Ciccarese Giulia, Parodi Aurora, Drago Francesco
Clinica Dermatologica, Policlinico San Martino, Genova, Italy.
Di.S.Sal, University of Genoa, Genova, Italy.
Dermatol Ther. 2022 May;35(5):e15370. doi: 10.1111/dth.15370. Epub 2022 Feb 19.
Different therapeutic modalities for ano-genital warts (AGWs) are available but data on the efficacy of 5-fluorouracil 0.5%/salicylic acid 10% solution (5FU/SAsol) in the treatment of AGWs are scarse. We enrolled 17 patients with AGWs (14 males, 3 females with a mean age of 34.2 years) who gave written informed consent to the off-label use of topical 5FU/Sasol. Response to treatment was assessed based on the AGWs number: complete if there was complete clearance of the lesions; partial if there was >50% decrease in the lesion number and none if there was <50% decrease in the lesion number. Considering together partial and complete treatment response, 88% of the patients at 3 months and 94% at 6 months benefited from the 5FU/SAsol treatment. 5FU/SAsol was well tolerated by all the patients except one who experienced a burning sensation immediately after the application. The clearance rate that we found for 5-FU/SAsol after 3 months of treatment is comparable with that of the other commonly used therapeutic modalities (liquid nitrogen cryotherapy, imiquimod 5% cream). However, several patients on imiquimod and almost who underwent cryotherapy reported pain as adverse event while a mild pain was rarely reported with 5-FU/Sasol. In conclusion, although nowadays in Italy 5-FU/SAsol is marketed only for the treatment of actinic keratosis, our study described its effectiveness and tolerability also in the treatment of AGWs. Our data suggest that 5-FU/SAsol should be considered not only in case of resistant/recurrent AGWs but also as the first therapeutic option, especially when the number of lesions is small.
治疗肛门生殖器疣(AGW)有多种不同的治疗方式,但关于0.5% 5-氟尿嘧啶/10%水杨酸溶液(5FU/SAsol)治疗AGW疗效的数据却很少。我们招募了17例AGW患者(14例男性,3例女性,平均年龄34.2岁),这些患者书面知情同意超说明书使用外用5FU/Sasol。根据AGW的数量评估治疗反应:如果病变完全清除则为完全反应;如果病变数量减少>50%则为部分反应;如果病变数量减少<50%则为无反应。综合考虑部分反应和完全反应,3个月时88%的患者、6个月时94%的患者从5FU/SAsol治疗中获益。除1例患者在用药后立即出现烧灼感外,所有患者对5FU/SAsol耐受性良好。我们发现5-FU/SAsol治疗3个月后的清除率与其他常用治疗方式(液氮冷冻疗法、5%咪喹莫特乳膏)相当。然而,数例使用咪喹莫特的患者以及几乎所有接受冷冻疗法的患者报告疼痛为不良事件,而5-FU/Sasol很少报告有轻微疼痛。总之,尽管目前在意大利5-FU/SAsol仅被批准用于治疗光化性角化病,但我们的研究描述了其在治疗AGW方面的有效性和耐受性。我们的数据表明,5-FU/SAsol不仅应在AGW耐药/复发的情况下考虑使用,也应作为首选治疗方案,尤其是在病变数量较少时。