RECCURENT GIANT CONDYLOMATA ACUMINATA CAUSED BY HUMAN PAPILLOMA VIRUS IN HIV WITH HOMOSEXUAL MALE
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Perianal giant condylomata acuminate (GCA) is a rare clinical condition associated with low-risk Human papillomavirus (HPV) type 6 and 11 infections. Human Immunodeficiency Virus (HIV) infection is one of the risk factors for GCA, that can increase the condylomata acuminate incidence and spread caused by HPV. A 28-year-old man came with a cauliflower-like mass complaint in his perianal and anal since 2 months ago. The patient did not complain of pain or itching on the mass but often bled when defecating. The patient is a male who has sex with men (MSM) and often changes partners. He has been diagnosed with HIV since 11 months ago and regularly taking anti-retroviral drugs, Efavirenz 600 mg daily. He was also diagnosed having lung tuberculosis at the same time, got 6 months treatment and was declared cured. The venereological examination of the perianal and anal region revealed erythematous and grayish stem-shaped vegetation and papules, verrucous surface, multiple, well defined, with 3 x 1.5 x 2 cm in size. A positive act of white examination was obtained. Blood tests revealed CD+4 230 cells /μL. Polymerase chain reaction (PCR) examination for HPV obtained HPV types 6 and 11 infections. Histopathologic examination revealed acanthosis, papillomatosis, and hyperkeratotic epidermis and koilocytotic cells. The patient was treated with electrodesiccation three times but obtained mass in anal getting bigger with a size of 6 x 3 x 3 cm. Therefore, he agreed to be referred to the surgical department with an extensive surgical excision plan. Screening of GCA using PCR is not a routine examination but PCR has high sensitivity and specificity for determining the type of HPV, is useful for determining GCA prognosis and therapy, and is recommended for malignant and possible GCA recurrence detection
Guttadauro A, Chiarelli M, Macchini D, Frassani S, Maternini M, Bertolini A, Gabrielli F. Circumferential anal giant condyloma acuminatum: a new surgical approach. Diseases of the Colon & Rectum. 2015;58(4): e49-52.
Akhavizadegan H. Electrocautery resection, shaving with a scalpel, and podophyllin: a combination therapy for giant condyloma acuminatum. The world journal of men's health. 2015;33(1):39-41.
De Toma G, Cavallaro G, Bitonti A, Polistena A, Onesti MG, Scuderi N. Surgical management of perianal giant condyloma acuminatum (Buschke-Löwenstein tumor). European Surgical Research. 2006;38(4):418-22.
Murtiastutik D. Kelainan Infeksi Menular Seksual pada Infeksi HIV. Dalam: Barakbah J, Lumintang H, Martodihardjo S, editors. Buku Ajar Infeksi Menular Seksual. Surabaya: Airlangga University Press; 2008. h. 260-268.
Schadendorf D, Tiedemann KH, Haas N, Czarnetzki BM. Detection of human papillomaviruses in paraffin-embedded condylomata acuminata”comparison of immunohistochemistry, in situ hybridization, and polymerase chain reaction. Journal of investigative dermatology. 1991;97(3):549-54.
Chao MW, Gibbs P. Squamous cell carcinoma arising in a giant condyloma acuminatum (Buschke-Lowenstein tumour). Asian Journal of Surgery. 2005;28(3):238-40.
Nebesio CL, Mirowski GW, Chuang TY. Human papillomavirus: clinical significance and malignant potential. International journal of dermatology. 2001;40(6):373-9.
De Toma G, Cavallaro G, Bitonti A, Polistena A, Onesti MG, Scuderi N. Surgical management of perianal giant condyloma acuminatum (Buschke-Löwenstein tumor). European Surgical Research. 2006;38(4):418-22.
Mudrikova T, Jaspers C, Ellerbroek P, Hoepelman A. HPV-related anogenital disease and HIV infection: not always ‘ordinary'condylomata acuminata. Neth J Med. 2008;66(3):98-102.
Chu QD, Vezeridis MP, Libbey NP, Wanebo HJ. Giant condyloma acuminatum (Buschke-Lowenstein tumor) of the anorectal and perianal regions. Diseases of the colon & rectum. 1994;37(9):950-7.
Palefsky JM, Holly EA, Ralston ML, Jay N, Berry JM, Darragh TM. High incidence of anal high"grade squamous intra"epithelial lesions among HIV"positive and HIV"negative homosexual and bisexual men. Aids. 1998;12(5):495-503.
Arany I, Evans T, Tyring SK. Tissue specific HPV expression and downregulation of local immune responses in condylomas from HIV seropositive individuals. Sexually transmitted infections. 1998;74(5):349-53.
Moussa R, Stephenson I, Fisk P, Dhar J, Nicholson KG, Wiselka MJ. Buschke–Loewenstein lesion: another possible manifestation of immune restoration inflammatory syndrome?. Aids. 2004;18(8):1221-3.
Massad LS, Silverberg MJ, Springer G, Minkoff H, Hessol N, Palefsky JM, Strickler HD, Levine AM, Sacks HS, Moxley M, Watts DH. Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus. American Journal of Obstetrics & Gynecology. 2004;190(5):1241-8.
Martin JM, Molina I, Monteagudo C, Marti N, Lopez V, Jorda E. Buschke-Lowenstein tumor. Journal of dermatological case reports. 2008;2(4):60.
Koutsky LA, Kiviat NB. Genital human papillomavirus. In: Holmes KK, Sparling PF, Lemon SM, Stamm WE, Piot P, Wasserheit JN, editors. Sexually Transmitted Disease. 3rd ed. New York: Mc Graw-Hills; 1999. p. 347–59
Cong X, Sun R, Zhang X, Wang Y, Wang L, Yu Y. Correlation of human papillomavirus types with clinical features of patients with condyloma acuminatum in China. International journal of dermatology. 2016;55(7):775-80.
Lilungulu A, Mpondo BC, Mlwati A, Matovelo D, Kihunrwa A, Gumodoka B. Giant Condyloma Acuminatum of Vulva in an HIV-Infected Woman. Case reports in infectious diseases. 2017;2017.
Mistrangelo M, Cornaglia S, Pizzio M, Rimonda R, Gavello G, Dal Conte I, Mussa A. Immunostimulation to reduce recurrence after surgery for anal condyloma acuminata: a prospective randomized controlled trial. Colorectal Disease. 2010;12(8):799-803.
Leszczyszyn J, Lebski I, Lysenko L, Hirnle L, Gerber H. Anal warts (condylomata acuminata)-current issues and treatment modalities. Adv Clin Exp Med. 2014;23(2):307-11.
Darwich L, Cañadas MP, Videla S, Coll J, Piñol M, Cobarsi P, Molina"López RA, Vela S, García"Cuyás F, Llatjos M, Sirera G. Condylomata, cytological abnormalities and human papillomavirus infection in the anal canal in HIV"infected men. HIV medicine. 2012 Oct 1;13(9):549-57.
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