Filip Rob

Successful Treatment with 10% Sinecatechins Ointment for Recurrent Anogenital Warts in an Eleven-Year-Old Child.

Treatment of anogenital warts was successful in an 11-year-old child with sinecatechins ointment 10%. After application for 10 weeks, the warts completely disappeared, without recurrence during a 12-week follow-up. Treatment was well tolerated, without notable side effects. Sinecatechins appear to be a reasonable treatment for anogenital warts in children who have difficulty tolerating painful destructive therapy.

Steady increase of lymphogranuloma venereum cases, Czech Republic, 2010 to 2015.

Since the notification of the first case of lymphogranuloma venereum (LGV) in the Czech Republic in 2010, the numbers of LGV cases have steadily increased in the country. In 2015, 40 LGV cases were diagnosed, bringing the total for 2010-2015, to 88 cases. The profile of the most affected group, HIV-positive men who have sex with men with a previous sexually transmitted infection, matches that of those described in LGV outbreaks in western Europe.

Significantly higher incidence of skin cancer than other malignancies in patients after heart transplantation. A retrospective cohort study in the Czech Republic

AIMS To perform the first study in Czech Republic on heart transplant recipients (HTRs), compare the risks for different types of cancer and provide comprehensive analysis of skin cancer and other types of cancer morbidity from which we would be able to derive an evidence-based skin cancer surveillance program. MATERIALS AND METHODS A retrospective cohort study was performed to determine and compare standardized morbidity ratio (SMR) of different types of cancer developed after heart transplantation. We analysed data obtained from medical documentation of 603 HTRs transplanted between 1993 and 2010. RESULTS 191 incident cases of malignancy occurred in123 HTRs (20.4%). According to expectations, nonmelanoma skin cancer was the most frequent type of malignancy (119 cases) with SMR 7.6 (P < 0.001), followed by lung cancer with SMR 2.7 (P < 0.001). SMR for melanoma was 2.5, P = 0.129. Other types of cancer in HTRs (prostate and kidney cancer) were less frequent (SMR 2.06, P = 0.038 and SMR 2.03, P = 0.122). CONCLUSION The risk of malignancy development is significantly higher for HTRs compared to the general population. Squamous cell carcinoma of the skin is the most frequent type of cancer followed by basal cell carcinoma. These findings emphasise the importance of regular skin cancer screening in HTRs.

First case of pachyonychia congenita in the Czech Republic

Pachyonychia congenita (PC) is a rare autosomal dominant skin disorder characterized predominantly by hypertrophic nail dystrophy, oral leukokeratosis, and painful palmoplantar keratoderma. It is associated with a mutation in one of five keratin genes, KRT6A, KRT6B, KRT6C, KRT16, or KRT17. The International PC Research Registry (IPCRR) confirms that as of January 2014 there have been 547 cases of PC genetically confirmed. It is estimated that there are between 2000 and 10,000 cases of PC in the world. However, the exact prevalence of PC is not yet established. We report a case of PC‐K6a, p.Arg164Pro, in a 40‐year‐old man. Initially he was diagnosed with onychomycosis and was treated with systemic antifungals. This is the first genetically confirmed case of PC in the Czech Republic.

Benzathine penicillin G once-every-3-week prophylaxis for recurrent erysipelas a retrospective study of 132 patients

Abstract Objective: To evaluate effectivity, safety and patients’ adherence to benzathine penicillin G (BPG) 1,200,000 units (1.2 MU) once-every-3-week intramuscularly prophylaxis for recurrent erysipelas. Methods: Patients with documented two or more erysipelas episodes in last two years who received at least one of 10 planned doses of BPG 1.2 MU intramuscularly between January 2009 and December 2015 were analyzed in this retrospective study. Number of recurrences during the 30-week prophylaxis and in the 30-week follow-up period, frequency of adverse events, patients’ adherence to the treatment and factors associated with the recurrence were analyzed. Results: From 132 patients, 109 (82.6%) finished the 30-week prophylactic regimen successfully. The incidence of erysipelas was 8 per 100 patient-years during the prophylactic period and 28 per 100 patient-years in the follow-up period (incidence rate ratio = 0.20; 95% CI: 0.05–0.34; p < .01). In univariate analysis recurrence was significantly associated only with presence of any local risk factor concurrently with obesity (OR 3.40; 95% CI: 1.10–10.50; p < .05). Conclusion: Benzathine penicillin G 1.2 MU once every 3 weeks is an effective and well-tolerated prophylaxis of recurrent erysipelas with good patient adherence to the treatment. Further studies to determine the appropriate duration of prophylaxis are necessary.

First reported case of chancroid in the Czech Republic

We describe the first case of chancroid seen in the Czech Republic, diagnosed in a 40-year-old heterosexual HIV-positive man. Despite genital localization of the ulcer, the transmission of Haemophilus ducreyi infection in our patient remains unclear, as he denied having sexual intercourse and he did not travel outside the Czech Republic for several months before the ulcer appeared. The correct diagnosis has been revealed by a multiplex nucleic acid amplification test. Physicians in countries in the eastern and central Europe region should be aware that chancroid can occur in their patients.

The first case of lymphogranuloma venereum in a woman in East-Central Europe and its multiple co-infections

We are reporting the first case of lymphogranuloma venereum in women in East-Central Europe. A 22-year-old heterosexual woman attended our department of venereology. She complained about a burning sensation in the urethra and vaginal discharge. Many tests were performed, and lymphogranuloma venereum, syphilis, gonorrhea, chlamydial urethritis and cervicitis, genital herpes, genital warts, and hepatitis C were diagnosed. Lymphogranuloma venereum was originally endemic in tropical and subtropical areas, but since 2003, outbreaks of this infection have been reported in North America, Europe, and Australia in men who have sex with men (MSM) community. To date, all cases of lymphogranuloma venereum in the Czech Republic appeared in men, predominantly in HIV-positive MSM. There are not many evidences about lymphogranuloma venereum (LGV) in women in developed countries. This report underlines the need for awareness of lymphogranuloma venereum in women among gynecologists, venereologists, and other physicians not only in Western Europe, but across all European countries.

Lymphogranuloma venereum with only proximal rectal involvement mimicking inflammatory bowel disease: a potential diagnostic pitfall.

Lymphogranuloma venereum (LGV) is a sexually transmitted infection (STI) caused by the invasive serovars L1, L2 and L3 of Chlamydia trachomatis (C. trachomatis). [1] The incidence of LGV is rising in many Western countries. [2] The most common symptoms of LGV are proctitis and inguinal lymphadenopathy. LGV mimicking inflammatory bowel disease (IBD) is not a rare condition and has already been described in several reports. [3,4] LGV can affect even more proximal parts of the bowel. [5] Diagnosis of LGV is usually done by positive NAAT for C. trachomatis with subsequent specifying of LGV serovars. [1] This article is protected by copyright. All rights reserved.

Concordance of HPV‐DNA in cervical dysplasia or genital warts in women and their monogamous long‐term male partners

Transmission of human papillomavirus (HPV) is a premise for development of cervical dysplasia and genital warts (GWs). This cross‐sectional study assesses concordance of HPV types present in GWs or cervical dysplasia in women and genital infection of their monogamous male partners in conjunction with seroprevalence of HPV‐6, ‐11, ‐16, and ‐18 antibodies. Blood was taken from both women and men, as well a smear of the urogenital area of men. HPV DNA detection in women was done in fixed paraffin embedded tissues under histological control. Of 143 couples who agreed to participate in the study, 68 met inclusion criteria. Type‐specific concordance was observed in 32.5% (13/40) of couples in which women had genital warts and in 32.1% (9/28) of couples in which women had cervical dysplasia. In multivariate analysis only smoking in women was associated with concordance (P < 0.05). Prevalence of HPV‐specific antibodies was high in male partners, but was not associated with presence of the same HPV type on their genitals. The same type‐specific HPV antibodies were detected in 81.8% of men in couples with HPV‐6 concordant genital warts, but only in 14.3% of men in couples with HPV‐16 concordant cervical dysplasia (P < 0.01). These results suggest that type‐specific HPV concordance in genital warts and cervical dysplasia lesions of women and genital infection of their male partners is common and similar. Higher seroconversion in couples with HPV‐6 concordant genital warts compared with couples with HPV‐16 concordant cervical dysplasia may be explained by viral load exposure.

High prevalence of genital HPV infection among long-term monogamous partners of women with cervical dysplasia or genital warts—Another reason for HPV vaccination of boys

We conducted a cross‐sectional study on the occurrence of a specific type of genital human papillomavirus (HPV) among long‐term monogamous male partners of women with cervical dysplasia and genital warts. The purpose of the study was to improve knowledge with regards to the management of these couples. The presence of genital HPV‐DNA was detected by PCR with broad spectrum primers followed by hybridization. 82 males met the study criteria, 41 in each group. Genital HPV‐DNA prevalence was 67.5% in the genital warts group and 72.2% in the cervical dysplasia group. The prevalence of high risk HPVs was higher in the cervical dysplasia group, while low risk HPVs were more prevalent in the genital warts group (p < .05). The prevalence of HPV in males was independent of the duration of the relationship (73.5% for 6–24 months and 66.7% for longer relationships). In conclusion, our results suggest that the prevalence of the genital HPV infection in both groups of male partners is comparable and very high, but the spectrum of HPV types varies significantly. The presence of the genital HPV infection in male sexual partners seems to be independent of the duration of the relationship. Applying the HPV vaccination to boys may prevent this phenomenon.