Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, the Netherlands.
Department of Public Health and Primary Care, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
Br J Dermatol. 2018 Jan;178(1):253-260. doi: 10.1111/bjd.15758. Epub 2017 Dec 14.
Cutaneous warts have a cure rate after therapy of no more than approximately 50%. Recently, we developed and validated a standard assessment tool for warts (Cutaneous WARTS diagnostic tool, CWARTS) based on phenotypical characteristics.
To assess whether patient and morphological wart characteristics predict the human papillomavirus (HPV) type in a specific wart and whether these characteristics as well as the HPV type predict a favourable treatment response.
Photographs were used to score nine morphological wart characteristics using the newly developed CWARTS tool. Genotyping of 23 wart-associated HPV types was performed using the hyperkeratotic skin lesion-polymerase chain reaction/multiplex genotyping assay. The results were correlated with a favourable response to treatment with monochloroacetic acid, cryotherapy or a combination of cryotherapy and salicylic acid. Odds ratios were calculated using logistic regression in a generalized estimating equations model.
Black dots (capillary thrombosis) strongly predicted the presence of any HPV type in a wart. From all characteristics tested, the HPV type most strongly predicted the treatment response when the warts were treated with monochloroacetic acid or a combination of cryotherapy and salicylic acid with a significantly decreased treatment response if the warts contained HPVs of the alpha genus (HPV2, HPV27 or HPV57). When cryotherapy alone was used for common warts, HPV type did not play a role, but cryotherapy was less effective in the presence of callus and when the wart was located deeper in the skin.
Morphological characteristics of the warts and the HPV genotype influence treatment outcome and thus potentially influence future treatment decisions for common and plantar warts.
经治疗后，皮肤疣的治愈率不超过约 50%。最近，我们基于表型特征开发并验证了一种用于疣的标准评估工具（皮肤疣诊断工具，CWARTS）。
评估患者和疣的形态特征是否能预测特定疣中的人乳头瘤病毒（HPV）类型，以及这些特征和 HPV 类型是否能预测治疗效果。
使用新开发的 CWARTS 工具对 9 种形态疣特征进行拍照评分。使用角化过度皮肤病变-聚合酶链反应/多重基因分型检测法对 23 种与疣相关的 HPV 型进行基因分型。将结果与使用单氯乙酸、冷冻疗法或冷冻疗法联合水杨酸治疗的良好反应相关联。使用广义估计方程模型中的逻辑回归计算比值比。
黑点（毛细血管血栓）强烈预测了疣中存在任何 HPV 型。在所有测试的特征中，当用单氯乙酸或冷冻疗法联合水杨酸治疗时，HPV 型对治疗反应的预测最强，如果疣中含有 alpha 属的 HPV（HPV2、HPV27 或 HPV57），则治疗反应明显降低。当单独使用冷冻疗法治疗常见疣时，HPV 型没有发挥作用，但冷冻疗法在存在胼胝体和疣位于皮肤深处时效果较差。
疣的形态特征和 HPV 基因型影响治疗结果，从而可能影响常见和足底疣的未来治疗决策。
