complex, partly because infection can appear in several forms and often follows a fluctuating course. The primary mode of transmission of genital strains of HPV is through sexual contact. Most clinically apparent genital warts are caused by HPV type 6 or 11. The main manifestations of anogenital warts are cauliflower-like condylomata acuminata that usually involve moist surfaces; keratotic and smooth papular warts, usually on dry surfaces; and subclinical "flat" warts, which can be found on any mucosal or cutaneous surface. Latent infections that can be detected only by the presence of HPV DNA, with neither macroscopic nor histologic abnormality, are probably the most common form of anogenital HPV infection, regardless of HPV type. Most untreated genital tract lesions eventually resolve spontaneously, but it is likely that latent or subclinical infection persists indefinitely. The natural history of anogenital HPV infection is likely influenced by the cell-mediated immune system.
Within 9 days in a day-care centre of 20 children 3 cases and 2 suspected cases of perianal infection (PAI) were revealed. The causative agent for PAI was confirmed to be beta-haemolytic group A streptococcus (GAS). The isolates were further characterized by T- and M-serotyping, conventional restriction endonuclease analysis (REA) and pulsed field gel electrophoresis (PFGE). The typing methods revealed that all outbreak isolates were of same T28R28-serotype and genetically identical. Unrelated, control GAS isolates of the same serotype differed genetically from the outbreak isolates indicating that a single clone had caused the perianal infections.
BACKGROUND: Perianal Bowen's disease (BD) is an intraepithelial nonkeratinizing carcinoma, associated historically with internal tumors. METHODS: A review of patients with perianal BD presenting consecutively during a 25-year span was undertaken, excluding Bowenoid papulosis and contiguous genital BD. Histologic slides were resubmitted for review by an experienced pathologist, in a "blind" fashion among other slides. Follow-up was updated in every patient. Survival and recurrence curves were generated by the Kaplan-Meier method and were compared with a normal age-matched population (log-rank test). RESULTS: Nineteen patients were identified; 15 of them were females. Mean age +/- standard deviation was 49.6 +/- 10.6 years. Five patients had a coincidental diagnosis (hemorrhoidectomy or wart excision). No associated carcinomas were found; however, eight patients had isolated BD of the vulva. Eleven patients had a history of anal warts, cervical/vulvar dysplasia, or both. Wide resection, including V-Y flaps, was performed in 18 patients without dysfunction. One-year and five-year recurrence was 16 and 31 percent. Recurrence was treated in all but one case by wider resection. Mean follow-up was 8.4 years. Five-year survival was 75 percent, lower than the matched population (P = 0.001); however, only one death was related to BD. CONCLUSIONS: Perianal BD has no association with internal tumors. Despite a high rate of recurrence, perianal BD can be treated by local excision. An increased rate of human papilloma virus-related entities was found, which could suggest a causative role.