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Abstract
A wide range of approaches is available to treat external genital warts (EGWs), including cytotoxic agents, ablative procedures and immunotherapy. Some of these treatments are applied by the health care provider and others are prescribed for home use. The choice of therapy depends on the extent and anatomical distribution of lesional tissue and on agreement between the patient and the health care provider. Regardless of the therapies used, latent HPV in the adjacent epithelium may fail to be eradicated. As a result, there may be recurrences, necessitating multiple therapeutic attempts. Fortunately, in the majority of patients, treatments are successful on a long-term basis or at least provide sustained disease-free periods. New developments in the field include the patient-applied cytotoxic solution and immunomodulator cream formulations. Either of these may be used as first-line or second-line therapy for EGWs. These agents are likely to improve treatment results as they encourage compliance and improve application to the site of disease. While the emerging therapies are improvements in our fight against EGWs, the ultimate goal is the development of effective, polyvalent, prophylactic HPV vaccines.
Résumé
Un large éventail d’approches existe pour le traitement des verrues génitales externes (VGE), comme, par exemple, les agents cytotoxiques, l’ablation et l’immunothérapie. Certains de ces traitements sont pratiqués par les prestateurs de soins alors que d’autres sont prescrits pour un usage personnel. Le choix de la thérapie appropriée est dicté par l’étendue et la distribution anatomique des tissus atteints et par une entente entre la patiente et le prestateur de soins. Quelle que soit la thérapie utilisée, il se peut qu’un VPH latent dans l’épithélium avoisinant ne soit pas éliminé. Pour cette raison, des récurrences se produisent, nécessitant parfois plusieurs tentatives thérapeutiques. Heureusement, chez la majorité des patientes, les traitements réussissent à long terme ou, du moins, ils permettent des périodes de temps exemptes de maladies. Parmi les nouvelles percées dans ce domaine, on compte une solution cytotoxique et des préparations de crèmes immunostimulatrices appliquées par la patiente elle-même. Ces deux médicaments peuvent s’utiliser pour une thérapie de choix ou secondaire contre les VGE. Ils amélioreront probablement les résultats du traitement dans la mesure où ils facilitent l’observance et améliorent l’application au site de la maladie. L’apparition de ces thérapies représente des progrès certains dans notre lutte contre les VGE. Cependant, notre objectif ultime est la création de vaccins contre le VPH qui soient efficaces, polyvalents et prophylactiques.
Key Words
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Article info
Publication history
Received in revised form:
June 16,
1999
Received in revised form:
June 16,
1999
Received:
March 22,
1999
Identification
Copyright
© 1999 Published by Elsevier Inc.
