However, both the perianal and anal lesions recurred after a further 5 months. 1b) and topical treatment with 5% imiquimod cream, 3 times per week for 2 months, resulted in disappearance of these lesions (Fig. Only the perianal condyloma acuminata recurred after 2 months (Fig. The anal lesions were surgically removed, and they were also histologically confirmed as condyloma acuminata. The perianal condyloma acuminata were treated with cryotherapy. The patient was an HIV-positive MSM who had not yet received AIDS therapy because CD4-positive T-cell count was 431/μl. Histological examination of a perianal papule biopsy specimen resulted in a diagnosis of condyloma acuminata. A large number of nodules, 5–35 mm in diameter, were observed by colonoscopy on the mucous membrane of the anal canal, around the dentate line (Fig. At the first consultation, several papules and nodules, 2–5 mm in diameter, were observed around the anus (Fig.
#UMARK 5 VIRUS SKIN#
This report supports the widely held belief that imiquimod can induce a field effect in an area, such that susceptible lesions adjacent to the treated area can also be eradicated.Ī 21-year-old Japanese man noted anal oozing and an increasing number of small papillomatous papules on his perianal skin 2 months before the first consultation. We report here a recurrent case of perianal and anal condyloma acuminata that was treated successfully with topical imiquimod to the perianal area. Imiquimod has therefore been applied via suppositories (anal tampons) to anal canal condylomas (3). However, it is not practical to apply this cream topically to the mucous membranes of the anal canal, particularly inside the dentate line.
Imiquimod, a topical immune-response modifier, is also effective against condyloma acuminata and skin tumours, such as basal cell carcinoma and actinic keratosis (2). Current therapies for condyloma acuminata include surgical excision and ablation by cryotherapy, electrocautery, or lasers. In HIV-positive patients and in men who have sex with men (MSM), the prevalence of anal HPV infection is particularly high (45–95%) (1). Condyloma acuminata are genital or perianal warts caused mainly by human papillomavirus (HPV) types 6 and 11.
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