Department of Dermatology, Venereology, and Aesthetics, Dr Mohammad Hoesin General Hospital, Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia.
Int J STD AIDS. 2024 Nov;35(13):1079-1083. doi: 10.1177/09564624241276574. Epub 2024 Aug 28.
Giant condylomata acuminata (GCA) is a rare presentation of anogenital wart (AGW), invasive locally but does not metastasize. Combination therapy for GCA is suggested based on modalities and experiences. The combination of TCA and podophyllin has showed good efficacy, followed by electrocautery to eradicate warts. A 24-year-old male had a chief complaint of large warts on the base of the penis that had started to bleed for 4 weeks. The initial lesion appeared 8 months prior as a small varucose papule. The patient is unmarried and has history of sexual contact with sex workers. Physical examination showed multiple verrucous papules, flesh-coloured, cauliflower-like shaped, 5 × 2 × 1 cm in size. The patient tested negative for HIV infection. Histopathological examination showed acanthosis, exophytic growth, parakeratosis, and koilocytosis with no signs of malignancy. This patient received a combination of TCA 90% and podophyllin 25% to initially reduce the tumor size, followed by electrocautery to eradicate the remaining lesions. The tumor showed complete clearance. There is no definitive evidence that one therapy is superior to completely eliminating warts. Combination therapy of TCA and podophyllin leads to complete wart clearance, followed by electrocautery to destroy smaller warts.
巨大尖锐湿疣（GCA）是一种罕见的肛门生殖器疣（AGW）表现形式，局部侵袭但不会转移。基于现有方法和经验，建议对 GCA 进行联合治疗。三氯乙酸（TCA）和鬼臼毒素联合治疗显示出良好的疗效，随后用电灼术根除疣。一名 24 岁男性因阴茎基部的大疣而就诊，该疣已开始出血 4 周。最初的病变出现在 8 个月前，表现为一个小的静脉曲张性丘疹。患者未婚，有与性工作者接触的病史。体格检查显示多个疣状丘疹，呈肉色，呈菜花状，大小为 5×2×1cm。患者 HIV 感染检测结果为阴性。组织病理学检查显示棘层肥厚、外生性生长、角化不良和空泡化，无恶性征象。该患者先接受三氯乙酸 90%和鬼臼毒素 25%联合治疗以初步缩小肿瘤大小，然后用电灼术根除残留的病变。肿瘤完全消退。目前没有明确的证据表明一种疗法优于完全消除疣。三氯乙酸和鬼臼毒素联合治疗可彻底清除疣，随后用电灼术破坏较小的疣。
