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PubMed1992

Oral condyloma lesions in patients with extensive genital human papillomavirus infection.

OBJECTIVES: The incidence, location, and morphologic appearances of human papillomavirus oral lesions in patients with genital condylomatosis were investigated with clinical, colposcopic, and histologic examination as diagnostic procedures. The human papillomavirus types were also evaluated with filter in situ hybridization. STUDY DESIGN: One hundred one patients, 66 female and 35 male, with genital condyloma underwent an oral cavity examination. Ninety-nine (99%) practiced orogenital sex, and all were asymptomatic for oral lesions. RESULTS: Ninety-one underwent biopsy; histologic studies gave a diagnosis of condyloma in 48% of 101 specimens collected. In 8 of 91 (9%) oral lesions were suspected by naked-eye examination; they were confirmed histologically in all eight. Of 83 patients suspected of having oral condyloma on colposcopic examination, 38 (46%) were confirmed histologically. Thus 38 of 46 patients (83%) had oral condyloma not visible to the naked eye. Colposcopically, oral lesions appeared filiform (50%), moruloid (26%), and mixed (24%). Twenty cytologic oral samples were also collected for deoxyribonucleic filter in situ hybridization analysis. Human papillomavirus deoxyribonucleic genital types were observed in 45% (9/20) of all oral scrapings collected, and all were histologically confirmed. CONCLUSION: Our data indicate that genital human papillomavirus types are capable of establishing a local infection in the oral cavity and demonstrate a high incidence of human papillomavirus oral lesions in patients with genital condyloma.

Adult↗
PubMed1996

Selective photosensitizer distribution in vulvar condyloma acuminatum after topical application of 5-aminolevulinic acid.

OBJECTIVE: Our purpose was to determine the feasibility of selective photosensitization of vulvar condylomas by use of tropical application of 5-aminolevulinic acid. STUDY DESIGN: In vivo fluorescence was assessed and biopsy specimens of condylomas were taken for fluorescence microscopy in 24 patients at different times after application of 2.5% 5-aminolevulinic acid ointment or 20% 5-aminolevulinic acid cream. RESULTS: Both in vivo fluorescence imaging and fluorescence microscopy showed selective fluorescence of condylomas of the labia minora and vestibule only within short time intervals, because fluorescence of poorly keratinized normal epithelium was induced by both 5-aminolevulinic acid formulations. In non-hair-bearing skin, lesional fluorescence remained highly selective. Fluorescence microscopy showed that 90 minutes after drug application peak selectivity in epithelial lesional fluorescence was significantly higher with 2.5% 5-aminolevulinic acid ointment (4.5 +/- 0.9) than it was with 20% cream (2.1 +/- 0.2). CONCLUSION: Selective fluorescence of vulvar condyloma acuminatum can be induced by nonselective topical 5-aminolevulinic acid application. Studies evaluating selective photodynamic destruction of condylomas are justified.

Administration, Topical↗
PubMed1995

Risk of dysplasia in anal condyloma.

BACKGROUND: Recent studies suggest an alarming incidence of dysplasia in homosexuals with anal condyloma. The purpose of our study was to determine the incidence of dysplasia in anal condyloma in our male patients and to determine risk factors for premalignant or malignant change. METHODS: Between 1986 and 1994, 103 male patients were referred to our colorectal clinic for evaluation of anal condyloma. Ninety-one patients had biopsy for pathology and form the basis of this report. All charts were reviewed and results analyzed using the chi-squared test with the Yates correction factor. RESULTS: Mean patient age was 31 +/- 11 years (range, 13 to 78 years) and mean duration of disease was 20 +/- 26 months (range, 2 to 120 months). There were 59 heterosexuals and 32 homosexuals/bisexuals. Two heterosexuals (3%) had invasive squamous cell carcinoma and four (6%) had dysplasia. One homosexual/bisexual (3%) had squamous cell carcinoma in situ and nine (28%) had dysplasia (p < 0.05). Statistical analysis revealed that HIV seropositive status and disease location above the dentate line also predicted increased risk of dysplasia, whereas duration of disease, previous topical therapy, substance abuse, and other sexually transmitted diseases were not significant risk factors. CONCLUSIONS: Homosexual orientation, disease above the dentate line and HIV seropositivity increase the risk of dysplasia in perianal condyloma. The incidence of dysplasia in perianal condyloma is significant enough to warrant consideration of biopsy in all patients.

Adolescent↗
PubMed1998

Papillary immature metaplasia (immature condyloma) of the cervix: a clinicopathologic analysis and comparison with papillary squamous carcinoma.

Papillary immature metaplasia (PIM) is a variant of human papillomavirus (HPV) 6 or 11 infection. PIM resembles an immature metaplasia but has filiform papillae, variable cytological atypia, and, frequently, extension into the endocervical canal. Because the unusual morphology and presentation of PIM may cause confusion between this and other benign and malignant papillary neoplasms, we conducted a clinicopathologic analysis of PIM and compared expression of Ki-67 between PIM, condyloma, and papillary carcinoma. Data on patient age, duration of the lesions, and procedures, including cone biopsy, were obtained. The distribution and intensity of staining for Ki-67 in the epithelium was recorded and compared with both condyloma and papillary carcinoma. HPV typing was performed by polymerase chain reaction (PCR) and restriction fragment length pleomorphism analysis (RFLP). Ten of 13 PIMs were HPV 6/11 positive. Three cases contained areas closely resembling condyloma. Eleven cone biopsies were performed on nine cases. Three were found to have a coexisting high-grade squamous intraepithelial lesion that was either HPV 6/11 negative or contained another HPV type. All PIMs displayed variable staining for Ki-67 with a low index of staining in the mid and upper epithelial layers. In contrast, areas of condyloma had significantly stronger staining in areas with viral cytopathic effect (koilocytosis). Six papillary carcinomas were analyzed and displayed moderate to diffuse staining, including staining of the superficial cell nuclei. PIM is a distinct pathological subset of cervical condyloma that frequently is managed by cone biopsy and may persist. The marked reduction in Ki-67 staining in superficial cell layers distinguishes PIM from some condylomata and most HSILs and papillary carcinomas. Immunostaining thus may be helpful in distinguishing PIM from papillary carcinoma, although the differentiation of the two is best made on morphological grounds.

Adult↗
PubMed2003

The histologic differentiation of oral condyloma acuminatum from its mimics.

OBJECTIVE: The purpose of this study was to determine which histologic features could enable one to distinguish oral condyloma, as defined by the detection of human papillomavirus (HPV) DNA through in situ hybridization, from its mimics. STUDY DESIGN: Thirty-two paraffin-embedded specimens from 28 patients that were clinically suggestive of oral condyloma were analyzed histologically and through in situ hybridization with a consensus HPV probe. RESULTS: HPV DNA was detected in 17/32 (53%) of the lesions; no additional positive cases were detected after polymerase chain reaction amplification. Only 5 of the 17 virus-positive cases were considered to be histopathologically unequivocal for condyloma. The histologic features significantly associated with HPV detection were nonuniform perinuclear halos, often in association with epithelial crevices (P =.02), and papillomatosis (P =.02). Each of the 17 patients who were HPV-positive had either HPV-6 or HPV-11, a finding that is similar to those for condyloma involving the penis and vulva/vagina. CONCLUSION: Differentiation between oral condyloma and its mimics is best accomplished by using a combination of histologic, clinical, and in situ viral studies.

Adult↗
PubMed2003

[Carbon dioxide laser vaporization of genital condyloma in pregnancy].

OBJECTIVE: To evaluate therapeutic effectiveness of the carbon dioxide laser on genital condyloma in pregnancy. PATIENTS AND METHODS: From 1998 to 2002, 18 pregnant women with genital condyloma were treated with laser vaporization. Treatment was given without regard to the gestational period. All the women were treated at least once. Condyloma localisation, treatment gestational age and complication rate were analysed. RESULTS: Patients were treated at a gestational age of 15-38 weeks. During pregnancy follow-up, 2 patients had recurrences that required repeated treatment before delivery. In each case, no condylomas were found during delivery. There were no abortions, no premature birth and no complications (bleeding, infections) in our study. CONCLUSION: Laser vaporisation is a safe and effective treatment for condyloma during pregnancy.

Carbon Dioxide↗
PubMed1996

Presence of human papillomavirus type 6f in tonsillar condyloma acuminatum and clinically normal tonsillar mucosa.

An attempt was made to detect human papillomavirus (HPV) in 8 cases of oral papilloma by Southern blot hybridization. HPV type 6 was identified in a case of tonsillar condyloma acuminatum, but neither HPV type 6 nor 11 was found in the 7 other cases of squamous papilloma. The hybridization pattern of the HPV type 6 DNA after digestion with restriction enzymes revealed that the HPV was of the 6f subtype. DNA samples isolated from the condyloma acuminatum, 3 peripheral specimens of clinically normal tonsillar mucosa, a swab sample and saliva from the male patient with this tonsillar condyloma acuminatum were examined further by polymerase chain reaction (PCR). HPV type 6 DNA was detected in the tonsillar condyloma acuminatum and the 3 specimens of clinically normal tonsillar mucosa, but no HPV type 6 DNA was detectable in the normal tonsillar mucosa by Southern blot hybridization using a whole HPV DNA probe. The presence of a small amount of HPV in clinically normal tissue detectable only by PCR suggests latent infection of peripheral tissues with HPV produced from the condyloma acuminatum. Although HPV type 6 DNA was not detectable in the swab and saliva samples of this single case, further study is necessary for the clinical application of preoperative virological diagnosis by PCR using these samples.

Adult↗
PubMed2000

MIB-1 immunostaining is a beneficial adjunct test for accurate diagnosis of vulvar condyloma acuminatum.

The histopathologic diagnosis of vulvar condyloma acuminatum is often based on architectural features that are not specific for human papillomavirus (HPV) infection. Because HPV-associated lesions show increased cellular proliferation, the authors evaluated the usefulness of MIB-1 immunostaining as an aid in the differential diagnosis of cases equivocal for condyloma. The MIB-1 immunostaining pattern was correlated with HPV DNA detection in condyloma acuminatum (CON-A; n = 15), "consistent with condyloma" (c/w CON-A; n = 26), fibroepithelial polyp (FEP; n = 14), and squamous papilloma (n = 10). HPV was detected in 100% of the CON-A cases, and all cases demonstrated MIB-1-positive nuclei in the upper two thirds of the epithelial thickness. With this definition of MIB-1 positivity, there was complete concordance between MIB-1 positivity and HPV detection for all cases (kappa = 0.88). Of the cases c/w CON-A, 17 of 26 (65%) were positive for both MIB-1 and HPV, and could be reclassified as CON-A, whereas 35% were identified as an overdiagnosis based on negative results. In addition, two cases of FEP were MIB-1 and HPV positive, and thus were identified as an underdiagnosis. These results suggest significant overdiagnosis of cases equivocal for condyloma, and indicate that MIB-1 immunostaining is a beneficial adjunctive test when the morphologic features are suggestive but not diagnostic for CON-A.

Antigens, Nuclear↗
PubMed1984

Association of condylomas with intraepithelial and microinvasive cervical neoplasia: histopathology of conization and hysterectomy specimens.

The tissues for 110 patients who received conization and/or hysterectomy following colposcopic evaluation for abnormal Pap smears were evaluated in a blind, retrospective fashion. The patients were grouped as condyloma only, dysplasia, carcinoma in situ, and microinvasion. Special note was taken of the presence of condyloma in those patients with dysplasia or greater. The mean age for each group was determined, and the significance of the differences between groups was assessed using Student's t test. Eighty-three (75%) patients showed evidence of condyloma in at least one section. The mean age of 33.0 years for this group was significantly lower (p less than 0.01). Despite the possibility that condylomas may represent a venereal infection unrelated to carcinogenesis, the association of condylomas and cervical intraepithelial neoplasia is strong. The findings in this study are consistent with the hypothesis that some forms of dysplasia represent a virally transformed epithelium.

Adult↗
PubMed1983

Papillomavirus in cervical condylomas with and without associated cervical intraepithelial neoplasia.

The aim of this study was to analyze the cytohistologic features of cervical condylomas with respect to the presence of associated cervical intraepithelial neoplasia (CIN) and to evaluate whether or not the prevalence of virus antigen, as detected by immunologic staining with peroxidase-antiperoxidase technique, varies with the histologic appearance of the lesions. In a series of 94 histologically confirmed condylomas of the cervix, almost half (43) had features of CIN grades 1 and 2, corresponding to mild and moderate dysplasia. The prevalence of papillomavirus antigen decreased markedly as the features of associated dysplasia became more severe. The antigen prevalence was 82% in pure condylomas, 32% in condylomas with CIN 1, and 0% in condylomas with CIN 2. The evidence that virus production decreased as the lesion became more severe does not preclude papillomavirus etiology for the CIN lesions. Cells transformed by papillomavirus may be expected to cease production of virus particles even as they continue to harbor the viral genome.

Adolescent↗
PubMed1993

Antibodies against papillomavirus antigens in cervical secretions from condyloma patients.

Samples of cervical secretions and serum from 30 women with genital condylomas and 30 age-matched controls were tested for the presence of immunoglobulin A (IgA) and IgG antibodies against a panel of papillomavirus-derived antigens. The same cervical samples were also analyzed for presence of human papillomavirus (HPV) DNA by Southern blotting and polymerase chain reaction. By Southern blotting HPV DNA was detected in 8 of 30 patients with condylomas and 2 of 30 controls, and by the polymerase chain reaction HPV DNA was detected in 14 of 30 patients with condylomas and 5 of 30 controls. A total of 18 of 29 patients with condylomas and 8 of 28 controls had IgA antibodies in cervical secretions to an E2 synthetic peptide, and 17 of 29 patients with condylomas and 5 of 28 controls had local IgA antibodies to an E7 peptide (P < 0.025 and P < 0.005, respectively). The results suggest that measurement of local antibody production against selected HPV antigens may be useful in the study of HPV immunology and, possibly, for the diagnosis of HPV infection.

Adolescent↗
PubMed1993

Papillomavirus DNA typing analysis in condyloma acuminatum patients and their consorts.

The present study demonstrated human papillomavirus (HPV) infection by means of an in situ HPV DNA hybridization screening test (BIOHIT) in 8 male patients with genital condyloma acuminatum, their asymptomatic female consorts and 6 female patients with vulval condyloma acuminatum. The investigations revealed that all but one of the female consorts were infected by HPV but did not show any clinical sign of papillomavirus infection. HPV DNA typing analyses with the most common HPVs present in the genital tract (HPV 6, 11, 16, 18, 31 and 33) revealed the same HPV types in the consorts as found in their partners. (HPV 6 and/or 11 were detected in 4 pairs, HPV 18 and 31 in one pair each, and HPV 18/31 and 16/31 double infections in one pair each.) All cytological specimens of female patients with condyloma acuminatum were HPV-infected, the most frequent type being HPV 31. In the one patient with vulval condyloma acuminatum and carcinoma epidermoides cornescens, the "high-risk" HPV 18 was identified in both condyloma and carcinoma tissues.

Adult↗
PubMed1991

[Condyloma acuminatum: detection of capsid antigen of human papillomavirus and microscopic study].

420 cases of condyloma acuminata and condyloma-like lesions in vulvar region in Guangzhou area were studies on paraffin sections: detection of capsid antigen of human papilloma-versus (HPV-Ag) and observation of microscopic morphology. Of the 420 cases, 160 cases (38.1%) were diagnosed condyloma acuminata. In which, diagnostic koilocytes can be found in 156 cases (97.5%) and HPV-Ag were positive in 105 cases (65.6%). 260 cases (61.9%) were diagnosed chronic inflammation of the skin or mucosa and were all negative for HPV-Ag, koilocyte-like cells but diagnostic koilocytes presented in these lesions. In this paper, morphological features of diagnostic koilocytes and koilocyte-like cells were detailed, and histological and gross distinction between condyloma and condyloma-like lesions were described.

Adolescent↗
PubMed1990

Vulvar condylomas and squamous vestibular micropapilloma. Differences in appearance and response to treatment.

A study of 37 women with typical condylomas and so-called squamous micropapilloma was undertaken to determine their response to systemic interferon and/or podophyllin treatment. Thirty lesions were classified as condylomas and 9 as squamous micropapillomas; two women had both lesions. Twenty-six (87%) of 30 condylomas responded, whereas only 1 (11%) of the 9 cases of micropapillomatosis showed a partial response (P less than .001) to podophyllin and/or interferon. Twenty-six biopsies from condylomas in which sufficient DNA was available for analysis contained human papillomavirus (HPV) DNA sequences that hybridized to an HPV 6 + 16 probe mix under nonstringent conditions. In contrast, HPV DNA sequences could not be detected in any of the nine cases of micropapillomatosis. Immunoperoxidase studies performed on these lesions failed to demonstrate viral capsid antigen. Thus, despite certain similarities in the clinical presentation and microscopic features of condylomas and squamous micropapillomas, it is not clear at present whether micropapillomas are HPV-related lesions.

Condylomata Acuminata↗
PubMedDate not supplied

Cytology of gynecologic condyloma acuminatum.

The morphology of certain cell types often encountered in vaginal and cervical smears of condyloma patients are described. These cells, considered to be exfoliated from epithelium affected by condyloma virus, were found in 60 per cent of the smears obtained from 192 women with condylomatat acuminata. Dysplasia of the cervical and vaginal epithelium is frequently associated with condyloma. Structural features typical of the condylomatous epithelium were common in these dysplasias. These lesions are probably also due to infection by condyloma virus, yet their significance is unknown and the possibility of a precancerous status cannot be ruled out except by a very long term follow-up study which is in progress. It may be assumed that this virus may affect the cervical and vaginal epithelium without any typical papillary condylomatous lesions resulting. Even in the absence of typical condylomatous papillary formations, the cytologic findings may reveal condyloma infection.

Adolescent↗
PubMed1989

[Condyloma acuminata in teenage patients].

From 1978 to 1987, 93 new patients with condyloma acuminata visited urological clinic of our hospital. Among them, 16 patients (17%) were teenagers. The number of teenage patients increased gradually year after year as the total number of patients increased. The proportion of females in teenagers was slightly higher than that in adults. Condyloma in male teenage patients frequently occurred around the cornal sulcus. The site of condyloma in female teenage patients were labia minora and anus. None of other sexually transmitted diseases except for urethritis accompanied condyloma. All patients underwent electrocautery. None of teenage patients showed recurrence of condyloma in contrast with relative high recurrence rate (19%) in adult patients.

Adolescent↗
PubMed1983

[Cervical condyloma and dysplasia: histological and virological correlation apropos of 100 cases].

Colposcopy and cytology have pointed at the frequency of cervical condylomas with special consideration to flat types. The association condyloma/dysplasia and the behavior of carcinomas in situ as sexually transmitted diseases, suggest that human papillomavirus (H. P. V.) could play a role in cervical cancer. 100 patients have undergone examination for coloscopy, cytology, histology and virology. Dysplastic features were observed in 47 p. 100 and led to classify the lesions in 3 groups according to their importance: condylomas (53 p. 100), dysplastic condylomas (25 p. 100) with predominance of condylomatous pattern, dysplasia (22 p. 100) with a predominant dysplastic pattern. Virologic data were correlated with this classification and demonstrate a dramatic relationship between viral disappearance and the presence of dysplastic features. Virus was found in 83 p. 100 of pure condylomas, 16 p. 100 of dysplastic condylomas and 0 p. 100 of condylomatous dysplasias. Such a phenomenon of viral absence is observed in animal models (malignant transformation of Shope's papilloma): this could be a new argument to suspect the carcinogenic potential of H. P. V. for cervix and external genitalia.

Adolescent↗
PubMed1984

Condyloma acuminatum in Rochester, Minn, 1950-1978. II. Anaplasias and unfavorable outcomes.

A total of 746 patients residing in Rochester, Minn, received the diagnosis of condyloma acuminatum between 1950 and 1978. Anaplasia was present in six and subsequently developed in 36 patients during follow-up examination in 42 patients (one male and 41 female). One had invasive squamous cell carcinoma (vulva), six had severe dysplasias, 21 had moderate to mild dysplasias, and 14 had carcinomas in situ (CIS), of which 11 were cervical. In the female patients, 37 of the anaplasias were cervical and the other four were vulval or vaginal. The 11 cervical CIS amounted to 3.8 times the expected number of 2.9, based on an earlier study of cervical cancer incidence in the community. The risk of cervical CIS developing among patients with condyloma is significantly higher than expected. Neither laryngeal papilloma nor other unfavorable outcomes substantially affected the conceptus of 51 pregnancies in women with concurrent condyloma. There appears to be an association between condyloma and genital malignant neoplasms and a relationship of condyloma with sexually transmitted disease and warts.

Anaplasia↗