Effectiveness of 5-Fluorouracil 5% Cream in Perianal Condylomata Accuminata Treatment: A Case Report

Background: Condylomata accuminata is a sexually transmitted disease, appeared as verrucous or cauliflower-like papules or warts in the anogenital. It is caused by human papillomavirus (HPV), mostly type 6 and 11. The ideal therapy should be simple, inexpensive, effective, does not cause side effects, and can be used by the patient himself. Purpose: To assess the effectiveness of 5-Fluorouracil (5-FU) 5% cream therapy for perianal condylomata accuminata treatment. Case: A 24-year-old male presented with a chief complaint of warts around the anal area that multiplied in the past 3 weeks. The acetowhite test was positive. The patient was diagnosed with condylomata accuminata perianal. The patient received 5-FU 5% cream, applied 3 times a week to the lesions for 5 weeks. After 5 weeks, no new warts were found. Discussion: 5-FU 5% cream is a therapeutic option for perianal wart lesions that easily applied, inexpensive, effective, does not cause side effects, and can be used by the patient himself. It is well known as an antimetabolite with a cytotoxic effect that occurs through a mechanism of disruption in the normal synthesis and function of deoxyribonucleic acid (DNA) and ribonucleic acid (RNA). The treatment with 5-FU 5% cream 3 times a week for 5 weeks provided good results with no side effects were reported. Conclusion: The application of 5-FU 5% cream was a modality of self-application treatment that effective for perianal condylomata accuminata.

Coinfection of High-Risk and Low-Risk Human Papillomavirus in Urethra Condylomata Accuminata

Background: Condylomata accuminata (CA) is a sexually transmitted infection caused by the Human Papillomavirus (HPV), which has more than 40 subtypes classified into high and low risks. The incidence of coinfection involving HPVs in genitalia varies between 2%–71%. Coinfection events increase in immunosuppressed patients. Purpose: To know the types of HPV in CA lesions and the risk factors of a high and low-risk HPV coinfection. Case: A 45-year-old woman presented with genital warts appeared three weeks before. The patient had a breast cancer history and undergone chemotherapy. The examination revealed multiple papules with verrucous surface, firm borders, with whitish color around the urethra and on the vaginal wall. Acetowhite test was positive. The biopsy examination showed squamous epithelium arranged to form papils and foci suspected as koilocytes suggesting CA. The Human Immunodeficiency Virus (HIV) rapid test, VDRL (Venereal Disease Research Laboratory) and TPHA (Treponema Pallidum Haemagglutination) examinations showed non-reactive results. The HPV deoxyribonucleic acid (DNA) genotyping test showed positive results for HPV type 56 (High-Risk Genotypes) and HPV type 6 (Low-Risk Genotypes). She was treated with electrosurgery and consulted to the urology department. Discussion: Coinfection of HPVs might cause a persistent HPV infection for a longer duration, as well as the risk of developing into cancerous lesion. The mechanism of high-risk and low-risk HPV coinfection in immunosuppressed individuals might be due to faster replication of the virus or reactivation of a latent infection. Conclusion: Coinfection of 2 types of HPV could happen in immunosuppression condition such as in patient undergone chemotherapy.