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HIV-positive men who have sex with men (MSM) are at high risk of developing human papillomavirus-associated anal squamous cell cancer. Similar to the management of cervical dysplasia, clinicians are treating high-grade anal dysplasia to prevent progression to cancer. Initial treatments such as cold scalpel excision and electrofulguration have shown limited efficacy in a HIV-positive population. Infrared coagulation (IRC) is an outpatient treatment for high-grade anal dysplasia. This retrospective clinical study reports on 68 HIV-positive MSM with 78 biopsy proven high-grade anal lesions. Each lesion was treated with the IRC with re-biopsy of the treatment site a mean of 140 days later. Of the 74 evaluable lesions; 39 had anal intraepithelial neoplasia (AIN) 1, 20 had AIN 2, seven had AIN 3, and eight had normal epithelium. The IRC showed 64% efficacy per treated lesion and shows promise as a treatment modality for high-grade anal dysplasia in this population.

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PURPOSE: Electrogalvanic stimulation and biofeedback therapy for the treatment of intractable anorectal pain have been reported. However, these therapeutic modalities have some disadvantages and insufficient effectiveness. We noticed that digital examination revealed the strongly tender point in both lateral sides of the rectum and introduced linearly polarized near-infrared irradiation therapy to the strongly tender point. The purpose of this study was to review the outcomes and estimate its usefulness. METHODS: A total of 35 consecutive patients complained of vague and deep pain in the anorectum. Fourteen patients had a history of lower abdominal surgery. Eighteen patients had disordered defecation. The linearly polarized near-infrared light was irradiated to the strongly tender point on or a few centimeters apart from the skin for ten minutes. The effect of the therapy was assessed as excellent, good, no change, or worse by the patients themselves. RESULTS: Ten patients had the strongly tender point in the left side, 8 in the right posterior, and 17 in both. Five patients estimated as excellent, 28 as good, and 2 as no change. Mean total number of irradiation was 18.8 (range, 1-235), and mean number of irradiation for relief from pain was 2.5 (range, 1-9). Anorectal pain recurred in four patients, who received the same therapy and improved. Four patients felt hot during the irradiation, and a patient had frequent micturition after the irradiation. These mild complications easily disappeared. CONCLUSION: The linearly polarized near-infrared irradiation therapy is a simple, safe, and effective modality for relief from intractable anorectal pain and recommended for primary therapy.

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BACKGROUND: Treatment of anogenital warts is difficult in that the disease spectrum is wide. Moreover, varying degrees of improvement are obtained. OBJECTIVE: To study the treatment of persistent anogenital warts by pulsed dye laser. METHODS: Pulsed dye laser was used with the following settings: spot size 7 mm, pulse duration 1500 microsec, and fluence 7.5 J/cm2. Two different wavelengths were used: 585 and 595 nm. RESULTS: Lesions healed completely using both wavelengths after one treatment. CONCLUSION: Pulsed dye laser has been found to be safe, effective, satisfactory, and less traumatic compared to other options for treatment of perianal warts in children.

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We report a case of a highly recurrent giant perianal condyloma, or Buschke-Lowenstein tumor, which was successfully treated by telecobalt therapy. We conclude that radiation therapy is an optional treatment modality for the management of giant perianal condylomata in selected cases.

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We present here the case of a patient with Buschke-Löwenstein tumor of the anus complicated by invasive squamous cell carcinoma metastatic to the inguinal and periaortic pelvic lymph nodes. Successful local palliation was achieved with 5-fluorouracil and mitomycin-C-based chemotherapy combined with radiation therapy, but systemic progression was unaffected.

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Report on empirical data of X-ray treatment of dermatoses in the genital area, concerning indications, technique and results. Irradiations are mainly successful in large patches of Bowen's disease and Bowen's carcinoma as well as in Queyrat's erythroplasia and Paget's disease. Carcinomata of the penis should not exceed the stages T1-T2. Regression of Peyronie's disease is accelerated. Psoriatic lesions disappear following Grenz-rays without further topical treatment. Grenz-rays can also prevent or delay local recurrences of herpes simplex eruptions in the genital area.

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