Hull York Medical School, University of York, York, UK Department of Dermatovenereology, Karolinska Hospital, Stockholm, Sweden Whittall Street Clinic, Birmingham, UK.
J Eur Acad Dermatol Venereol. 2013 Mar;27(3):e263-70. doi: 10.1111/j.1468-3083.2012.04493.x. Epub 2012 Mar 12.
Although new HPV vaccines have been developed and are in the process of implementation, anogenital warts remain a very frequent problem in clinical practice.
We wished to update previously published European guidelines for the management of anogenital warts.
We performed a systematic review of randomized controlled trials for anogenital warts. The primary data were analyzed and collated, and the findings were formulated within the structure of a clinical guideline. The IUSTI Europe Editorial Board reviewed the draft guideline which was also posted on the web for comments which we incorporated into the final version of the guideline.
The data confirm that only surgical therapies have primary clearance rates approaching 100%. Recurrences, including new lesions at previously treated or new sites, occur after all therapies, and rates are often 20-30% or more. All therapies are associated with local skin reactions including itching, burning, erosions and pain.
Physicians treating patients with genital warts should develop their own treatment algorithms which include local practice and recommendations. Such patient level management protocols should incorporate medical review of cases at least every 4 weeks, with switching of treatments if an inadequate response is observed. First episode patients should be offered sexually transmitted disease screening. Management should include partner notification and health promotion.
尽管已经开发出了新的 HPV 疫苗并正在实施过程中，但肛门生殖器疣仍然是临床实践中非常常见的问题。
我们希望更新之前发布的欧洲肛门生殖器疣管理指南。
我们对肛门生殖器疣的随机对照试验进行了系统评价。对主要数据进行了分析和整理，并在临床指南的结构中提出了研究结果。IUSTI Europe 编辑委员会审查了指南草案，该草案也在网上发布以供评论，我们将这些评论纳入了指南的最终版本。
数据证实，只有手术疗法的初步清除率接近 100%。所有治疗后都会出现复发，包括在以前治疗过或新部位的新病变，复发率通常为 20-30%或更高。所有的治疗方法都与局部皮肤反应有关，包括瘙痒、烧灼感、糜烂和疼痛。
治疗生殖器疣患者的医生应制定自己的治疗方案，包括局部治疗和建议。这种针对患者的管理方案应至少每 4 周对病例进行医学审查，如果观察到治疗效果不佳，则应更换治疗方法。初次发作的患者应接受性传播疾病筛查。管理应包括伴侣通知和健康促进。
