Genital verrunun topikal tedavisinde KOH ile 5-fluorourasil + Salisilik asit etkinliğinin karşılaştırılması
A comparison of efficiency of KOH and 5-Fluorouracil + Salicylic acid in the topical treatment of genital wart
Yazar: SELDA IŞIK
Danışman: DOÇ. DR. RAFET KOCA
Zonguldak Karaelmas Üniversitesi / Tıp Fakültesi / Dermatoloji Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2009
Konu: Dermatoloji = Dermatology

Özet:
Verruka (Verru), derinin HPV ile infeksiyonu sonucu oluşan selim epitelyal tümörüdür. Genital verruka en sık rastlanan cinsel yolla bulaşan hastalıktır. Tedavideki temel sorunlar düşük etkinlik, komplikasyonlar ve rekürrensdir. Bu çalışmada anogenital verrukalı olguların topikal tedavisinde %5 KOH ile 5-Fluorourasil + Salisilik Asit kombinasyonunun etkinliğini karşılaştırdık. Çalışmaya anogenital verruka tanılı altmış hasta dahil edildi. Hastalar topikal %5 KOH solusyonu ya da 5-fluorourasil + Salisilik asit kombinasyonu 12 hafta süreyle uygulanmak üzere rastgele iki gruba bölündü.Hastalar lezyonlar üzerine %5 KOH solüsyonunu günde bir kez, 5-fluorourasil + Salisilik asit kombinasyonunu günde iki kez, maksimum 12 hafta süreyle uyguladılar. Lezyon sayısı ve yan etkiler araştırmanın başında, 1, 2, 4, 6, 8. ve 12. haftaların sonunda aynı araştırmacı tarafından değerlendirildi. Tedavi bitiminden 1 ay sonra; 16. haftada rekürrens açısından yeniden değerlendirme yapıldı. Altmış hastanın tamamı çalışmayı tamamladı. Genital verruka tedavisinde her iki ilaç seçeneği de oldukça etkili bulundu. Tedavi grupları arasında başlangıçtan 12. haftaya kadar, lezyon sayılarında, final değerlendirmede ve yan etkilerde anlamlı bir fark görülmedi (p>0.05).Sonuç olarak %5 KOH solüsyonu genital verruka tedavisinde 5 FU+Salisilik asit kombinasyonuna benzer oranlarda etkili bulundu ve iyi tolere edildi. %5 KOH solüsyonu genital verrukanın topikal tedavisinde alternatif olarak kullanılabilir.

Abstract:
Wart is a benign epithelial tumor of the skin caused by HPV infection. Genital wart is the most common sexually transmitted infection. The primary problems in the treatment are; low efficacy, complications of the treatments and recurrences of lesions. In this study, we compare the efficacy of 5% KOH solution and 5-Fluorouracil + salicylic acid combination in the topical treatment of patients with anogenital wart. Sixty patients with anogenital wart were included in this study. Patients were randomly divided into two groups to receive either by topical 5% KOH solution or 5-Fluorouracil + salicylic acid combination for 12 weeks.Patients applied 5% KOH once daily and 5-Fluorouracil + salicylic acid combination twice daily on the lesions for maximum 12 weeks. Measurement of the lesions and adverse events were taken at baseline and at the end of weeks 1, 2, 4, 6, 8. and 12. by the same investigator. One month after the end of the treatment; at week 16, a new assessment was made for recurrence. In total, 60 patients completed the study. Both treatments were very effective in the treatment of genital wart. There were no significant differences between the treatment groups in lesion counts, in final assessment and in adverse event evaluated from baseline to week 12 (p>0.05).In conclusion, the effectiveness of 5% KOH solution was found similar to 5-FU + Salicylic acid combination and well tolerated in the treatment of genital wart. 5% KOH solution can be used as an alternative for topical treatment of genital wart.ABSTRACTSelda Işık, A comparison of efficiency of KOH and 5-Fluorouracil + salicylic acid in the topical treatment of genital wart. Zonguldak Karaelmas University Faculty of Medicine, Thesis of Dermatology. Zonguldak, 2009.Wart is a benign epithelial tumor of the skin caused by HPV infection. Genital wart is the most common sexually transmitted infection. The primary problems in the treatment are; low efficacy, complications of the treatments and recurrences of lesions. In this study, we compare the efficacy of 5% KOH solution and 5-Fluorouracil + salicylic acid combination in the topical treatment of patients with anogenital wart. Sixty patients with anogenital wart were included in this study. Patients were randomly divided into two groups to receive either by topical 5% KOH solution or 5-Fluorouracil + salicylic acid combination for 12 weeks.Patients applied 5% KOH once daily and 5-Fluorouracil + salicylic acid combination twice daily on the lesions for maximum 12 weeks. Measurement of the lesions and adverse events were taken at baseline and at the end of weeks 1, 2, 4, 6, 8. and 12. by the same investigator. One month after the end of the treatment; at week 16, a new assessment was made for recurrence. In total, 60 patients completed the study. Both treatments were very effective in the treatment of genital wart. There were no significant differences between the treatment groups in lesion counts, in final assessment and in adverse event evaluated from baseline to week 12 (p>0.05).In conclusion, the effectiveness of 5% KOH solution was found similar to 5-FU + Salicylic acid combination and well tolerated in the treatment of genital wart. 5% KOH solution can be used as an alternative for topical treatment of genital wart.Keywords: Genital wart, potassium hydroxide, 5-Fluorouracil, salicylic acid