巨大病毒疣的治療

Submitted by doctorLin on Thu, 05/06/2021 - 14:53

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Intralesional injection with 70% fruit acid in a solitary giant condyloma acuminata

The result and it’s imagination

Abstract:

Giant condyloma acuminata is a seldomly occurred condition,mostly the growth is noted over the genital or peri-genital areas.There are traditionally many kind of options for the treatment,however,while the lesion is located over some tricky treatment areas like intra-nasal cavity,vagina ,exocercix,or glans penis,all means of disposals are very embarrassing.In my clinic,I had dealt with a case presenting an outgrowth of condyloma acuminata like lump measuring around 1.8cm times 1.0cm over right eyebrow,it was florid with mixure of blue,purple,and red.

Case report:A 33 years-old male presented with an columnar outgrowth measuring 1.8cm in height,1.0cm in width over rt eyebrow.The growth owns smooth surface and florid color.It had been diagnosed as condyloma acuminata in teaching hospital for months,but hesitated to do a decision for the treatment.When appeared in our clinic,I decided to do a completely new try using intralesional injection with 70% fruit acid into the lump.

Methods and results:Under local anesthesia with xylocaine ,intralesional injection using 70% fruit acid was executed from three different points 2 mm upward from the base of the neoplasm.The moment after the injection,the upper part over the injected level turned pale sharply.We observed the lesion closely and found the whole lump developed dry gangrene gradually.About 7 days after the injection,the neoplasm was shrinked and detached easily from the bottom ,only remained a fresh reddish surface of the skin with some mild uneven protrusions.Few days later,the protrusions disappeared spontaneously without any visible scarring but still presented reddish fresh surface.Few weeks later,the focus turned to normal color and new growth of the eyebrow hair was noted.

Discussion:Heretofore,the choice of therapeutics for condyloma acuminata mainly included

surgical excision,laser therapy,cryosurgery,or chemical cauterization.Neverthleness,when the lump is located over the tricky areas like intranasal cavity,vagina,or glans penis,it is difficult to clear out the lesion completely without leaving some sequales and to prevent the recurrence.In our case ,the paling and gangrenous change of the part of neoplasm upward the injected line can be understood due to the strong cauterized action of 70% fruit acid that conduced ischemic effect of neoplastic tissue.The gangrenous change of the portion between the injected line and the base of the tumor also can be explained by the direct erosive action of the strong acid.But to our surprise,the thing happened to the surface of the invaded skin and its downside is truly interested to us.

As we know, condyloma acuminata has long been regarded as an important model of viral oncogenicity study. In our case,the spontaneous healing of the invaded skin surface and the subcutaneous tissue without any remained scar causing us tremendous imagination.

In fact,the tissue under the surface of the neoplasm did not attack by the strong acid directly,so,the healing of the downside can only be explained that the viruses under the invaded skin can feel the sustained fatal threatened force of the strong acid,then they chose to withdraw.
If this hypothesis can be established,then we can suppose that there must exsist some connected mechanisms between the viruses.And we might also believe there are division of labor between the viruses.
As certain cancers are provened to be associated with virus infection,the sustained damage and oppression of the 70% fruit acid may cause the withdrawal of the infecting viruses comprehensively.
We baldly suggest that maybe we can try to use the 70% fruit acid as the intralesional perfusing material due to the priority of the sustained cauterized potency that could cause the effect of irresistible pressure to the invasive viruses.Hopefully,leads to the remission of the tumor due to the comprehensive withdrawal of the viruses.

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