{"paper_id":"130775c2-fb4b-4d2d-a934-3d591f14f38c","body_text":"Condyloma acuminatum recurrence can be reduced by lesional autotransplantation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Condyloma acuminatum recurrence can be reduced by lesional autotransplantation Ntawuyamara Epipode, Zeeshan Bashir, Yuan Liang, Yanhua Liang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3920846/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Condyloma acuminatum (CA), also known as a genital wart (GW), is a sexually transmitted disease caused by human papillomavirus (HPV). HPV lesions, recurrence tendency, and risk of malignant formation are primarily dependent on the person’s immunity level. GW recurrence is a major challenge in CA treatment.The aim of this study was to explore how lesional autotransplantation (LT) can be used to treat coronary anemia and decrease its recurrence. Methods We treated CA through the preparation and implantation of tissue from nine CA patients in our dermatology clinic. Transplantation of small pieces of HPV lesions to the subcutaneous fat of the inguinal region was carried out with the help of a simple surgical method under local anesthesia. Patients were followed up for six to eight months. We searched PubMed and the Web of Science for treatment options for CA to compare our treatment method recurrence rate with existing treatment options. Results During three months of follow-up, seven patients experienced no recurrence of condyloma lesions, while two patients experienced recurrence of small lesions of condyloma acuminatum. The recurrence rate of CA once treated by autotransplantation was relatively low compared to that of other CA treatment options. Conclusions Transplantation of HPV lesions to the inguinal area reduces the recurrence rate in sexually active individuals. The 2/9 recurrence after implantation could be due to poor hygiene, sexual relationships or immune factors. Autotransplantation Condyloma acuminatum Human papillomavirus Recurrence Figures Figure 1 Figure 2 Figure 3 Background Condyloma acuminatum (CA), often known as genital warts (GWs), is a sexually transmitted infection (STI) caused by human papillomavirus (HPV) types 6 and 11. HPV is the most common STI and is frequently transmitted from one individual to the next after the first sexual activity( 1 , 2 ). HPV is transmitted through direct skin-to-skin contact with an infected person, most commonly during intercourse. The term “HPV” does not describe a single specific virus. It is a group of double-stranded DNA viruses with several characterized subtypes( 3 ). The CA presents the clinical features of epidermal lesions in, over and around the genitalia. It usually appears near moist surfaces but may include dry surfaces as well. Subclinical lesions have oncogenic and infectious potential. The prevalence of genital HPV infections is estimated to be between 10% and 20%, with only 1% showing clinical manifestations. The rate of HPV infection has been on the rise, and approximately 80% of those affected fall within the age range of 17 to 33 years, with the highest occurrence observed among individuals aged > 20 to 24 years. Moreover, men are prone to GWs, which could be due to a less hygienic environment or multiple sexual partners. However, the infection may be more prevalent in women. Therapeutically, there is no basic cure for HPV infection, but elimination of HPV lesions is needed because this approach would be very beneficial for patients and reduce the risk of developing malignancies. However, further evidence that the recurrence or transmission of viral infection can be reduced by removing visible lesions is still lacking. To treat confirmative HPV lesions, various treatment modalities, such as salicylic acid, trichloroacetic acid, microwave treatment, retinoids, podophyllin, levamisole, imiquimod and zinc sulfate, were used. None of them achieved a full cure without the possibility of recurrence. Additional treatment options include radiocautery, cryotherapy, surgical excision, and the use of a carbon dioxide laser. Nevertheless, it is important to note that these approaches carry a significant risk of scarring( 4 , 5 ). In the case of pharmacological methods, medicines are applied topically on cutaneous surfaces, although these agents may cause a skin reaction or local allergic side effects. On the other hand, surgical ablation is a much quicker and more efficient method for removing superficial wart lesions. A number of surgical procedures are available for the treatment of CA( 6 ). Prevention of CA recurrence is highly essential for the new generation for many reasons. The patient may experience pain and additional treatment expenditures again due to recurrent viral lesions. Repeated viral attacks also cause self-discomfort, social dissatisfaction, relationship problems and mental distress. These factors may cause patients to not visit medical centers, which increases susceptibility to disease severity, complications, and vulnerability in the form of cancer. Vaccination for HPV is still unavailable in many countries. Poor medical facilities and inadequate health funding also cause an increase in viral disease incidence in many third-party countries worldwide. Considering all the reasons cited above, in this study, we explored a therapeutic technique to decrease recurrent viral attacks in HPV-infected people by transplanting the viral pathogen into other body areas. Methods Study settings The research was carried out at the Dermatology, Cosmetology, and Venereology Department of Shenzhen Hospital, which is affiliated with Southern Medical University. Nine patients who were diagnosed with CA and willing to participate in this study were enrolled and treated by autotransplantation after providing informed consent. Diagnosis and treatment procedure Clinical features and acetic acid test were used for diagnosis. All other STDs, including syphilis, HIV/AIDS, chlamydia and gonorrhea, were ruled out for better experimental results. No additional diagnostic measurements were performed. Patients were briefed about their medical status, disease progress, disease complications, and plan to deal with the lesions before autotransplantation. The procedure consists of three steps ( Fig. 1 ): The first part included patient preparation for surgery and laser treatment. Infected lesions were sterilized with gauze and povidone-iodine tincture. The specimens that were required to be transplanted were chosen according to their size, location, and clinical appearance. Local anesthesia was applied with the help of 2% xylocaine hydrochloride without adrenaline around and under genital warts. Surgical or CO2 ablative treatment is typically performed for CA, but the only difference in our study was the removal of the wart lesions and the transplantation of the lesions to another body area. Defined incisions were made around the HPV lesions with a surgical blade, and the whole cauliflower-like cluster was removed for transplantation. Additional clusters of HPV lesions were removed with the help of the same surgical blade, after which the lesions were ready for transplantation through the designated area. For short and not very classical GWs, a CO2 laser was used. Bleeding due to the incision was stopped either by the pressure method or with the help of the laser ligation method. The second part of the procedure involved preparing and transplanting the incised cluster of CA tissue. Small Metzenbaum scissors were used to cut the incised lesions into many small pieces that could be easily implanted into the target area. A 2 cm incision was made over the inguinal region. A space was drawn between the subcutaneous fat under the incised skin with the help of forceps. Half of the incised wart lesions were implanted into the subcutaneous fat precisely and adequately. Two to three surgical sutures (number 4 − 0, 75 cm long and 18 mm needle diameter) were made after the lesions were inserted into the subcutaneous fat. The same procedure was repeated on the second side of the inguinal area to attain the maximum result. Third, in the last part of this new treatment, all remaining HPV lesions were removed with the help of CO2 laser therapy. All the bones were cleared from any genital lesions. Postoperative follow-up All patients who agreed to participate in the study completed the follow-up period. Patients were advised to return to the hospital the next day to receive a new wound dressing and for further examination. All patients were followed up for six to eight months. The primary aim of this follow-up was to rule out inflammation, pain, swelling, itching, recurrence or any other irritating conditions. Data collection and presentation The proper medical history and full demographic data were collected for each enrolled patient. The data were collected on the basis of age, sex, lesion site, duration and number of lesions, recurrent attacks, and postoperative follow-up duration in an Excel file. We searched the PubMed and Web of Science recurrence rates of CA treated by different modalities for comparison with our new method. The results are presented in the table and figures. Results Nine patients, including six males and three females, received lesional transplantation therapy. Among these nine patients, the ages ranged between 20 and 29 years in females and between 23 and 46 years in males. In male participants, HPV lesions were found on the penile foreskin, penile shaft, penile body, penis glans, frenulum, corona and around the pubic area, while in female patients, HPV lesions were present on the labia majora, labia minora, vestibule, perineal body and around the vaginal opening. The size of the CA lesions ranged from 0.1 cm to 0. 5 cm in diameter. Most of the lesions presented a nodular or cauliflower-like appearance. However, some lesions are round or oval shaped. All patients tested negative for HIV infection, gonorrhea, Chlamydia and trichomoniasis. Seven patients (77.8%) did not experience any recurrent attacks after the initial surgical or autotransplantation therapy, while two patients experienced recurrent attacks during the six-month follow-up duration. All female patients achieved complete remission of the CA lesions. Among the six male patients, four were negative for recurrent attack, while two were positive (Table 1 ). Among those two patients who had recurrent complaints, one patient had recurrent lesions only once, while the other patient came to the hospital four times with recurrent GW. Table 1 Patient presentation Gender Male Female Number of participants 6 3 Age level (years) 24–50 22–28 Size of lesions(cm 2 ) 0.1–0.5 0.1–0.3 Duration of CA presentation (months) 1–6 1–4 Recurrent attacks (persons) 2 0 The treatment outcomes are illustrated in Fig. 2 for female patients and for males ( Fig. 3 ). Recurrence rates in patients receiving several treatment options, such as imiquimod (50–73%), podophyllin (46–60%), a carbon dioxide laser (2.5–77%), trichloroacetic acid (18–36%), 5-flurouracil (50%), and interferon (9–69%), were greater than the 22.2% reported in our study (Table 2 ). Table 2 The recurrence rate of condyloma acuminata treatment options Treatment Success rate (%) Recurrence rate (%) Imiquimod 89 50–73 Trichloroacetic acid 66–100 18–36 Podophyllotoxin 70–100 45–94 Sinecatechins 40–81 07-Dec Cryotherapy 46–96 18–39 Surgery 89–93 18–65 CO2 laser 23–95 2.5–77 Podophyllin 42-46.9 46–60 Photodynamic Therapy 76–100 Oct-14 Electrosurgery 35–94 20–25 Immunotherapy 66–98 2 5-Fluorouracil Oct-50 Feb-50 Interferon 17–67 Sep-69 Isotretinoin 39–60 9.5 Electrocautery 93 24 Cidofovir 90.91 9.09 Discussion The recurrence rate of CA is very high, reaching 100% in some studies( 7 , 8 ). This fact constitutes a main challenge in CA treatment. CA causes numerous physiological and psychological problems due to its high likelihood of recurrence( 9 , 10 ). In most cases, patients visit medical centers to seek better and faster cures for GW, but recurrent viral infections usually cause considerable frustration. Such persistent behavior of CA makes it a crucial disease to address in the modern era( 11 ). Different types of treatment, such as imiquimod, immunotherapy, CO2 laser therapy, PDT, and cidofovir isotretinoin, are used to treat CA, but frequent therapies are required to address recurrent attacks. Our study ultimately revealed the enormous impact of this virus on the lives of many HPV-infected individuals and improved treatment methods by preventing repetitive disease. The principle behind autotransplantation is to trigger cell-mediated immunity, which is unaffected by HPV infection, by introducing a larger amount of the same antigen at a site where a robust immune response can take place. A single wart is completely removed, and the minced particles are subsequently inserted into a dermal pocket. Planting of incised pathogens in the same infected person will lead to a scenario of resistance against that particular viral infection and cessation of further growth. This method is similar to vaccination in that weak or identical disease pathogens are given to individuals to create antibodies against the required disease( 12 , 13 ). In this study, we planned to establish immunity from previous viral lesions to further decrease disease manifestations. After pathogens are propagated to the subcutaneous fat, the infection cannot be established in the subcutaneous area due to the structural and pathogenic capacity of the fungus in the subcutaneous region( 14 – 16 ). On the other hand, body immunity works more efficiently when the pathogen is in a mute state, producing antibodies against it. Later, these antibodies are transferred to the blood and slowly circulate to all body areas even over the genital tract so that secondary attack will be terminated much easier and faster. This methodology also facilitates body immunity against other identical viral attacks, as has just been demonstrated in other studies. Our results indicated that seven patients (77.8%) were negative for recurrent HPV infection after the initial surgical implantation of pathogens in inguinal sites, while the remaining (22.2%) patients were positive for recurrent HPV infection. During our study, we reviewed existing treatment modalities for CA and their recurrence rates. Our technique’s recurrence rate was relatively low in comparison to other treatment options such as Imiquimod (50–73%), podophyllin(46—60%), podophyllotoxin(approximately 38%),Carbon dioxide laser(2.5–77%), trichloroacetic acid(18–36%),5-Flurouracil(50%),Interferon(9–69%)( 7 – 9 , 17 – 22 ). The findings of this study exhibited improved outcomes in contrast to the findings of Shiva Kumar et al., in which a significant 73.3% of warts were completely cleared, with the majority of them (91%) experiencing clearance within a span of two months( 23 ). Nischal et al. used this therapy in the treatment of multiple recurrent palmoplantar warts, for which the clearance rate was 74.1%. Our results are also higher than those of similar techniques used for nongenital warts, for which 60.6% of the procedures were successful. Various studies have shown that subcutaneous embedding of autologous warts improves immune function and antiviral ability. It can effectively prevent the early recurrence of GW and has good clinical efficacy in the treatment and prevention of GW; thus, it is worth promoting clinical efficacy( 5 , 24 , 25 ). All patients were advised to maintain the operative sites clean and dry to attain effective results. Throughout their treatment interval, no patients received any physical ablative medication or any other photodynamic therapy (PDT) over the lesional sites. It is a low-priced experimental treatment used to treat and control CA, whereas other therapies cost more money and time. Other procedures, such as PDT and repeated CO2 laser surgeries, are more painful than our experimental procedure is. Our methodology of transplanting the pathogen to subcutaneous fat will limit all extra expenses and decrease patient discomfort. Recurrent attacks in those two individuals can be explained by either failure to maintain the postoperative sanitary atmosphere or persistent viral exposure. Moist skin is known to be more favorable for virus growth and the production of warts( 26 ). This is the reason why it is important to maintain postoperative hygiene, and a dry environment decreases the vulnerability of viruses to attack. Another reason why a patient experienced a single recurrent attack in one week can be presumed to be that the new wart may indeed have arisen from previous lesion sites or scars that were not visualized during the first surgery or during CO2 laser therapy. These viruses may reside in the skin epithelium in the latent stage and cause disease when they reach a suitable environment. After secondary CO2 laser treatment, no recurrent lesions were recorded. Once this technique is used in the local health care system, we expect that the recurrence rate of typical HPV infection will be reduced and that the burden of expenditure on patients can also be minimized compared to that of other therapeutic methods. As many countries’ health systems still do not involve HPV vaccination in the local medical system, implantation of such techniques would be favorable and decrease the incidence of HPV in local populations. After explaining our treatment technique, some patients did not consent to this surgical technique, and the number of participants was not high. To obtain the maximum results from this new technique, a larger sample size and longer follow-up may support the discoveries of the present work. Conclusions This study revealed that autotransplantation of HPV lesions to other body areas is associated with a low recurrence rate in people diagnosed with GW. This implantation will introduce new immunity against the very specific pathogen that has been implanted. This newly formed immune system helps to decrease recurrent attacks in the CA within the same person. This treatment method will also be highly beneficial because of its low cost and decreased pain compared to other ablative treatments. Declarations Ethics approval and consent to participate: Consent for the study was provided by Shenzhen Hospital of Southern Medical University Department of Dermatology, Cosmetology and Venereology. Ethical approval for this study was then waived by Shenzhen Hospital of Southern Medical University Review Board . Informed consent was obtained from all subjects involved in the study before autotransplantation. The study was conducted in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Availability of data and materials: The data are available on request from the corresponding author. Competing interests: The authors declare that they have no competing interests. Funding: This research received no external funding. Authors’ Contributions: Conceptualization, methodology, Zeeshan Bashir; formal analysis and data curation, Yuan Liang; writing, original draft preparation, review, editing and submission, Ntawuyamara Epipode; supervision, Yanhua Liang. All the authors have read and approved the manuscript. Acknowledgments: We thank all the participants who underwent surgery. References Nia MH, Rahmanian F, Ghahartars M, Janghorban R. Sexual function and sexual quality of life in men with genital warts: a cross-sectional study. Reprod Health. 2022;19(1):102. Daugherty M, Byler T. Genital Wart and Human Papillomavirus Prevalence in Men in the United States From Penile Swabs: Results From National Health and Nutrition Examination Surveys. Sexually Transmitted Diseases. 2018;45(6):412-6. McBride AA. Human papillomaviruses: diversity, infection and host interactions. Nat Rev Microbiol. 2022;20(2):95-108. Awal G, Kaur S. Therapeutic Outcome of Intralesional Immunotherapy in Cutaneous Warts Using the Mumps, Measles, and Rubella Vaccine: A Randomized, Placebo-controlled Trial. J Clin Aesthet Dermatol. 2018;11(5):15-20. Wilson M, Wilson PJK. Genital Warts. Close Encounters of the Microbial Kind: Everything You Need to Know About Common Infections. Cham: Springer International Publishing; 2021. p. 415-22. Asadi N, Hemmati E, Namazi G, Jahromi MP, Sarraf Z, Pazyar N, Salehi A. A Comparative Study of Potassium Hydroxide versus CO2 Laser Vaporization in The Treatment of Female Genital Warts: A Controlled Clinical Trial. Int J Community Based Nurs Midwifery. 2016;4(3):274-82. Diţescu D, Istrate-Ofiţeru AM, Roşu GC, Iovan L, Liliac IM, Zorilă GL, et al. Clinical and pathological aspects of condyloma acuminatum - review of literature and case presentation. Rom J Morphol Embryol. 2021;62(2):369-83. Sindhuja T, Bhari N, Gupta S. Asian guidelines for condyloma acuminatum. Journal of Infection and Chemotherapy. 2022;28(7):845-52. Widschwendter A, Böttcher B, Riedl D, Coban S, Mutz-Dehbalaie I, Matteucci Gothe R, et al. Recurrence of genitals warts in pre-HPV vaccine era after laser treatment. Arch Gynecol Obstet. 2019;300(3):661-8. Maggino T, Casadei D, Panontin E, Fadda E, Zampieri MC, Donà MA, et al. Impact of an HPV diagnosis on the quality of life in young women. Gynecol Oncol. 2007;107(1 Suppl 1):S175-9. 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[Malpighian epithelia and papillomavirus infections]. Arch Anat Cytol Pathol. 1992;40(4):202-11. Läuchli S, Kempf W, Dragieva G, Burg G, Hafner J. CO2 laser treatment of warts in immunosuppressed patients. Dermatology. 2003;206(2):148-52. Eftaiha MS, Amshel AL, Shonberg IL, Batshon B. Giant and recurrent condyloma acuminatum: appraisal of immunotherapy. Dis Colon Rectum. 1982;25(2):136-8. O'Mahony C, Gomberg M, Skerlev M, Alraddadi A, de Las Heras-Alonso ME, Majewski S, et al. Position statement for the diagnosis and management of anogenital warts. J Eur Acad Dermatol Venereol. 2019;33(6):1006-19. Akhavan S, Mohammadi SR, Modarres Gillani M, Mousavi AS, Shirazi M. Efficacy of combination therapy of oral zinc sulfate with imiquimod, podophyllin or cryotherapy in the treatment of vulvar warts. J Obstet Gynaecol Res. 2014;40(10):2110-3. Batista CS, Atallah AN, Saconato H, da Silva EM. 5-FU for genital warts in non-immunocompromised individuals. Cochrane Database Syst Rev. 2010;2010(4):Cd006562. Nambudiri VE, Mutyambizi K, Walls AC, Fisher DC, Bleday R, Saavedra AP. Successful Treatment of Perianal Giant Condyloma Acuminatum in an Immunocompromised Host With Systemic Interleukin 2 and Topical Cidofovir. JAMA Dermatology. 2013;149(9):1068-70. Shivakumar V, Okade R, Rajkumar V. Autoimplantation therapy for multiple warts. Indian J Dermatol Venereol Leprol. 2009;75(6):593-5. Yuan J, Ni G, Wang T, Mounsey K, Cavezza S, Pan X, Liu X. Genital warts treatment: Beyond imiquimod. Hum Vaccin Immunother. 2018;14(7):1815-9. Gilson R, Nugent D, Werner RN, Ballesteros J, Ross J. 2019 IUSTI-Europe guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol. 2020;34(8):1644-53. Oriel JD. Natural history of genital warts. Br J Vener Dis. 1971;47(1):1-13. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-3920846\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":272319183,\"identity\":\"f49d14c0-358c-41a0-888e-5e0a4b93a021\",\"order_by\":0,\"name\":\"Ntawuyamara Epipode\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Shenzhen Hospital of Southern Medical University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Ntawuyamara\",\"middleName\":\"\",\"lastName\":\"Epipode\",\"suffix\":\"\"},{\"id\":272319184,\"identity\":\"f0f731fd-376e-465f-b0df-271af0b2c8b7\",\"order_by\":1,\"name\":\"Zeeshan Bashir\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Shenzhen Hospital of Southern Medical University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Zeeshan\",\"middleName\":\"\",\"lastName\":\"Bashir\",\"suffix\":\"\"},{\"id\":272319185,\"identity\":\"7f338f09-7127-4579-b1e3-3f58bc86a939\",\"order_by\":2,\"name\":\"Yuan Liang\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Concord College of Sino-Canada\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Yuan\",\"middleName\":\"\",\"lastName\":\"Liang\",\"suffix\":\"\"},{\"id\":272319186,\"identity\":\"3f16d60a-e080-4418-ae32-7bdd0b4d9513\",\"order_by\":3,\"name\":\"Yanhua Liang\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzUlEQVRIiWNgGAWjYBACPmYQyQZmMz5IqKghrIUNpoWHgYHZ4MGZY0RogZFALWySD1uYidDCzvzs4ZcyG3l79t5nFYkNbAz87d0JBBzGZm4scy7NsIfnuNmNxB0yDBJnzm4g5Bczacm2wwk8EmlsNxLPsDEYSOQS0sL+Da6lILGNmRgtPGaSH6FaGIjVUibNAPLLmWPMEglnjvEQ9As///Ftkj+AIcbe3sb48UdFjRx/ey9+LSDAzIPE4cGpDBkw/iBK2SgYBaNgFIxYAAD6dDwglqlIagAAAABJRU5ErkJggg==\",\"orcid\":\"\",\"institution\":\"Shenzhen Hospital of Southern Medical University\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Yanhua\",\"middleName\":\"\",\"lastName\":\"Liang\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2024-02-02 12:29:20\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-3920846/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-3920846/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":51082098,\"identity\":\"833a2cfd-f36f-452d-abf0-0e79cbce3e92\",\"added_by\":\"auto\",\"created_at\":\"2024-02-13 19:20:56\",\"extension\":\"png\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":1123036,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eSurgery procedure. (A)\\u003cstrong\\u003e \\u003c/strong\\u003eCutting the lesions;\\u003cstrong\\u003e \\u003c/strong\\u003e(B)Pieces of lesion;(C) Implantation to subcutaneous fat;(D) After the procedure.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"floatimage1.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3920846/v1/23741a3d6dc638323d29183f.png\"},{\"id\":51082096,\"identity\":\"13f4634b-87bb-4145-8df3-cf3fecaaba2b\",\"added_by\":\"auto\",\"created_at\":\"2024-02-13 19:20:56\",\"extension\":\"png\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":812656,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eClinical changes of a female at different time points\\u003cstrong\\u003e. \\u003c/strong\\u003e(A) Before procedure; (B) Immediately after the procedure; (C) 60 days after the procedure.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"floatimage2.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3920846/v1/68fed828224eb3de905e94c4.png\"},{\"id\":51082099,\"identity\":\"7f9e0570-c853-436f-8b1a-fbbf4d47f35f\",\"added_by\":\"auto\",\"created_at\":\"2024-02-13 19:20:56\",\"extension\":\"png\",\"order_by\":3,\"title\":\"Figure 3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":1118202,\"visible\":true,\"origin\":\"\",\"legend\":\"\\u003cp\\u003eClinical changes of a male at different time points ;(A) Before procedure; (B) Immediate after the procedure ;(C)15 days after the procedure.\\u003c/p\\u003e\",\"description\":\"\",\"filename\":\"floatimage3.png\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3920846/v1/0a2b07702cf7089263ae8646.png\"},{\"id\":52488897,\"identity\":\"50709d3c-a6df-4d5b-ab94-3051af10bbb1\",\"added_by\":\"auto\",\"created_at\":\"2024-03-12 08:08:12\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":5162565,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-3920846/v1/98d8a9bf-a0c3-429c-81d4-4eda88eeb1ca.pdf\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Condyloma acuminatum recurrence can be reduced by lesional autotransplantation\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003eCondyloma acuminatum (CA), often known as genital warts (GWs), is a sexually transmitted infection (STI) caused by human papillomavirus (HPV) types 6 and 11. HPV is the most common STI and is frequently transmitted from one individual to the next after the first sexual activity(\\u003cspan citationid=\\\"CR1\\\" class=\\\"CitationRef\\\"\\u003e1\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR2\\\" class=\\\"CitationRef\\\"\\u003e2\\u003c/span\\u003e). HPV is transmitted through direct skin-to-skin contact with an infected person, most commonly during intercourse. The term \\u0026ldquo;HPV\\u0026rdquo; does not describe a single specific virus. It is a group of double-stranded DNA viruses with several characterized subtypes(\\u003cspan citationid=\\\"CR3\\\" class=\\\"CitationRef\\\"\\u003e3\\u003c/span\\u003e). The CA presents the clinical features of epidermal lesions in, over and around the genitalia. It usually appears near moist surfaces but may include dry surfaces as well. Subclinical lesions have oncogenic and infectious potential. The prevalence of genital HPV infections is estimated to be between 10% and 20%, with only 1% showing clinical manifestations. The rate of HPV infection has been on the rise, and approximately 80% of those affected fall within the age range of 17 to 33 years, with the highest occurrence observed among individuals aged\\u0026thinsp;\\u0026gt;\\u0026thinsp;20 to 24 years. Moreover, men are prone to GWs, which could be due to a less hygienic environment or multiple sexual partners. However, the infection may be more prevalent in women.\\u003c/p\\u003e \\u003cp\\u003eTherapeutically, there is no basic cure for HPV infection, but elimination of HPV lesions is needed because this approach would be very beneficial for patients and reduce the risk of developing malignancies. However, further evidence that the recurrence or transmission of viral infection can be reduced by removing visible lesions is still lacking. To treat confirmative HPV lesions, various treatment modalities, such as salicylic acid, trichloroacetic acid, microwave treatment, retinoids, podophyllin, levamisole, imiquimod and zinc sulfate, were used. None of them achieved a full cure without the possibility of recurrence. Additional treatment options include radiocautery, cryotherapy, surgical excision, and the use of a carbon dioxide laser. Nevertheless, it is important to note that these approaches carry a significant risk of scarring(\\u003cspan citationid=\\\"CR4\\\" class=\\\"CitationRef\\\"\\u003e4\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eIn the case of pharmacological methods, medicines are applied topically on cutaneous surfaces, although these agents may cause a skin reaction or local allergic side effects. On the other hand, surgical ablation is a much quicker and more efficient method for removing superficial wart lesions. A number of surgical procedures are available for the treatment of CA(\\u003cspan citationid=\\\"CR6\\\" class=\\\"CitationRef\\\"\\u003e6\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003ePrevention of CA recurrence is highly essential for the new generation for many reasons. The patient may experience pain and additional treatment expenditures again due to recurrent viral lesions. Repeated viral attacks also cause self-discomfort, social dissatisfaction, relationship problems and mental distress. These factors may cause patients to not visit medical centers, which increases susceptibility to disease severity, complications, and vulnerability in the form of cancer. Vaccination for HPV is still unavailable in many countries. Poor medical facilities and inadequate health funding also cause an increase in viral disease incidence in many third-party countries worldwide. Considering all the reasons cited above, in this study, we explored a therapeutic technique to decrease recurrent viral attacks in HPV-infected people by transplanting the viral pathogen into other body areas.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStudy settings\\u003c/h2\\u003e \\u003cp\\u003eThe research was carried out at the Dermatology, Cosmetology, and Venereology Department of Shenzhen Hospital, which is affiliated with Southern Medical University. Nine patients who were diagnosed with CA and willing to participate in this study were enrolled and treated by autotransplantation after providing informed consent.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec4\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eDiagnosis and treatment procedure\\u003c/h2\\u003e \\u003cp\\u003eClinical features and acetic acid test were used for diagnosis. All other STDs, including syphilis, HIV/AIDS, chlamydia and gonorrhea, were ruled out for better experimental results. No additional diagnostic measurements were performed. Patients were briefed about their medical status, disease progress, disease complications, and plan to deal with the lesions before autotransplantation.\\u003c/p\\u003e \\u003cp\\u003eThe procedure consists of three steps \\u003cb\\u003e(\\u003c/b\\u003eFig.\\u0026nbsp;\\u003cspan refid=\\\"Fig1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e):\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe first part included patient preparation for surgery and laser treatment. Infected lesions were sterilized with gauze and povidone-iodine tincture. The specimens that were required to be transplanted were chosen according to their size, location, and clinical appearance. Local anesthesia was applied with the help of 2% xylocaine hydrochloride without adrenaline around and under genital warts. Surgical or CO2 ablative treatment is typically performed for CA, but the only difference in our study was the removal of the wart lesions and the transplantation of the lesions to another body area. Defined incisions were made around the HPV lesions with a surgical blade, and the whole cauliflower-like cluster was removed for transplantation. Additional clusters of HPV lesions were removed with the help of the same surgical blade, after which the lesions were ready for transplantation through the designated area. For short and not very classical GWs, a CO2 laser was used. Bleeding due to the incision was stopped either by the pressure method or with the help of the laser ligation method.\\u003c/p\\u003e \\u003cp\\u003eThe second part of the procedure involved preparing and transplanting the incised cluster of CA tissue. Small Metzenbaum scissors were used to cut the incised lesions into many small pieces that could be easily implanted into the target area. A 2 cm incision was made over the inguinal region. A space was drawn between the subcutaneous fat under the incised skin with the help of forceps. Half of the incised wart lesions were implanted into the subcutaneous fat precisely and adequately. Two to three surgical sutures (number 4\\u0026thinsp;\\u0026minus;\\u0026thinsp;0, 75 cm long and 18 mm needle diameter) were made after the lesions were inserted into the subcutaneous fat. The same procedure was repeated on the second side of the inguinal area to attain the maximum result.\\u003c/p\\u003e \\u003cp\\u003eThird, in the last part of this new treatment, all remaining HPV lesions were removed with the help of CO2 laser therapy. All the bones were cleared from any genital lesions.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec5\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003ePostoperative follow-up\\u003c/h2\\u003e \\u003cp\\u003eAll patients who agreed to participate in the study completed the follow-up period. Patients were advised to return to the hospital the next day to receive a new wound dressing and for further examination. All patients were followed up for six to eight months. The primary aim of this follow-up was to rule out inflammation, pain, swelling, itching, recurrence or any other irritating conditions.\\u003c/p\\u003e \\u003c/div\\u003e \\u003cdiv id=\\\"Sec6\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eData collection and presentation\\u003c/h2\\u003e \\u003cp\\u003eThe proper medical history and full demographic data were collected for each enrolled patient. The data were collected on the basis of age, sex, lesion site, duration and number of lesions, recurrent attacks, and postoperative follow-up duration in an Excel file. We searched the PubMed and Web of Science recurrence rates of CA treated by different modalities for comparison with our new method. The results are presented in the table and figures.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eNine patients, including six males and three females, received lesional transplantation therapy. Among these nine patients, the ages ranged between 20 and 29 years in females and between 23 and 46 years in males. In male participants, HPV lesions were found on the penile foreskin, penile shaft, penile body, penis glans, frenulum, corona and around the pubic area, while in female patients, HPV lesions were present on the labia majora, labia minora, vestibule, perineal body and around the vaginal opening. The size of the CA lesions ranged from 0.1 cm to 0. 5 cm in diameter. Most of the lesions presented a nodular or cauliflower-like appearance. However, some lesions are round or oval shaped. All patients tested negative for HIV infection, gonorrhea, Chlamydia and trichomoniasis.\\u003c/p\\u003e \\u003cp\\u003eSeven patients (77.8%) did not experience any recurrent attacks after the initial surgical or autotransplantation therapy, while two patients experienced recurrent attacks during the six-month follow-up duration. All female patients achieved complete remission of the CA lesions. Among the six male patients, four were negative for recurrent attack, while two were positive (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab1\\\" class=\\\"InternalRef\\\"\\u003e1\\u003c/span\\u003e). Among those two patients who had recurrent complaints, one patient had recurrent lesions only once, while the other patient came to the hospital four times with recurrent GW.\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab1\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 1\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003ePatient presentation\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eGender\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eMale\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFemale\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eNumber of participants\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eAge level (years)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e24\\u0026ndash;50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e22\\u0026ndash;28\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSize of lesions(cm\\u003csup\\u003e2\\u003c/sup\\u003e)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e0.1\\u0026ndash;0.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0.1\\u0026ndash;0.3\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eDuration of CA presentation (months)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e1\\u0026ndash;6\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e1\\u0026ndash;4\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eRecurrent attacks (persons)\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e0\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e \\u003cp\\u003eThe treatment outcomes are illustrated \\u003cb\\u003ein\\u003c/b\\u003e Fig.\\u0026nbsp;\\u003cspan refid=\\\"Fig2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e for female patients and for males \\u003cb\\u003e(\\u003c/b\\u003eFig.\\u0026nbsp;\\u003cspan refid=\\\"Fig3\\\" class=\\\"InternalRef\\\"\\u003e3\\u003c/span\\u003e\\u003cb\\u003e).\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003e \\u003c/p\\u003e \\u003cp\\u003eRecurrence rates in patients receiving several treatment options, such as imiquimod (50\\u0026ndash;73%), podophyllin (46\\u0026ndash;60%), a carbon dioxide laser (2.5\\u0026ndash;77%), trichloroacetic acid (18\\u0026ndash;36%), 5-flurouracil (50%), and interferon (9\\u0026ndash;69%), were greater than the 22.2% reported in our study (Table\\u0026nbsp;\\u003cspan refid=\\\"Tab2\\\" class=\\\"InternalRef\\\"\\u003e2\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003e \\u003cdiv class=\\\"gridtable\\\"\\u003e\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e \\u003ccaption language=\\\"En\\\"\\u003e \\u003cdiv class=\\\"CaptionNumber\\\"\\u003eTable 2\\u003c/div\\u003e \\u003cdiv class=\\\"CaptionContent\\\"\\u003e \\u003cp\\u003eThe recurrence rate of condyloma acuminata treatment options\\u003c/p\\u003e \\u003c/div\\u003e \\u003c/caption\\u003e \\u003ccolgroup cols=\\\"3\\\"\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c1\\\" colnum=\\\"1\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c2\\\" colnum=\\\"2\\\"\\u003e\\u003c/div\\u003e \\u003cdiv align=\\\"left\\\" class=\\\"colspec\\\" colname=\\\"c3\\\" colnum=\\\"3\\\"\\u003e\\u003c/div\\u003e \\u003cthead\\u003e \\u003ctr\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTreatment\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eSuccess rate (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eRecurrence rate (%)\\u003c/p\\u003e \\u003c/th\\u003e \\u003c/tr\\u003e \\u003c/thead\\u003e \\u003ctbody\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eImiquimod\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e89\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e50\\u0026ndash;73\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eTrichloroacetic acid\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e66\\u0026ndash;100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18\\u0026ndash;36\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePodophyllotoxin\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e70\\u0026ndash;100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e45\\u0026ndash;94\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSinecatechins\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e40\\u0026ndash;81\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e07-Dec\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCryotherapy\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e46\\u0026ndash;96\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18\\u0026ndash;39\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eSurgery\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e89\\u0026ndash;93\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e18\\u0026ndash;65\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCO2 laser\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e23\\u0026ndash;95\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2.5\\u0026ndash;77\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePodophyllin\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e42-46.9\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e46\\u0026ndash;60\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003ePhotodynamic Therapy\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e76\\u0026ndash;100\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eOct-14\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eElectrosurgery\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e35\\u0026ndash;94\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e20\\u0026ndash;25\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eImmunotherapy\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e66\\u0026ndash;98\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e2\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003e5-Fluorouracil\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003eOct-50\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eFeb-50\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eInterferon\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e17\\u0026ndash;67\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003eSep-69\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eIsotretinoin\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e39\\u0026ndash;60\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.5\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eElectrocautery\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e93\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e24\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003ctr\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e \\u003cp\\u003eCidofovir\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e \\u003cp\\u003e90.91\\u003c/p\\u003e \\u003c/td\\u003e \\u003ctd align=\\\"left\\\" colname=\\\"c3\\\"\\u003e \\u003cp\\u003e9.09\\u003c/p\\u003e \\u003c/td\\u003e \\u003c/tr\\u003e \\u003c/tbody\\u003e \\u003c/colgroup\\u003e \\u003c/table\\u003e\\u003c/div\\u003e \\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThe recurrence rate of CA is very high, reaching 100% in some studies(\\u003cspan citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR8\\\" class=\\\"CitationRef\\\"\\u003e8\\u003c/span\\u003e). This fact constitutes a main challenge in CA treatment. CA causes numerous physiological and psychological problems due to its high likelihood of recurrence(\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR10\\\" class=\\\"CitationRef\\\"\\u003e10\\u003c/span\\u003e). In most cases, patients visit medical centers to seek better and faster cures for GW, but recurrent viral infections usually cause considerable frustration. Such persistent behavior of CA makes it a crucial disease to address in the modern era(\\u003cspan citationid=\\\"CR11\\\" class=\\\"CitationRef\\\"\\u003e11\\u003c/span\\u003e). Different types of treatment, such as imiquimod, immunotherapy, CO2 laser therapy, PDT, and cidofovir isotretinoin, are used to treat CA, but frequent therapies are required to address recurrent attacks.\\u003c/p\\u003e \\u003cp\\u003eOur study ultimately revealed the enormous impact of this virus on the lives of many HPV-infected individuals and improved treatment methods by preventing repetitive disease. The principle behind autotransplantation is to trigger cell-mediated immunity, which is unaffected by HPV infection, by introducing a larger amount of the same antigen at a site where a robust immune response can take place. A single wart is completely removed, and the minced particles are subsequently inserted into a dermal pocket. Planting of incised pathogens in the same infected person will lead to a scenario of resistance against that particular viral infection and cessation of further growth. This method is similar to vaccination in that weak or identical disease pathogens are given to individuals to create antibodies against the required disease(\\u003cspan citationid=\\\"CR12\\\" class=\\\"CitationRef\\\"\\u003e12\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR13\\\" class=\\\"CitationRef\\\"\\u003e13\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eIn this study, we planned to establish immunity from previous viral lesions to further decrease disease manifestations. After pathogens are propagated to the subcutaneous fat, the infection cannot be established in the subcutaneous area due to the structural and pathogenic capacity of the fungus in the subcutaneous region(\\u003cspan additionalcitationids=\\\"CR15\\\" citationid=\\\"CR14\\\" class=\\\"CitationRef\\\"\\u003e14\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR16\\\" class=\\\"CitationRef\\\"\\u003e16\\u003c/span\\u003e). On the other hand, body immunity works more efficiently when the pathogen is in a mute state, producing antibodies against it. Later, these antibodies are transferred to the blood and slowly circulate to all body areas even over the genital tract so that secondary attack will be terminated much easier and faster. This methodology also facilitates body immunity against other identical viral attacks, as has just been demonstrated in other studies.\\u003c/p\\u003e \\u003cp\\u003eOur results indicated that seven patients (77.8%) were negative for recurrent HPV infection after the initial surgical implantation of pathogens in inguinal sites, while the remaining (22.2%) patients were positive for recurrent HPV infection. During our study, we reviewed existing treatment modalities for CA and their recurrence rates. Our technique\\u0026rsquo;s recurrence rate was relatively low in comparison to other treatment options such as Imiquimod (50\\u0026ndash;73%), podophyllin(46\\u0026mdash;60%), podophyllotoxin(approximately 38%),Carbon dioxide laser(2.5\\u0026ndash;77%), trichloroacetic acid(18\\u0026ndash;36%),5-Flurouracil(50%),Interferon(9\\u0026ndash;69%)(\\u003cspan additionalcitationids=\\\"CR8\\\" citationid=\\\"CR7\\\" class=\\\"CitationRef\\\"\\u003e7\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e9\\u003c/span\\u003e, \\u003cspan additionalcitationids=\\\"CR18 CR19 CR20 CR21\\\" citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e17\\u003c/span\\u003e\\u0026ndash;\\u003cspan citationid=\\\"CR22\\\" class=\\\"CitationRef\\\"\\u003e22\\u003c/span\\u003e). The findings of this study exhibited improved outcomes in contrast to the findings of Shiva Kumar et al., in which a significant 73.3% of warts were completely cleared, with the majority of them (91%) experiencing clearance within a span of two months(\\u003cspan citationid=\\\"CR23\\\" class=\\\"CitationRef\\\"\\u003e23\\u003c/span\\u003e). Nischal et al. used this therapy in the treatment of multiple recurrent palmoplantar warts, for which the clearance rate was 74.1%. Our results are also higher than those of similar techniques used for nongenital warts, for which 60.6% of the procedures were successful. Various studies have shown that subcutaneous embedding of autologous warts improves immune function and antiviral ability. It can effectively prevent the early recurrence of GW and has good clinical efficacy in the treatment and prevention of GW; thus, it is worth promoting clinical efficacy(\\u003cspan citationid=\\\"CR5\\\" class=\\\"CitationRef\\\"\\u003e5\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e24\\u003c/span\\u003e, \\u003cspan citationid=\\\"CR25\\\" class=\\\"CitationRef\\\"\\u003e25\\u003c/span\\u003e).\\u003c/p\\u003e \\u003cp\\u003eAll patients were advised to maintain the operative sites clean and dry to attain effective results. Throughout their treatment interval, no patients received any physical ablative medication or any other photodynamic therapy (PDT) over the lesional sites. It is a low-priced experimental treatment used to treat and control CA, whereas other therapies cost more money and time. Other procedures, such as PDT and repeated CO2 laser surgeries, are more painful than our experimental procedure is. Our methodology of transplanting the pathogen to subcutaneous fat will limit all extra expenses and decrease patient discomfort.\\u003c/p\\u003e \\u003cp\\u003eRecurrent attacks in those two individuals can be explained by either failure to maintain the postoperative sanitary atmosphere or persistent viral exposure. Moist skin is known to be more favorable for virus growth and the production of warts(\\u003cspan citationid=\\\"CR26\\\" class=\\\"CitationRef\\\"\\u003e26\\u003c/span\\u003e). This is the reason why it is important to maintain postoperative hygiene, and a dry environment decreases the vulnerability of viruses to attack. Another reason why a patient experienced a single recurrent attack in one week can be presumed to be that the new wart may indeed have arisen from previous lesion sites or scars that were not visualized during the first surgery or during CO2 laser therapy. These viruses may reside in the skin epithelium in the latent stage and cause disease when they reach a suitable environment. After secondary CO2 laser treatment, no recurrent lesions were recorded.\\u003c/p\\u003e \\u003cp\\u003eOnce this technique is used in the local health care system, we expect that the recurrence rate of typical HPV infection will be reduced and that the burden of expenditure on patients can also be minimized compared to that of other therapeutic methods. As many countries\\u0026rsquo; health systems still do not involve HPV vaccination in the local medical system, implantation of such techniques would be favorable and decrease the incidence of HPV in local populations.\\u003c/p\\u003e \\u003cp\\u003eAfter explaining our treatment technique, some patients did not consent to this surgical technique, and the number of participants was not high. To obtain the maximum results from this new technique, a larger sample size and longer follow-up may support the discoveries of the present work.\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eThis study revealed that autotransplantation of HPV lesions to other body areas is associated with a low recurrence rate in people diagnosed with GW. This implantation will introduce new immunity against the very specific pathogen that has been implanted. This newly formed immune system helps to decrease recurrent attacks in the CA within the same person. This treatment method will also be highly beneficial because of its low cost and decreased pain compared to other ablative treatments.\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003eEthics approval and consent to participate: Consent for the study was provided by Shenzhen Hospital of Southern Medical University Department of Dermatology, Cosmetology and Venereology. Ethical approval for this study was then waived by Shenzhen Hospital of Southern Medical University Review Board . Informed consent was obtained from all subjects involved in the study before autotransplantation. The study was conducted in accordance with the Declaration of Helsinki.\\u003c/p\\u003e\\n\\u003cp\\u003eConsent for publication: Not applicable.\\u003c/p\\u003e\\n\\u003cp\\u003eAvailability of data and materials: The data are available on request from the corresponding author.\\u003c/p\\u003e\\n\\u003cp\\u003eCompeting interests: The authors declare that they have no competing interests.\\u003c/p\\u003e\\n\\u003cp\\u003eFunding: This research received no external funding.\\u003c/p\\u003e\\n\\u003cp\\u003eAuthors\\u0026rsquo; Contributions: Conceptualization, methodology, Zeeshan Bashir; formal analysis and data curation, Yuan Liang; writing, original draft preparation, review, editing and submission, Ntawuyamara Epipode; supervision, Yanhua Liang. All the authors have read and approved the manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003eAcknowledgments: We thank all the participants who underwent surgery.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eNia MH, Rahmanian F, Ghahartars M, Janghorban R. Sexual function and sexual quality of life in men with genital warts: a cross-sectional study. Reprod Health. 2022;19(1):102.\\u003c/li\\u003e\\n\\u003cli\\u003eDaugherty M, Byler T. Genital Wart and Human Papillomavirus Prevalence in Men in the United States From Penile Swabs: Results From National Health and Nutrition Examination Surveys. Sexually Transmitted Diseases. 2018;45(6):412-6.\\u003c/li\\u003e\\n\\u003cli\\u003eMcBride AA. Human papillomaviruses: diversity, infection and host interactions. Nat Rev Microbiol. 2022;20(2):95-108.\\u003c/li\\u003e\\n\\u003cli\\u003eAwal G, Kaur S. Therapeutic Outcome of Intralesional Immunotherapy in Cutaneous Warts Using the Mumps, Measles, and Rubella Vaccine: A Randomized, Placebo-controlled Trial. J Clin Aesthet Dermatol. 2018;11(5):15-20.\\u003c/li\\u003e\\n\\u003cli\\u003eWilson M, Wilson PJK. Genital Warts. Close Encounters of the Microbial Kind: Everything You Need to Know About Common Infections. Cham: Springer International Publishing; 2021. p. 415-22.\\u003c/li\\u003e\\n\\u003cli\\u003eAsadi N, Hemmati E, Namazi G, Jahromi MP, Sarraf Z, Pazyar N, Salehi A. A Comparative Study of Potassium Hydroxide versus CO2 Laser Vaporization in The Treatment of Female Genital Warts: A Controlled Clinical Trial. Int J Community Based Nurs Midwifery. 2016;4(3):274-82.\\u003c/li\\u003e\\n\\u003cli\\u003eDiţescu D, Istrate-Ofiţeru AM, Roşu GC, Iovan L, Liliac IM, Zorilă GL, et al. Clinical and pathological aspects of condyloma acuminatum - review of literature and case presentation. Rom J Morphol Embryol. 2021;62(2):369-83.\\u003c/li\\u003e\\n\\u003cli\\u003eSindhuja T, Bhari N, Gupta S. Asian guidelines for condyloma acuminatum. Journal of Infection and Chemotherapy. 2022;28(7):845-52.\\u003c/li\\u003e\\n\\u003cli\\u003eWidschwendter A, B\\u0026ouml;ttcher B, Riedl D, Coban S, Mutz-Dehbalaie I, Matteucci Gothe R, et al. Recurrence of genitals warts in pre-HPV vaccine era after laser treatment. Arch Gynecol Obstet. 2019;300(3):661-8.\\u003c/li\\u003e\\n\\u003cli\\u003eMaggino T, Casadei D, Panontin E, Fadda E, Zampieri MC, Don\\u0026agrave; MA, et al. Impact of an HPV diagnosis on the quality of life in young women. Gynecol Oncol. 2007;107(1 Suppl 1):S175-9.\\u003c/li\\u003e\\n\\u003cli\\u003eGiuliano AR, Lee JH, Fulp W, Villa LL, Lazcano E, Papenfuss MR, et al. Incidence and clearance of genital human papillomavirus infection in men (HIM): a cohort study. 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Am J Surg Pathol. 1981;5(7):661-70.\\u003c/li\\u003e\\n\\u003cli\\u003eChardonnet Y, B\\u0026eacute;jui-Thivolet F, Viac J. [Malpighian epithelia and papillomavirus infections]. Arch Anat Cytol Pathol. 1992;40(4):202-11.\\u003c/li\\u003e\\n\\u003cli\\u003eL\\u0026auml;uchli S, Kempf W, Dragieva G, Burg G, Hafner J. CO2 laser treatment of warts in immunosuppressed patients. Dermatology. 2003;206(2):148-52.\\u003c/li\\u003e\\n\\u003cli\\u003eEftaiha MS, Amshel AL, Shonberg IL, Batshon B. Giant and recurrent condyloma acuminatum: appraisal of immunotherapy. Dis Colon Rectum. 1982;25(2):136-8.\\u003c/li\\u003e\\n\\u003cli\\u003eO\\u0026apos;Mahony C, Gomberg M, Skerlev M, Alraddadi A, de Las Heras-Alonso ME, Majewski S, et al. Position statement for the diagnosis and management of anogenital warts. J Eur Acad Dermatol Venereol. 2019;33(6):1006-19.\\u003c/li\\u003e\\n\\u003cli\\u003eAkhavan S, Mohammadi SR, Modarres Gillani M, Mousavi AS, Shirazi M. Efficacy of combination therapy of oral zinc sulfate with imiquimod, podophyllin or cryotherapy in the treatment of vulvar warts. J Obstet Gynaecol Res. 2014;40(10):2110-3.\\u003c/li\\u003e\\n\\u003cli\\u003eBatista CS, Atallah AN, Saconato H, da Silva EM. 5-FU for genital warts in non-immunocompromised individuals. Cochrane Database Syst Rev. 2010;2010(4):Cd006562.\\u003c/li\\u003e\\n\\u003cli\\u003eNambudiri VE, Mutyambizi K, Walls AC, Fisher DC, Bleday R, Saavedra AP. Successful Treatment of Perianal Giant Condyloma Acuminatum in an Immunocompromised Host With Systemic Interleukin 2 and Topical Cidofovir. JAMA Dermatology. 2013;149(9):1068-70.\\u003c/li\\u003e\\n\\u003cli\\u003eShivakumar V, Okade R, Rajkumar V. Autoimplantation therapy for multiple warts. Indian J Dermatol Venereol Leprol. 2009;75(6):593-5.\\u003c/li\\u003e\\n\\u003cli\\u003eYuan J, Ni G, Wang T, Mounsey K, Cavezza S, Pan X, Liu X. Genital warts treatment: Beyond imiquimod. Hum Vaccin Immunother. 2018;14(7):1815-9.\\u003c/li\\u003e\\n\\u003cli\\u003eGilson R, Nugent D, Werner RN, Ballesteros J, Ross J. 2019 IUSTI-Europe guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol. 2020;34(8):1644-53.\\u003c/li\\u003e\\n\\u003cli\\u003eOriel JD. Natural history of genital warts. Br J Vener Dis. 1971;47(1):1-13.\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Autotransplantation, Condyloma acuminatum, Human papillomavirus, Recurrence\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-3920846/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-3920846/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003ch2\\u003eBackground\\u003c/h2\\u003e \\u003cp\\u003eCondyloma acuminatum (CA), also known as a genital wart (GW), is a sexually transmitted disease caused by human papillomavirus (HPV). HPV lesions, recurrence tendency, and risk of malignant formation are primarily dependent on the person\\u0026rsquo;s immunity level. GW recurrence is a major challenge in CA treatment.The aim of this study was to explore how lesional autotransplantation (LT) can be used to treat coronary anemia and decrease its recurrence.\\u003c/p\\u003e\\u003ch2\\u003eMethods\\u003c/h2\\u003e \\u003cp\\u003eWe treated CA through the preparation and implantation of tissue from nine CA patients in our dermatology clinic. Transplantation of small pieces of HPV lesions to the subcutaneous fat of the inguinal region was carried out with the help of a simple surgical method under local anesthesia. Patients were followed up for six to eight months. We searched PubMed and the Web of Science for treatment options for CA to compare our treatment method recurrence rate with existing treatment options.\\u003c/p\\u003e\\u003ch2\\u003eResults\\u003c/h2\\u003e \\u003cp\\u003eDuring three months of follow-up, seven patients experienced no recurrence of condyloma lesions, while two patients experienced recurrence of small lesions of condyloma acuminatum. The recurrence rate of CA once treated by autotransplantation was relatively low compared to that of other CA treatment options.\\u003c/p\\u003e\\u003ch2\\u003eConclusions\\u003c/h2\\u003e \\u003cp\\u003eTransplantation of HPV lesions to the inguinal area reduces the recurrence rate in sexually active individuals. The 2/9 recurrence after implantation could be due to poor hygiene, sexual relationships or immune factors.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Condyloma acuminatum recurrence can be reduced by lesional autotransplantation\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2024-02-13 19:20:49\",\"doi\":\"10.21203/rs.3.rs-3920846/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"7f975fb0-b127-4220-934a-c212af04c886\",\"owner\":[],\"postedDate\":\"February 13th, 2024\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2024-03-12T08:06:28+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2024-02-13 19:20:49\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-3920846\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-3920846\",\"identity\":\"rs-3920846\",\"version\":[\"v1\"]},\"buildId\":\"qtupq5eGEP_6zYnWcrvyt\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}