National Skin Centre, Singapore, Singapore.
Dermatol Ther. 2014 Mar-Apr;27(2):79-82. doi: 10.1111/dth.12059. Epub 2013 May 21.
Genital warts in immunocompromised patients can be extensive and recalcitrant to treatment. We report a case of recalcitrant genital warts in a female patient with systemic lupus erythematosus (SLE), who achieved complete remission with a combination approach of surgical debulking and oral isotretinoin at an initial dose of 20 mg/day with a gradual taper of dose over 8 months. She had previously been treated with a combination of topical imiquimod cream and regular fortnightly liquid nitrogen. Although there was partial response, there was no complete clearance. Her condition worsened after topical imiquimod cream was stopped because of her pregnancy. She underwent a combination approach of surgical debulking and oral isotretinoin after her delivery and achieved full clearance for more than 2 years duration. Oral isotretinoin, especially in the treatment of recalcitrant genital warts, is a valuable and feasible option when other more conventional treatment methods have failed or are not possible. It can be used alone or in combination with other local or physical treatment methods.
免疫功能低下患者的生殖器疣可能广泛且对治疗有抗性。我们报告了一例系统性红斑狼疮（SLE）女性患者的难治性生殖器疣病例，该患者通过手术切除和口服异维 A 酸（初始剂量为 20mg/天）联合治疗，在 8 个月内逐渐减少剂量，达到完全缓解。她之前曾接受过咪喹莫特乳膏联合定期每两周一次液氮治疗。尽管有部分缓解，但并未完全清除。由于怀孕停用咪喹莫特乳膏后，她的病情恶化。分娩后，她接受了手术切除和口服异维 A 酸联合治疗，2 年多来疣体完全清除。当其他更传统的治疗方法失败或不可行时，口服异维 A 酸，特别是在治疗难治性生殖器疣方面，是一种有价值且可行的选择。它可以单独使用或与其他局部或物理治疗方法联合使用。
