PDF(Pubmed)
Abstract：
Anogenital warts (AGWs) are globally recognized as the most common sexually transmitted infections (STIs) caused by the human papillomavirus (HPV), particularly types 6 and 11. Meanwhile, immunotherapy is one of the treatments of choice for patients with extensive AGWs. Measles, mumps, and rubella (MMR) vaccine induce the production of various T helper 1 cytokines to elicit immune responses, resulting in the clearance of both treated and untreated warts. This study reported a case of extensive genital and extragenital warts in a 53-year-old male which had occurred for five years, with no pseudo-Koebner phenomenon. The history of MMR vaccination was uncertain but the patient received oral antibiotics for one week, one month before seeking consultation. Physical examination showed extensive verrucous and hyperkeratotic papules, plaques, and nodules in the lower abdomen, pubic, inguinal, genital, and gluteal regions. Acetowhite test results were positive, while polymerase chain reaction (PCR) results were positive for HPV types 6 and 11. The patient received an intralesional injection of 0.5 mL MMR vaccine into the largest warts with a 3-week interval. However, during the one-month follow-up after the third injection, no improvement was observed in either the size or number of warts. Based on the results, several factors must be considered to determine the best candidate for immunotherapy, particularly with MMR vaccine, to achieve an optimal outcome. These factors include the active state of diseases, duration of diseases, as well as a history of sensitization, and broad-spectrum antibiotics.
摘要：
肛门生殖器疣（AGW）是全球公认的由人类乳头瘤病毒（HPV）引起的最常见的性传播感染（STIs），特别是类型6和11。同时,免疫治疗是广泛AGW患者的首选治疗方法之一.麻疹,腮腺炎,和风疹（MMR）疫苗诱导各种T辅助1细胞因子的产生引发免疫反应，导致清除处理和未处理的疣。这项研究报告了一例广泛的生殖器和外生殖器疣在53岁的男性发生了五年，没有伪Koebner现象.MMR疫苗接种史不确定，但患者口服抗生素一周，在寻求咨询前一个月。体格检查显示广泛的疣状和过度角化丘疹，斑块,和小腹结节,耻骨,腹股沟,生殖器,和臀区。乙酰白色试验结果呈阳性，而聚合酶链反应（PCR）结果对6型和11型HPV呈阳性。患者接受了0.5mLMMR疫苗的病灶内注射到最大的疣中，间隔3周。然而,在第三次注射后一个月的随访中，疣的大小和数量均无改善.根据结果,必须考虑几个因素来确定免疫疗法的最佳候选者，特别是MMR疫苗，以达到最佳的结果。这些因素包括疾病的活跃状态，疾病的持续时间，以及敏感化的历史，和广谱抗生素.
