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Indian Journal of Critical Care... Jun 2020Accidental poisoning in children is very common, making up 10.9% of all unintentional injuries worldwide. Africa has the highest incidence of fatal poisonings worldwide,...
Accidental poisoning in children is very common, making up 10.9% of all unintentional injuries worldwide. Africa has the highest incidence of fatal poisonings worldwide, at 4 per 100,000. Poisoning with podophyllin is rare, with most cases documented around the 1970s to 1980s. Podophyllin is a resin mixture obtained from the dried Rhizome and roots of (North America) and (India). Podophyllotoxin is the most toxic chemical present in the podophyllin, which is lipid soluble; so crosses the cell membrane easily and inhibits mitotic spindle formation. Both topical application and oral consumption can cause podophyllin poisoning. Neurotoxicity is the most serious effect along with bone marrow depression, gastrointestinal irritation, and hepatic and renal dysfunction. Management of podophyllin toxicity is mainly symptomatic, and no specific antidote exists. We report a case of a 2-year-old-year girl with accidental podophyllin poisoning, who presented with neurotoxicity followed by multiorgan dysfunction and then succumbed. Education of parents and healthcare workers on home safety still remains the mainstay of prevention. Jain MK, Patnaik S, Rup AR, Gaurav A. A Rare Case of Podophyllin Poisoning: Early Intervention is Lifesaving. Indian J Crit Care Med 2020;24(6):477-479.
PubMed: 32863644
DOI: 10.5005/jp-journals-10071-23448 -
Sexually Transmitted Infections Dec 2017Anogenital warts (AGW, condylomata acuminata) and intraepithelial neoplasia (IEN) do not only impact health and social well-being, they are also associated with... (Meta-Analysis)
Meta-Analysis Review
Anogenital warts and other HPV-associated anogenital lesions in the HIV-positive patient: a systematic review and meta-analysis of the efficacy and safety of interventions assessed in controlled clinical trials.
OBJECTIVES
Anogenital warts (AGW, condylomata acuminata) and intraepithelial neoplasia (IEN) do not only impact health and social well-being, they are also associated with considerable costs for the healthcare systems. Immunocompromised and HIV-positive patients carry the highest epidemiological burden of human papillomavirus (HPV) infection and comprise a population specifically susceptible to treatment failures and recurrences. This systematic review aimed at identifying and appraising the available evidence from controlled studies of interventions for the treatment of AGW and IEN in immunocompromised patients.
METHODS
We conducted a comprehensive literature search. The Cochrane Collaboration's tool was used to assess risk of bias in included studies. Our confidence in the (pooled) effect-estimates was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation approach. All evaluations were based on data independently extracted by two review authors.
RESULTS
Nine randomised controlled trials and two controlled studies were eligible, investigating external AGW, intra-anal and/or vaginal warts, and intra-anal and/or perianal IEN. The identified studies assessed imiquimod, cidofovir, fluorouracil, electrocautery, systemic interferon-α and interferon-β, and the combination of intralesional interferon-α and podophyllin. Four studies combined an ablational intervention with either imiquimod, cidofovir, intralesional or systemic interferon-α. One study investigated an experimental therapeutic vaccination (HPV 16 E7) at different concentrations.
CONCLUSIONS
The quality of the evidence ranged from 'very low' to 'moderate' and was limited by the often small samples. Evidence was available for the efficacy of electrocautery for intra-anal IEN, and imiquimod cream for external AGW. Some further interventions should be subjected to investigations in larger samples. No data on some interventions established for the treatment of AGW in immunocompetent patients such as podophyllotoxin, sinecatechins, laser ablation or trichloroacetate were available. Future trials should address these gaps and include relevant patient-reported outcomes such as health-related quality of life.
Topics: Aminoquinolines; Antiviral Agents; Anus Diseases; Coinfection; Female; Genital Diseases, Female; Genital Diseases, Male; HIV Seropositivity; Humans; Imiquimod; Immunocompetence; Male; Neoplasm Recurrence, Local; Papillomavirus Infections; Randomized Controlled Trials as Topic; Warts
PubMed: 28637906
DOI: 10.1136/sextrans-2016-053035 -
American Family Physician Sep 2014Genital warts affect 1% of the sexually active U.S. population and are commonly seen in primary care. Human papillomavirus types 6 and 11 are responsible for most...
Genital warts affect 1% of the sexually active U.S. population and are commonly seen in primary care. Human papillomavirus types 6 and 11 are responsible for most genital warts. Warts vary from small, flat-topped papules to large, cauliflower-like lesions on the anogenital mucosa and surrounding skin. Diagnosis is clinical, but atypical lesions should be confirmed by histology. Treatments may be applied by patients, or by a clinician in the office. Patient-applied treatments include topical imiquimod, podofilox, and sinecatechins, whereas clinician-applied treatments include podophyllin, bichloroacetic acid, and trichloroacetic acid. Surgical treatments include excision, cryotherapy, and electrosurgery. The quadrivalent human papillomavirus vaccine is active against virus subtypes that cause genital warts in men and women. Additionally, male circumcision may be effective in decreasing the transmission of human immunodeficiency virus, human papillomavirus, and herpes simplex virus.
Topics: Administration, Topical; Adult; Antineoplastic Agents; Combined Modality Therapy; Condylomata Acuminata; Cryotherapy; Diagnosis, Differential; Electrosurgery; Female; Human papillomavirus 11; Humans; Keratolytic Agents; Male; Papillomavirus Infections; Papillomavirus Vaccines; Precancerous Conditions; Urogenital Surgical Procedures
PubMed: 25251091
DOI: No ID Found -
International Journal of STD & AIDS Aug 2023Many therapeutic modalities are available for treating genital warts; however, the effectiveness of both diphenylcyclopropenone and podophyllin is still controversial. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Many therapeutic modalities are available for treating genital warts; however, the effectiveness of both diphenylcyclopropenone and podophyllin is still controversial.
AIM
To evaluate the effectiveness and safety of diphenylcyclopropenone and podophyllin in treating genital warts.
METHODS
This study included 57 patients, divided randomly into two groups. Group (A): diphenylcyclopropenone ( = 29). Group (B): podophyllin 25% ( = 28). In group (A), sensitization was done with 2% diphenylcyclopropenone. Then, after 1 or 2 weeks, treatment started with a weekly application of diphenylcyclopropenone solutions ranging between 0.001 and 1% until clearance, or for a maximum of 10 sessions. In group (B), podophyllin 25% was applied weekly until clearance or for a maximum of 6 weeks.
RESULTS
Higher clearance was achieved in group A, with 19 of 29 (65.5%) patients, than in group B, with 9 of 28 (32.1%) (-value = 0.004). Also, effectiveness increases with young age in group A. Shorter wart duration was associated with better response in both groups (-value = 0.005). No serious adverse effects occurred in either group. No recurrence was detected in group A, while seven patients (77.8%) had recurrence in group B after 1 year of follow up.
CONCLUSION
Diphenylcyclopropenone shows a higher success rate than podophyllin in treating genital warts and a lower recurrence rate.
Topics: Humans; Condylomata Acuminata; Cyclopropanes; Podophyllin; Warts
PubMed: 37018551
DOI: 10.1177/09564624231169330 -
JAMA Dermatology Oct 2016
Topics: England; History, 17th Century; History, 18th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Medieval; Humans; North America; Podophyllin
PubMed: 27732733
DOI: 10.1001/jamadermatol.2015.6301 -
Dermatologic Therapy Nov 2019Patients often request treatment of their burdensome cutaneous warts. However, a safe and effective treatment for cutaneous warts is lacking. This study evaluates...
Patients often request treatment of their burdensome cutaneous warts. However, a safe and effective treatment for cutaneous warts is lacking. This study evaluates treatment outcome, side effects, and patient satisfaction after topical application of cantharidin 1% podophyllin 2% salicylic acid 30% (CPS1) solution in a large series of children and adults with cutaneous warts. Fifty-two children and 83 adults with warts, treated with CPS1 solution between October 2012 and October 2014, were included. Complete clearance of warts occurred in 86.5% of children and 62.7% of adults treated with CPS1 solution (p < .01). Resolution of warts was partial in 3.9 and 24.1% and absent in 9.6 and 13.2% of children and adults respectively. Side effects were present in 41.2% of children and 46.3% of adults (p = .7). Most common side effects were blistering, pain, and burning sensation. No serious adverse events occurred. On a 10-point scale, median patient satisfaction score was 9.0 (interquartile range 7.8-10.0) and 8.0 (interquartile range 5.1-9.7) for children and adults respectively (p < .01). CPS1 solution is a safe and promising treatment modality with a high clearance and high patient satisfaction rate for the management of cutaneous warts, particularly in children.
Topics: Administration, Cutaneous; Adult; Age Factors; Cantharidin; Child; Cohort Studies; Female; Humans; Keratolytic Agents; Male; Patient Satisfaction; Podophyllin; Retrospective Studies; Salicylic Acid; Treatment Outcome; Warts
PubMed: 31664756
DOI: 10.1111/dth.13143 -
The Journal of Dermatological Treatment Mar 2022
Topics: Administration, Cutaneous; Condylomata Acuminata; Humans; Podophyllin; Salicylic Acid; Warts
PubMed: 32643462
DOI: 10.1080/09546634.2020.1793882 -
Evidence-based Complementary and... 2021Lindua (), a strong antiviral traditional medicine, can be used to treat condyloma acuminata (CA) caused by the human papillomavirus (HPV). However, its molecular...
Lindua (), a strong antiviral traditional medicine, can be used to treat condyloma acuminata (CA) caused by the human papillomavirus (HPV). However, its molecular mechanism for CA elimination is unknown. Herein, we conducted a randomized clinical trial to evaluate the effectiveness of and its molecular mechanism compared with podophyllin, the gold standard treatment. Using a randomized block design, six patients were treated with and podophyllin for four weeks. Efficacy of drugs was assessed by size reduction of the warts and HPV viral load quantification using droplet digital PCR. The gene expression profiling of CA was analyzed using NanoString Technology. After the podophyllin and treatments, CA lesion sizes were reduced to 97.0% and 84.4% clearance, and the HPV viral loads were reduced by 74.0% and 46.6%, respectively. The gene expression pattern of immune profiling showed that 23 genes (i.e., , and ) were significantly differentially expressed by podophyllin, whereas 2 genes ( and ) were remarkably expressed by In inflammatory profiling, 108 genes (i.e., , , and ) were highly expressed by podophyllin, but none of genes were observed to change expression by These results suggested that podophyllin may reduce the HPV infection through a mechanism related to proinflammatory response. In addition, was found to suppress the HPV infection through mechanism related to the activation of immune response. This study shows novel therapeutic mechanisms of podophyllin and . It is suggested that might be used as an alternative treatment for CA treatment.
PubMed: 34567214
DOI: 10.1155/2021/5579520 -
Evidence-based Complementary and... 2022Human papillomavirus (HPV) infection causes condyloma acuminata (CA). Podophyllin is the standard treatment. (), a medicinal plant, has potent anti-inflammatory and...
Human papillomavirus (HPV) infection causes condyloma acuminata (CA). Podophyllin is the standard treatment. (), a medicinal plant, has potent anti-inflammatory and antiviral effects. cream is widely used in Thailand to treat the herpes simplex virus. We proposed that might also induce CA clearance. There are no studies of treatment of CA. This randomized controlled trial at Siriraj Hospital, Thailand, was conducted between January 2018 and December 2019. CA samples were obtained from 10 men with at least two CAs 1 centimeter apart. Each wart was randomized to a 4-week treatment with either or podophyllin. The participants were 24 to 72 years old. Most HPV types were low-risk HPVs (HPV 11, HPV 6). Median CA clearance with podophyllin was a 97% CA clearance with podophyllin and 82% with . may be an alternative treatment for CA.
PubMed: 35783521
DOI: 10.1155/2022/1577716 -
Journal of the European Academy of... Apr 2016Paclitaxel and docetaxel are antineoplastic drugs that bind the microtubules, producing the arrest of mitoses, which may be seen histopathologically. These...
BACKGROUND
Paclitaxel and docetaxel are antineoplastic drugs that bind the microtubules, producing the arrest of mitoses, which may be seen histopathologically. These histopathologic changes may simulate an intraepidermal keratinocytic malignant neoplasm, and an accurate diagnosis may be only established by clinicopathological correlation.
OBJECTIVES
We report six cases of cutaneous eruptions by taxanes in which a striking cytotoxic effect was evident histopathologically.
METHODS
Cutaneous biopsies were obtained in each patient.
RESULTS
Atypical starburst-like or ring-like mitoses and dyskeratosis on basal and suprabasal layers of the epidermis. Areas of squamous syringometaplasia were also seen in one case.
DISCUSSION
These findings were interpreted as expression of mitotic arrest due to taxanes. Similar changes have been described in association with other chemotherapeutic drugs such as vincristine, podophyllin and its derivative etoposide; colchicine, busulfan and maytansine, but cases like ours due to taxanes are exceptional or under-reported.
CONCLUSION
Dermatopathologists should be aware of these effects in order to interpret carefully cutaneous biopsy specimens of patients receiving taxanes.
Topics: Bridged-Ring Compounds; Diagnosis, Differential; Exanthema; Female; Humans; Male; Middle Aged; Skin; Skin Neoplasms; Taxoids
PubMed: 26558745
DOI: 10.1111/jdv.13475