DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20190984

A prospective clinical study on homologous autoinoculation in anogenital wart

Saravanan Narayanan, Kamalanathan Nallu, Sridhar Venu, Muthusubramanian Chandrasekar

Abstract


Background: Ano-genital wart, an infection of the anal and genital mucosa with their adjoining area is caused by human papilloma virus. Genital warts pose a bigger challenge, because of the lack of cell mediated immunity and its propensity to relapse and the reluctance of patients to consult a physician. The main aim of our study is to determine whether autoinoculation is effective in treatment of ano-genital warts.

Methods: 25 cases of anogenital warts of either sex, who attended RTI/STI clinic in Chengalpattu Medical College from September 2017 to September 2018. The study design was prospective. A detailed history taking, thorough clinical examination and appropriate relevant investigations were done for all the patients who fulfilled the inclusion and exclusion criteria. Autoinoculation was done for those patients. They were assessed periodically for clinical outcome.

Results: A sample size of 25 patients (20 men and 5 women) was included in the study. After 3 months of therapy 8 (32%) patients recovered completely and more than 75% improvement occurred in another 7 (28%) patients. At 6 months 15 (60%) patients showed complete resolution. No significant complication was documented.

Conclusions: Autoinoculation is a single time minimal invasive procedure effective in management of anogenital wart. It also reduces the recurrence of lesions.


Keywords


Viral wart, Genital wart, Autoinoculation, Immunotherapy

Full Text:

PDF

References


Plasencia JM. Cutaneous warts: Diagnosis and treatment. Prim Care. 2000;27:423-34.

Sterling JC, Handfield-Jones S, Hudson PM. Guidelines for the management of cutaneous warts. Br J Dermatol. 2001;144:4-11.

Kuykendall-Ivy TD, Johnson SM. Evidence-based review of management of nongenital cutaneous warts. Cutis. 2003;71:213-22.

Gibbs S, Harvey I, Sterling J, Stark R. Local treatments for cutaneous warts: Systematic review. BMJ. 2002;325:461.

Shivakumar V, Okade R, Rajkumar V. Autoimplantation therapy for multiple warts. Indian J Dermatol Venereol Leprol. 2009;7:593-5.

Nischal KC, Sowmya CS, Swaroop MR, Agrawal DP, Basavaraj HB, Sathyanarayana BD. A novel modification of the autoimplantation therapy for the treatment of multiple, recurrent and palmoplantar warts. J Cutan Aesthet Surg. 2012;5:28-9

Lal NR, Sil A, Gayen T, Bandyopadhyay D, Das NK. Safety and effectiveness of autoinoculation therapy in cutaneous warts: a double--blind, randomized, placebo—controlled study. Indian J Dermatol Venereol Leprol. 2014;80:515-20.

Das S, Das S, Chowdhury J, Patra S, Ghoshal L, Banerjee S. Auto-wart inoculation: An easy and effective treatment in multiple, recalcitrant and genital warts. J Pakistan Association Dermatol. 2016;26(3):229-234.

Sheppard S, White M, Walzman M. Genital warts: Just a nuisance? Genitourin Med. 1995;71:194-5.

Forcier M, Musacchio N. An overview of Human Papilloma Virus infection for a dermatologists: disease, diagnosis, management and prevention. Dermatol Ther. 2010;23:458-76.

Usman N, Udayashankar K, Subramanian S, Thyagarajan SP. Autoimplantation technique in the treatment of anogenital warts: A clinic-immunological study. Int J STD AIDS. 1996;7:55–7.

Drake LA, Ceilley RI, Cornelison RL, Dobes WL, Dorner W, Goltz RW, et al. Guidelines of care for warts: Human Papilloma Viruses. J Am Acad Dermatol. 1995;32:98-103.

Morrison W. In Vitro assay of cell-mediated immunity to human wart antigen. Br J Dermatol. 1974;90:531-4.

Viac J, Thivolet J, Chardonnet Y. Specific Immunity in patients of recurring warts. Br J Dermatol. 1977;97:365-70.

Oriel, JD. Pathogenesis. In: von Krogh G, Rylander E, eds. GPVI. Genitoanal papilloma virus infection. A survey for the clinician. Karlstad, Sweden: Conpharm/Kabi; 1989: 7–17.