College of Medicine, University of Florida, Gainesville, FL.
Department of Dermatology, University of Florida, Gainesville, FL.
Dermatol Ther. 2019 Mar;32(2):e12803. doi: 10.1111/dth.12803. Epub 2019 Jan 6.
Treatment of recalcitrant warts in solid organ transplant recipients (SOTR) can pose a therapeutic challenge for dermatologists. Successful treatment of recalcitrant warts can serve as secondary prevention for skin cancer in those with chronic immunosuppression. Given the heterogeneity of associated comorbid conditions in SOTR, clinical trials are difficult to conduct in this high-risk population, therefore, our clinical practice is mostly driven by observed responses from studies in immunocompetent patients or from case reports of immunocompromised patients. The combination of systemic retinoids and candida immunotherapy likely provide the most effective treatment for recalcitrant warts in SOTR. However, many SOTR have chronic renal insufficiency and are not candidates for acitretin therapy. We provide two cases of recalcitrant warts in SOTR successfully treated with isotretinoin in the setting of impaired renal function.
治疗实体器官移植受者（SOTR）的顽固性疣可能对皮肤科医生构成治疗挑战。成功治疗顽固性疣可以作为预防那些慢性免疫抑制患者皮肤癌的二级预防措施。鉴于 SOTR 相关合并症的异质性，在这种高危人群中进行临床试验非常困难，因此，我们的临床实践主要基于在免疫功能正常的患者中进行的研究或免疫功能低下患者的病例报告得出的观察结果。全身性维甲酸和念珠菌免疫疗法的联合应用可能为 SOTR 中的顽固性疣提供最有效的治疗方法。然而，许多 SOTR 患有慢性肾功能不全，不适合阿维 A 治疗。我们提供了两例肾功能受损的 SOTR 患者，他们成功地用异维 A 酸治疗了顽固性疣。
