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Therapieoptionen bei Condylomata acuminata und analen Dysplasien

Treatment options for condylomata acuminata and anal dysplasia

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  • Published:
coloproctology Aims and scope

Zusammenfassung

Infektionen mit humanen Papillomviren (HPV) sind bei sexuell aktiven Menschen sehr häufig, verlaufen jedoch überwiegend asymptomatisch. Von den bislang mehr als 200 komplett klassifizierten HPV-Typen gehören etwa 40 zum Genus Alpha und führen überwiegend zu Infektionen des Anogenitalbereichs. Condylomata acuminata werden durch Low-risk-HPV-Typen verursacht und zählen zu den häufigsten sexuell übertragenen Erkrankungen. Hochgradige anale Dysplasien sind potenzielle Vorläuferläsionen invasiver Analkarzinome und werden durch High-risk-HPV-Typen ausgelöst. Da es sich um intraepitheliale Läsionen handelt, sollte die Behandlung von Condylomata acuminata und analen Dysplasien immer gewebeschonend und oberflächlich erfolgen. Die Therapiemöglichkeiten für Condylome und anale Dysplasien unterscheiden sich nicht wesentlich und können in ablative und topische Verfahren unterteilt werden. Condylomata acuminata und ein wesentlicher Anteil analer Dysplasien sind durch die prophylaktische HPV-Impfung verhinderbar. Bei bereits erfolgter HPV-Infektion bzw. vorhandenen HPV-induzierten Läsionen kann eine prophylaktische HPV-Impfung nicht empfohlen werden.

Abstract

Human papillomavirus (HPV) infections belong to the most common sexually transmitted infections but most infections are asymptomatic. Approximately 40 of the so far more than 200 completely classified HPV types belong to the genus Alpha and predominantly lead to infections of the anogenital region. Condylomata acuminata are caused by low-risk HPV types and belong to the most common sexually transmitted diseases. High-grade anal dysplasia is a potential precursor lesion of invasive anal carcinoma and is induced by high-risk HPV types. As condylomata acuminata and anal dysplasia are both intraepithelial lesions, treatment which is gentle on the tissue and superficial should always be performed. Treatment options for anogenital warts and anal dysplasia do not substantially differ and can be divided into ablative and topical procedures. Condylomata acuminata and a large proportion of anal dysplasias are preventable by prophylactic HPV vaccination. In the case of an already present HPV infection or HPV-induced lesions, prophylactic HPV vaccination cannot be recommended.

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Authors and Affiliations

  1. Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen, Josefstr. 3, 46045, Oberhausen, Deutschland

    Alexander Kreuter

  2. Klinik für Dermatologie und Allergologie, Klinikum Bayreuth GmbH, Bayreuth, Deutschland

    Gerhard Weyandt

  3. Institut für Virologie, Nationales Referenzzentrum für Papillom- und Polyomaviren, Universitätsklinikum Köln, Köln, Deutschland

    Ulrike Wieland

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  1. Alexander Kreuter
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  2. Gerhard Weyandt
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Correspondence to Alexander Kreuter.

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Interessenkonflikt

G. Weyandt und U. Wieland geben an, dass kein Interessenkonflikt besteht. A. Kreuter hat Referentenhonorare von MSD Sharp & Dohme GmbH erhalten und war im Advisory Board von MSD Sharp & Dohme GmbH tätig.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Für Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts, über die Patienten zu identifizieren sind, liegt von ihnen und/oder ihren gesetzlichen Vertretern eine schriftliche Einwilligung vor.

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Kreuter, A., Weyandt, G. & Wieland, U. Therapieoptionen bei Condylomata acuminata und analen Dysplasien. coloproctology 43, 87–91 (2021). https://doi.org/10.1007/s00053-021-00518-4

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