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Ŀ´Ƽ

[ֽ]ο ߻ ܵθ ġ
ۼ : ۼ : 2018.03.20 ȸ : 7454

ο ߻ ܵθ ġ

 

- Ǵ Ȼ꺴 ΰ/ Ȳȿ

 

 

ܵθ ​̷ ̸ ӻ پ ־ ɼ ؾ Ѵ.


• ܵθ ¸ ų ħ(pigmented) ̴ ˻縦 Ͽ Ѵ.
• ܵθ ġ Ͽ ġ ؾ Ѵ.​ 

 

 

縶(external genital warts) ̷(HPV) Ű ȯ̸ ÷ܵθ, (condyloma acuminatum)ε Ҹ. 100 ̻ ̷ HPV 6, 11 ܵθ Ű ˷ ִ. ܵθ 90% ̷ 豺 ̷ Ǿ ִ ˷ ִ.

 

, , ȸο ׹ , ڱðο ߻ϸ ̳ κ, Ȳ̳ ׹ ̳ 񿡵 ִ. ̷ Ǻο ,  ̼ ̳ ı Ű ˷ ִ.

 

Ϲ ִ ߻ 20-24 (25-29) ̿ ߻ϸ ̻ ̷ Ǿ ִ 쵵 ִ. κ 찡 ÷ ܵθ κ ݸö(cauliflower) ݸ · ȴ(׸ 1). 


 ׹ۿ ȭ ̴ پ ·ε ȴ. ȯڴ Ҿ簨, , , ߻ Ŵ 쿡 幰 䵵, , Ա ̳ ⸦ ų ִ. ̷ 2-3 Ŀ Ÿ 찡 . ۰ų ġⰣ ª 1/3 4 Ŀ ڿ ȣȴٰ ˷ ִ. ߻ Ŀ ӻ ȣǰų ȯ ӵǰų ִ(׸ 2). 


 ġῡ ұϰ ȣ ʴ , ̴ , 鿪 ȯ 쿡 ˻簡 ʿ ִ. ̷ ˻縦 ν õ ʰ ִ ̴. ˻縦 Ѵ Ͽ ӻ ٸ ġ ʴ´ٰ ˷ ֱ ̴. ܵθ Ǻ ǥ 1 ϴ ʿϰ ̳ (melanoma) ȯ ؾ ϱ ¸ ų ħ(pigmented) ̴ ˻縦 Ͽ Ѵ. 


  ܵθ ġ ̴ Ͽ ȣ θ ϴ ̸ ̿ 鵵 ؾ ̴. ̷ ñ ġϴ ̹Ƿ ̿ ʿ δ. ġɼ ġ ġ ٸ Ÿ κ Ѵ. ġḦ ұϰ ġϷ 3 ̳ ϰų ߻ Ȯ 25-67% DZ⵵ ߴ.

 

ġ ũ ַ ִ(ǥ 2). 


 

1) ļ
 ʸ(podophyllin resin 10-25%, podofilox/podophyllotoxin 0.5% solution)

 

2) /İ
 õ, bi-or trichloroacetic acid(BCA or TCA), ۼ, CO2 ,

 

3) 鿪
Imiquimod(aldara cream), sinecatechins

 Imiquimod, sinecatechins ȯ ڽ õ, podophyillin, TCA/BCA, , ۼ, Ƿο ؼ ̷ ִ. ġ ǥ 3 Ȯ ִ. 


 

(1) TCA& BCA
 꼺 ȭ ȭ Ŵν ջŲ. 1 ϸ ġⰣ 6-10ְ ҿȴ. 70-80% ġ ̸ 36% Ͽٰ ǰ ִ.  ӽ ߿ ϰ ִ. ۿδ , ȭ, ֺ Ǻ ջ ߻ ִ.

 

(2) õ(׸ 3)
ƻȭҳ ȭҷ ðѼ ϴ Ǻ ջ 鿪 ü踦 ȰȭŴν, Ű ı ϵ Ѵ. 1-2 ϸ 79-80% ġ ̸ 25-40% Ͽٰ ǰ ִ. ۿδ , , ߻ ִ. ַ ǥ鿡 ߻ ټ ȿ̴.

(3) ۼ
  Ͽ ¿ ı ܾ ̴. ϴ ü̱ Ȥ Ÿ븦 ϸ Ͱ ߻ Ŭ 쿡 õ ʴ´. ġ 94% ٴٸ Ǿ.

 

(4)
  Ž ̿ ϴ ſ Ŭ ִ. Ǽ ǽɵǾ ˻簡 õȴ. ġ 72% ǰ ִ.

 

(5) CO2 ġ
 ġ 23-52% ߷ ִ 77% ǰ ִ. δ ħϴ ȿ ־ ϰ ̷ ִٴ ̷ Ͽ 鿪 ϵ ȯڿԼ ġ ȴ.

 

(6) Imiguimod
ī ڸ(apoptosis) ϴ 鿪 5% ȴ. ħ Ϸ翡 1ȸ ϸ 3ȸ ִ 16ֱ ִ. 6-10ð Ŀ 񴩷 ۾Ƴ ϸ , ι, ȭۿ, ˾ȭ, ħ ۿ Ǿ. 12 뷫 70% ġ . 2010⵵ 3.75% FDA ؼ εǾ Ͽ ġⰣ 6-8ַ ۿ Ǿ. ӻο ȮǾ ʴ.

 

(7) ʸ(podofilox)
ļ ̸ ʷ Ĺ ⹰̸ 0.5% Ǿִ. Ϸ翡 2ȸ 3 ؾ ϸ 4ϰ ġḦ ߴ ٽ 3 ϸ ִ 4-cycle ִ. 10cm2 ʰϸ ȵǸ ӻο ȮǾ ʴ.

 

(8) Sinecatechin
п Ͽ ׻ȭ, ׹̷, ˷ ۿ ؼ ν ٰ . ġ 58%, ߷ 6-9% Ǿ imiquimod ۿ . ӻ, HIV ȯڱ ȿ ؼ ȮǾ ʴ.

ġ ȭŰ ñ ϴ ̸ ġδ ̷ ҽų ñ Ѹ Ѵ.

 


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1. Yanofsky VR, Patel RV, Goldenberg C. Genital warts: a comprehensive review. J Clin Aesthet Dermatol 2012;5:25-36.

 2. Centers for Disease Control and Prevention. Human papillomavirus: HPV information for clinicians. November 2006. Available at: http://www.cdc.gov/std/HPV/hpv-clinicians-brochure.htm (accessed May 1, 2013)

 3. Marra F, Ogilvie G, Colley L, et al. Epidemiology and costs associated with genital warts in Canada. Sex Transm Infect 2009;85:111-5, doi: 10.1136/sti.2008.030999.

 4. Kliewer EV, Demers AA, Elliot L, et al. Twenty-year trends in the incidence and prevalence of diagnosed anogenital warts in Canada. Sex Transm Dis 2009;36:380-386, doi:10.1097/OLQ.0b013e318198de8c.

 5. Gunter J. Genital and perianal warts: new treatment opportunities for human papillomavirus infection. Am J Obstet Gynecol 2003;189(3 Suppl):S3-ll.

 6. Charles L, Ronald V, Marc Bourcier, et al. Clinical Features Of External Genital warts. Journal of Cutaneous Medicine and Surgery Vol7, No S2,2013:pp S55-60.

 7. Beutner KR, Reitano MV, Wiley DJ, et al. External genital warts: report of the American Medical Association Consensus Conference. Clin Infect Dis 1998;27:796-806, doi:10.1086/514964.

 8. Scheinfeld N, Lehman DS. An evidence-based review of medical and surgical treatments of genital warts. Dermatol Online J 2006;12:5.

 9. Yanofsky VR, Patel RV, Goldenberg G. Genital warts: a comprehensive review. J Clin Aesthet Dermatol 2012;5:25-36.

 10. Stone KM, Becker TM, Hadgu A, et al. Treatment of external genital warts: a randomised clinical trial comparing podophyllin, cryotherapy, and electrodesiccation. Genitourin Med 1990;66:16-19.

 11. Duus BR, Phüipsen T, Christensen JD, et al. Refractory condylomata acuminata: a controlled clinical trial of carbon dioxide laser versus conventional surgical treatment. Genitourin Med 1985;61:59-61.

 12. Canada Newswire. Health Canada approves (Pr)Vyloma(TM) (imiquimod) cream 3.75% for the treatment of external genital warts. Available at: http://www.newswire.ca/en/story/730171/healthcanada-approves-pr-vyloma-tm-imiquimod-cream-3-75-for-thetreatment-of-external-genital-warts (accessed December 5, 2012).

 13. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR Morb Mortal Wkly Rep 2010;59 (No. RR-12):69-74.


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