Position statement for the diagnosis and management of anogenital warts.
Journal
Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
25
07
2018
accepted:
08
02
2019
pubmed:
11
4
2019
medline:
3
1
2020
entrez:
11
4
2019
Statut:
ppublish
Résumé
Anogenital warts (AGW) can cause economic burden on healthcare systems and are associated with emotional, psychological and physical issues. To provide guidance to physicians on the diagnosis and management of AGW. Fourteen global experts on AGW developed guidance on the diagnosis and management of AGW in an effort to unify international recommendations. Guidance was developed based on published international and national AGW guidelines and an evaluation of relevant literature published up to August 2016. Authors provided expert opinion based on their clinical experiences. A checklist for a patient's initial consultation is provided to help physicians when diagnosing AGW to get the relevant information from the patient in order to manage and treat the AGW effectively. A number of frequently asked questions are also provided to aid physicians when communicating with patients about AGW. Treatment of AGW should be individualized and selected based on the number, size, morphology, location, and keratinization of warts, and whether they are new or recurrent. Different techniques can be used to treat AGW including ablation, immunotherapy and other topical therapies. Combinations of these techniques are thought to be more effective at reducing AGW recurrence than monotherapy. A simplified algorithm was created suggesting patients with 1-5 warts should be treated with ablation followed by immunotherapy. Patients with >5 warts should use immunotherapy for 2 months followed by ablation and a second 2-month course of immunotherapy. Guidance for daily practice situations and the subsequent action that can be taken, as well as an algorithm for treatment of large warts, were also created. The guidance provided will help physicians with the diagnosis and management of AGW in order to improve the health and quality of life of patients with AGW.
Sections du résumé
BACKGROUND
BACKGROUND
Anogenital warts (AGW) can cause economic burden on healthcare systems and are associated with emotional, psychological and physical issues.
OBJECTIVE
OBJECTIVE
To provide guidance to physicians on the diagnosis and management of AGW.
METHODS
METHODS
Fourteen global experts on AGW developed guidance on the diagnosis and management of AGW in an effort to unify international recommendations. Guidance was developed based on published international and national AGW guidelines and an evaluation of relevant literature published up to August 2016. Authors provided expert opinion based on their clinical experiences.
RESULTS
RESULTS
A checklist for a patient's initial consultation is provided to help physicians when diagnosing AGW to get the relevant information from the patient in order to manage and treat the AGW effectively. A number of frequently asked questions are also provided to aid physicians when communicating with patients about AGW. Treatment of AGW should be individualized and selected based on the number, size, morphology, location, and keratinization of warts, and whether they are new or recurrent. Different techniques can be used to treat AGW including ablation, immunotherapy and other topical therapies. Combinations of these techniques are thought to be more effective at reducing AGW recurrence than monotherapy. A simplified algorithm was created suggesting patients with 1-5 warts should be treated with ablation followed by immunotherapy. Patients with >5 warts should use immunotherapy for 2 months followed by ablation and a second 2-month course of immunotherapy. Guidance for daily practice situations and the subsequent action that can be taken, as well as an algorithm for treatment of large warts, were also created.
CONCLUSION
CONCLUSIONS
The guidance provided will help physicians with the diagnosis and management of AGW in order to improve the health and quality of life of patients with AGW.
Identifiants
pubmed: 30968980
doi: 10.1111/jdv.15570
pmc: PMC6593709
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1006-1019Subventions
Organisme : Meda Pharma S.p.A. a Mylan Company
Informations de copyright
© 2019 The Authors Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
Références
Sex Transm Infect. 2008 Feb;84(1):3-7
pubmed: 18212186
Genitourin Med. 1995 Dec;71(6):391-2
pubmed: 8566980
Genitourin Med. 1990 Feb;66(1):16-9
pubmed: 2179111
Int J STD AIDS. 2001 Sep;12(9):565-70
pubmed: 11516364
J Cutan Med Surg. 2013 Dec;17 Suppl 2:S55-60
pubmed: 24388559
Int J STD AIDS. 2003 Jan;14(1):11-7
pubmed: 12590786
Sex Transm Dis. 2001 Apr;28(4):226-31
pubmed: 11318254
Int J STD AIDS. 2006 Jul;17(7):448-52
pubmed: 16820073
Skin Therapy Lett. 2012 Apr;17(4):5-7
pubmed: 22491804
Genitourin Med. 1988 Aug;64(4):263-5
pubmed: 3169757
Int J STD AIDS. 2004 Jan;15(1):17-20
pubmed: 14769165
Int J STD AIDS. 2001 Dec;12(12):789-92
pubmed: 11779368
Int J STD AIDS. 2017 Dec;28(14):1433-1443
pubmed: 28566057
Obstet Gynecol. 1991 May;77(5):735-9
pubmed: 2014088
Int J STD AIDS. 2001 Jan;12(1):22-8
pubmed: 11177478
N Engl J Med. 2007 May 10;356(19):1928-43
pubmed: 17494926
J Eur Acad Dermatol Venereol. 2009 Sep;23(9):1035-8
pubmed: 19470067
Genitourin Med. 1994 Apr;70(2):105-9
pubmed: 8206467
Dermatol Online J. 2006 Mar 30;12(3):5
pubmed: 16638419
Expert Opin Biol Ther. 2014 Jul;14(7):1033-43
pubmed: 24766274
Arch Dermatol. 1998 Jan;134(1):25-30
pubmed: 9449906
BMJ. 2013 Apr 18;346:f2184
pubmed: 23599299
Lancet. 1985 Nov 23;2(8465):1146-8
pubmed: 2865614
J Dermatol Surg Oncol. 1991 Mar;17(3):273-6
pubmed: 2005249
Int J STD AIDS. 2001 Nov;12(11):722-9
pubmed: 11589811
Otolaryngol Clin North Am. 2012 Jun;45(3):671-94, viii-ix
pubmed: 22588043
Iran J Microbiol. 2012 Dec;4(4):187-90
pubmed: 23205250
J Cutan Med Surg. 2013 Dec;17 Suppl 2:S47-54
pubmed: 24388558
Int J STD AIDS. 1995 Jul-Aug;6(4):257-61
pubmed: 7548288
J Clin Aesthet Dermatol. 2012 Jun;5(6):25-36
pubmed: 22768354
BMJ Clin Evid. 2010 Aug 13;2010:
pubmed: 21418685
Obstet Gynecol. 1989 Sep;74(3 Pt 1):393-7
pubmed: 2761917
Int J STD AIDS. 2016 Jan;27(1):51-7
pubmed: 25681263
Drugs. 2007;67(15):2187-210
pubmed: 17927284
Sex Transm Infect. 2009 Dec;85(7):514-9
pubmed: 19700413
Acta Derm Venereol. 1992;72(3):185-6
pubmed: 1357855
J Am Acad Dermatol. 2000 Jul;43(1 Pt 2):S6-11
pubmed: 10861101
Am J Clin Dermatol. 2005;6(4):239-43
pubmed: 16060711
Int J STD AIDS. 2010 Jul;21(7):457-9
pubmed: 20852193
J Immunol. 1996 Apr 1;156(7):2384-90
pubmed: 8786295
Infect Dis Obstet Gynecol. 2002;10(2):79-88
pubmed: 12530484
BMJ. 2010 Jul 20;341:c3493
pubmed: 20647284
Clin Dermatol. 2016 May-Jun;34(3):368-77
pubmed: 27265075
Lancet Infect Dis. 2011 Jan;11(1):39-44
pubmed: 21067976
Sex Transm Dis. 2011 Mar;38(3):216-8
pubmed: 20938374
Cutis. 2015 Oct;96(4):277-82
pubmed: 26682290
Arch Pediatr Adolesc Med. 2006 Feb;160(2):151-6
pubmed: 16461870
J Reprod Med. 2007 Jun;52(6):521-5
pubmed: 17694970
Int J Colorectal Dis. 2014 Aug;29(8):899-908
pubmed: 24935346
Int J STD AIDS. 2010 Mar;21(3):219-21
pubmed: 20215634
Sex Transm Infect. 2009 Dec;85(7):499-502
pubmed: 19837728
Eur J Dermatol. 2006 Nov-Dec;16(6):642-8
pubmed: 17229604
Skin Therapy Lett. 2015 Jan-Feb;20(1):6-8
pubmed: 25807215
J Eur Acad Dermatol Venereol. 2007 Nov;21(10):1404-12
pubmed: 17958849
G Ital Dermatol Venereol. 2015 Dec;150(6):643-8
pubmed: 26513041
Infect Dis Obstet Gynecol. 2011;2011:806105
pubmed: 21876641
Can Fam Physician. 2013 Jul;59(7):731-6
pubmed: 23851535
N Engl J Med. 2011 Feb 3;364(5):401-11
pubmed: 21288094
Respir Med. 2017 May;126:116-121
pubmed: 28427542
Obstet Gynecol. 2008 Jun;111(6):1371-9
pubmed: 18515521
J Cutan Med Surg. 2013 Dec;17 Suppl 2:S61-7
pubmed: 24388560
Sex Transm Infect. 2010 Aug;86(4):258-62
pubmed: 20660589
Cutis. 2007 Apr;79(4 Suppl):36-45
pubmed: 17508494
J Dermatol. 2004 Aug;31(8):627-31
pubmed: 15492435
Lancet. 1989 Apr 15;1(8642):831-4
pubmed: 2564912
J Am Acad Dermatol. 2002 Oct;47(4 Suppl):S212-6
pubmed: 12271280
Am Fam Physician. 2014 Sep 1;90(5):312-8
pubmed: 25251091
Antimicrob Agents Chemother. 1998 Apr;42(4):789-94
pubmed: 9559784
Dermatol Online J. 2013 Jun 15;19(6):18559
pubmed: 24011309
J Cutan Med Surg. 2013 Dec;17 Suppl 2:S68-75
pubmed: 24388561
J Eur Acad Dermatol Venereol. 2013 Mar;27(3):e263-70
pubmed: 22409368
J Am Acad Dermatol. 1998 Feb;38(2 Pt 1):230-9
pubmed: 9486679
Pharmacoeconomics. 2012 Jan;30(1):1-16
pubmed: 22201520
Int J STD AIDS. 2016 Oct;27(12):1071-1078
pubmed: 26404110
Br J Surg. 1989 Oct;76(10):1067-8
pubmed: 2597953
Br J Dermatol. 2010 Jan;162(1):176-84
pubmed: 19709100
Genitourin Med. 1987 Dec;63(6):390-2
pubmed: 3323028
Sex Transm Dis. 1993 Nov-Dec;20(6):344-5
pubmed: 8108758
Br J Dermatol. 2008 Jun;158(6):1329-38
pubmed: 18363746
Proc Natl Acad Sci U S A. 2017 Dec 19;114(51):13573-13578
pubmed: 29208707
Int J STD AIDS. 1993 Jul-Aug;4(4):194-9
pubmed: 8399497
Sex Reprod Healthc. 2012 Oct;3(3):117-21
pubmed: 22980737
Sex Transm Dis. 1992 May-Jun;19(3):170-4
pubmed: 1523534
Br J Dermatol. 2007 Dec;157 Suppl 2:52-5
pubmed: 18067633
Am J Med. 1990 May;88(5):465-9
pubmed: 2186623
Sex Transm Infect. 2017 May;93(3):155-161
pubmed: 27803240