Position statement for the diagnosis and management of anogenital warts
Position statement for the diagnosis and management of anogenital warts
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DOI：
10.1111/jdv.15570
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发表时间：
2019-06-01
影响因子：
9.2
通讯作者：
Cusini, M.
中科院分区：
文献类型：
--
作者：
O'Mahony, C.;Gomberg, M.;Cusini, M.
背景肛门生殖器疣（AGW）可对医疗保健系统造成经济负担，并与情绪，心理和身体问题有关。目的为临床医师诊断和治疗急性胃排空障碍提供指导。方法14位全球AGW专家制定了AGW诊断和管理指南，以统一国际建议。指南是根据已发表的国际和国家AGW指南以及对截至2016年8月发表的相关文献的评价制定的。作者根据其临床经验提供了专家意见。结果提供了一份患者初诊检查表，以帮助医生在诊断AGW时从患者那里获得相关信息，从而有效地管理和治疗AGW。还提供了一些常见问题，以帮助医生在与患者沟通AGW时。AGW的治疗应个体化，并根据疣的数量，大小，形态，位置和角化，以及它们是新的还是复发的选择。不同的技术可用于治疗AGW，包括消融、免疫疗法和其他局部疗法。这些技术的组合被认为在减少AGW复发方面比单一疗法更有效。创建了一个简化的算法，建议患有1-5个疣的患者应先进行消融治疗，然后进行免疫治疗。>5个疣的患者应使用免疫治疗2个月，然后进行消融和第二个2个月的免疫治疗。还创建了日常实践情况指南和可以采取的后续行动，以及治疗大疣的算法。结论该指南有助于临床医师对AGW的诊断和治疗，以提高AGW患者的健康水平和生活质量。
Background Anogenital warts (AGW) can cause economic burden on healthcare systems and are associated with emotional, psychological and physical issues. Objective To provide guidance to physicians on the diagnosis and management of AGW. Methods Fourteen global experts on AGW developed guidance on the diagnosis and management of AGW in an effort to unify international recommendations. Guidance was developed based on published international and national AGW guidelines and an evaluation of relevant literature published up to August 2016. Authors provided expert opinion based on their clinical experiences. Results A checklist for a patient's initial consultation is provided to help physicians when diagnosing AGW to get the relevant information from the patient in order to manage and treat the AGW effectively. A number of frequently asked questions are also provided to aid physicians when communicating with patients about AGW. Treatment of AGW should be individualized and selected based on the number, size, morphology, location, and keratinization of warts, and whether they are new or recurrent. Different techniques can be used to treat AGW including ablation, immunotherapy and other topical therapies. Combinations of these techniques are thought to be more effective at reducing AGW recurrence than monotherapy. A simplified algorithm was created suggesting patients with 1-5 warts should be treated with ablation followed by immunotherapy. Patients with >5 warts should use immunotherapy for 2 months followed by ablation and a second 2-month course of immunotherapy. Guidance for daily practice situations and the subsequent action that can be taken, as well as an algorithm for treatment of large warts, were also created. Conclusion The guidance provided will help physicians with the diagnosis and management of AGW in order to improve the health and quality of life of patients with AGW.