Patients with human immunodeficiency virus (HIV) disease are more likely to develop anogenital
warts (AGW) compared to HIV-negative people, and are susceptible to treatment failures and illness
recurrences. Glycyrrhizinic acid (GA) is extracted from licorice root (Glycyrrhiza glabra). Previous
studies have demonstrated the efficacy of GA 0.1% spray as a treatment for external AGW, but its role
in immunocompromised patients has not been explored. The current study reported two cases of
HIV-positive patients with AGW who experienced partial remission using GA 0.1% spray. The treatment was applied by the patients three times a day for eight weeks. Treatment evaluation were made
by using visual inspection and dermoscopy image analysis. After twelve weeks, clinical observation
revealed poor improvement with only slight reduction in number and size of the lesions; although
dermoscopy findings revealed an evolution from finger-like to knob-like pattern. GA facilitate the development of T helper lymphocytes in cell-mediated immune response, whereas in HIV, there are a decreased number of T helper lymphocytes. This may explain poor therapeutic response in our patient.
Dermoscope is useful in the evaluation of treatment progress, especially when invisible to unaided eye.