Management Recommendations of Chin-Hong and Palefsky for a Patient with an Anal HPV Infection

Description

Chin-Hong and Palefsky listed recommendations for managing a patient with anal HPV infection. The authors are from the University of California at San Francisco.

Parameters:

(1) grade of anal intraepithelial neoplasia (AIN) on biopsy

(2) location of disease (intra-anal vs perianal disease)

(3) size of lesion (small, medium or large)

(4) symptomatic or not

Grade	Location	Size	Symptomatic	Option
AIN I	intra-anal	small	NA	A, B
AIN I	intra-anal	medium or large	asymptomatic	A
AIN I	intra-anal	medium or large	symptomatic	A, C
AIN I	perianal	small	NA	A, D
AIN I	perianal	medium or large	asymptomatic	A
AIN I	perianal	medium or large	symptomatic	A, C
AIN II or III	intra-anal	small	NA	A, B
AIN II or III	intra-anal	medium	NA	A, C
AIN II or III	intra-anal	large	asymptomatic	A
AIN II or III	intra-anal	large	symptomatic	A, C
AIN II or III	perianal	small	NA	A, D
AIN II or III	perianal	medium or large	NA	A, C

Option	Management
A	Followup every 6 months
B	Treat with 80% trichloroacetic acid, cryotherapy and/or liquid nitrogen.
C	Biopsy with fulguration and/or laser therapy.
D	Treat with imiquimod, podophyllotoxin, 80% trichloroacetic acid, and/or liquid nitrogen.

where:

• Imiquimod and podophyllotoxin have not been approved for this indication by the US FDA.

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Description

Specialty

ICD-10