Failure of isotretinoin and interferon-alpha combination therapy for HPV-linked severe vulvar dysplasia. A report of two cases.
BACKGROUND
Retinoids (RA) and interferon (IFN) have been reported to be active against a variety of tumors and human papillomavirus (HPV)-related lesions. Because chronic and recurrent HPV-linked vulvar intraepithelial neoplasia 3 (VIN 3) have a high risk of invasion, we evaluated combined therapy of IFN-alpha with 13-cis-retinoic acid (13 cRA) in the treatment of two VIN 3 cases of this type.


METHODS
Two patients with chronic and recurrent VIN 3 were treated with combined therapy of IFN-alpha (4.5 x 10(6) five times a week) and 13 cRA (1 mg/kg/d) for six months. Clinical regression was observed at the end of treatment in both cases, but histologic features of VIN 3 were still present.


CONCLUSIONS
These data demonstrate the ineffectiveness of the combined regimen of IFN-alpha and 13 cRA with this schedule for a period of six months in recurrent and chronic VIN 3.
Vilmer
C
C
Department of Dermatology, Hôpital Saint-Louis, Paris, France.
Havard
S
S
Cavelier-Balloy
B
B
Pelisse
M
M
Dubertret
L
L
Leibowitch
M
M
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D015474:Isotretinoin / Q000008:administration & dosage*; D007641:Keratolytic Agents / Q000008:administration & dosage*; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000188:drug therapy*; D017211:Treatment Failure; D016896:Treatment Outcome; D014844:Vulva / Q000473:pathology / Q000821:virology; D014846:Vulvar Neoplasms / Q000188:drug therapy* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000150:complications
D016898:Interferon-alpha; D007641:Keratolytic Agents; D015474:Isotretinoin