Treatment of Genital Warts with a Combination of Cryotherapy and 5% Imiquimod

Abstract

Genital warts (condyloma acuminata) are benign, proliferative tumours which occur in the genital, anal, perineal and/or perianal areas. These warts are caused by Human Papilloma Virus (HPV). They are double-stranded DNA viruses which replicate in squamous epithelial cells. Many types of HPV has been recognised but 6 and 11 HPV types accounts almost 75-90% of genital warts cases. Many medical and ablative treatment modalities are available like topical podophyllin, imiquimod, cryotherapy, but recurrence is still a problem in many patients. Recently, a concept of combination treatment has been practiced and it was found to be better than monotherapy because of the synergistic effect of both the compounds. There are studies on the use of combination of cryotherapy with topical podophyllin and various other combinations but to achieve complete clearance of genital warts with no recurrence is still a challenge for the dermatologists. Thus, a combination treatment was needed to overcome this problem. So, a thought was given to use a combination of two modalities having different mechanism of action for treating genital warts. We hereby report a case of multiple giant genital warts in an immunocompetent female in whom complete clearance of lesions was achieved by a combination of Cryotherapy and 5% Imiquimod cream within six weeks of treatment.

Keywords

• condyloma acuminata
• human papilloma virus
• topical immunomodulators
• topical therapy