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Re: vaginal dysplasia From: Dr. John Provatopoulos B.Sc. M.D.C.M. F.R.S.C. (johnprov@sympatico.ca) Tue Nov 27 10:39:17 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Cliff Notes for the ABC recertification exam [Is That Cheating?]" Previous message: ainsron: "Re: vaginal dysplasia" At Tue, 27 Nov 2007, Richard Chudacoff wrote: > >I have a patient with a low-grade squamous intraepithelial lesion, and high >risk HPV. Colposcopy only noted a semicircular rang of koilocytic changes >in the posterior fornix. I'm sure there is a medical management protocol >using interferon, but I cannot find a reference. It seems silly to try to >remove this surgically. Can anyone help me? > >-- >Richard Chudacoff, MD, FACOG > > 5% imiquimod seems to be all the rage for low grade perinal,vulvar and anal lesions. Here is a paper for Vular lesions I don't see why it would not be effective for vaginal lesions, the problem is direct aplication without a speculum exam is just about impossible. 5 FU and laser or ultrasound are the other options. Gynecol Oncol. 2007 Nov;107(2):219-22. Epub 2007 Jul 25. Links Topical imiquimod can reverse vulvar intraepithelial neoplasia: A randomised, double-blinded study.Mathiesen O, Buus SK, Cramers M. Department of Gynaecology, University Hospital of Aarhus, Skejby, DK-8200 Aarhus N, Denmark. OBJECTIVE: To investigate the effect of topical imiquimod in patients with vulvar intraepithelial neoplasia (VIN). METHODS: We used a prospective, randomised, double-blinded, placebo-controlled study. Women with biopsy verified, visible VIN2 or VIN3, in a biopsy not older than 2 months were considered. RESULTS: Thirty-two patients were included, one was excluded before treatment. Twenty-one received active treatment, 10 received placebo. Seventeen (81%) in the treatment group showed complete response, two (10%) partial response and none responded in the placebo-group when evaluated by a biopsy 2 months after a treatment period of 16 weeks. Fourteen of 21 patients (67%) in the treatment group had to reduce the number of applications due to local side-effects. CONCLUSION: The topical treatment with imiquimod 5% was shown in this setting to be very efficient. Local side effects were a common feature, but tolerable after dose reduction. Long-term results are not known, but a planned cohort study of this population will show the rate of recurrences. PMID: 17655918 [PubMed - in process] -- Take care, John Next message: art fougner, md: "Re: Cliff Notes for the ABC recertification exam [Is That Cheating?]" Previous message: ainsron: "Re: vaginal dysplasia"

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