الفهرس 
GENITAL WARTSOnly 14 pages are availabe for public view
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Abstract
G
enital warts (Condylomata acuminata, venereal warts, anal warts and anogenital warts) are highly contagious sexually transmitted disease caused by some sub-types of human papillomavirus (HPV). It is spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner.
Warts are the most easily recognized symptom of genital HPV infection. They can be caused by strains 6, 11, 30, 42, 43, 44, 45, 51, 52 and 54 of HPV, but types 6 and 11 are responsible for 90% of genital warts cases. It is estimated that 1–2% of the sexually active population between the ages of 15 and 49 is afflicted with these HPV-associated verrucae.
The treatment of warts poses a therapeutic challenge for physicians. No single therapy had been proven effective at achieving complete remission in every patient. As a result, many different approaches to wart therapy exist. These approaches include chemotherapy by (salicylic acid, TCA, podophyllin, podophyllotoxin), cryotherapy mostly by liquid nitrogen, electrosurgery (curettage and cautary), laser therapy and photodynamic therapy. All these previous destructive modalities may be painful, ineffective, costly, and may be associated with disfiguring scarring and high recurrence rates.
There are new trends towards the use of immunotherapy in treatment of warts, as the immune system seems to play an important role in the control of warts infection. Although the exact mechanisms are unclear but most evidences suggest that cell mediated immunity plays an important role in control of HPV infection as the incidence of warts increases in subjects with cell mediated immune defects e.g (HIV infection patients, malignant diseases. etc….).
Various methods have been used to stimulate the immunological response as oral levamisole, cimetidine, zinc sulfate, cidovir, intralesional interferons, topical imiquimod, intralesional immunotherapy with mumps, candida and trichophyton antigens, PPD Tuberculin antigen, BCG and Mycobacterium w vaccines.
We aimed in this work to assess safety and effectiveness of intralesional injection of MMR vaccine for the treatment of genital warts. We performed our study on 40 patients with multiple or single genital warts. The patients were divided into 2 groups, the first group included 20 patients injected with MMR vaccine and the second group included 20 patients injected with salin as a control group. Only the mother wart was injected.
As regards the clearance of the target warts, the MMR- treated group showed (30%) success rate while control group showed 0%.
No serious side effects were reported in patients included in this study with MMR treatment. Only reported were mild pain, rash and itching.
We found a statistically significant difference between MMR group and Control group as regards the response. The cure rate was better in younger patients with a shorter duration of the disease, the difference was statistically significant. While we found no statistically significant difference in response regarding the sex and number of lesions.
We found that treatment of genital warts by MMR vaccine is safe and effective, with acceptable cure rates and better safety profile. So intralesional immunotherapy by MMR vaccine is a promising treatment modality for genital warts.