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Dermatologic Therapy May 2022A role of human papilloma virus (HPV) vaccines as a therapy for genital warts was suggested, nevertheless; it has not been established in clinical trials and has yet to...
A role of human papilloma virus (HPV) vaccines as a therapy for genital warts was suggested, nevertheless; it has not been established in clinical trials and has yet to be determined. The objective of this study is to evaluate a potential benefit of intralesional injection of bivalent HPV (Cervarix) vaccine as a treatment for anogenital warts versus topical podophyllin resin 25%. Forty-four patients with anogenital warts were included in the study, 22 patients received intralesional Cervarix every 2 weeks until clearance of lesions or for a maximum of five sessions. The other 22 patients received topical podophyllin resin 25% twice weekly until complete resolution or for a maximum of 4 weeks. Follow up was done for 6 months. Dermatology life quality index (DLQI) was measured. Complete clearance of warts was achieved in 10 patients (45.5%) in Cervarix group versus six patients (27.3%) in Podophyllin group. The difference was statistically insignificant. No recurrence of warts was reported in Cervarix group while two patients (33.3%) showed recurrence in Podophyllin group. Both treatments were well tolerated. All patients reported significant improvement of their DLQI. Intralesional Cervarix is a promising modality showing higher rates of complete response, high safety, and no recurrence.
Topics: Condylomata Acuminata; Humans; Injections, Intralesional; Papillomavirus Infections; Papillomavirus Vaccines; Pilot Projects; Podophyllin; Warts
PubMed: 35170176
DOI: 10.1111/dth.15384 -
Jos Journal of Medicine 2022Condyloma acuminata is an extremely common cutaneous sexually transmitted disease often diagnosed clinically, on the basis of its warty, cauliflower, and verrucous...
BACKGROUND
Condyloma acuminata is an extremely common cutaneous sexually transmitted disease often diagnosed clinically, on the basis of its warty, cauliflower, and verrucous appearance. It is caused by the "low risk" Human papillomavirus types 6 and 11 in 90 percent of cases. The immune system plays a critical role in determining the course of viral infection, with immune-suppression and advanced age increasing the risk for long term wart persistence. Treatment options include the use of a wide variety of topical medications as well as surgical excision by cauterisation.
PATIENT
A rare case of florid vulvar warts in a 21-year old nulliparous immuno-competent woman is presented and the literature reviewed. She had a 7-month history of progressive vulva swelling with associated itching, contact bleeding, and malodorous discharge. It measured about 14 × 10 cm in dimensions, occupying the posterior two-thirds of the labia majora and minora and obliterating the posterior commissure.
INTERVENTION
There was no positive response to Podophyllin application, however, it was eventually excised and histologic analysis excluded malignancy.
CONCLUSION
Florid vulvar warts though rare in immune-competent patients, could occur. Patients with persistent and recurrent infection often require surgical procedures as was performed in our patient with the possibility of speedy recovery and restoration of normal anatomy and cosmesis.
PubMed: 38155766
DOI: No ID Found -
International Journal of Molecular... Dec 2021β-apopicropodophyllin (APP), a derivative of podophyllotoxin (PPT), has been identified as a potential anti-cancer drug. This study tested whether APP acts as an...
β-apopicropodophyllin (APP), a derivative of podophyllotoxin (PPT), has been identified as a potential anti-cancer drug. This study tested whether APP acts as an anti-cancer drug and can sensitize colorectal cancer (CRC) cells to radiation treatment. APP exerted an anti-cancer effect against the CRC cell lines HCT116, DLD-1, SW480, and COLO320DM, with IC50 values of 7.88 nM, 8.22 nM, 9.84 nM, and 7.757 nM, respectively, for the induction of DNA damage. Clonogenic and cell counting assays indicated that the combined treatment of APP and γ-ionizing radiation (IR) showed greater retardation of cell growth than either treatment alone, suggesting that APP sensitized CRC cells to IR. Annexin V-propidium iodide (PI) assays and immunoblot analysis showed that the combined treatment of APP and IR increased apoptosis in CRC cells compared with either APP or IR alone. Results obtained from the xenograft experiments also indicated that the combination of APP and IR enhanced apoptosis in the in vivo animal model. Apoptosis induction by the combined treatment of APP and IR resulted from reactive oxygen species (ROS). Inhibition of ROS by N-acetylcysteine (NAC) restored cell viability and decreased the induction of apoptosis by APP and IR in CRC cells. Taken together, these results indicate that a combined treatment of APP and IR might promote apoptosis by inducing ROS in CRC cells.
Topics: Animals; Antineoplastic Agents; Apoptosis; Cell Line, Tumor; Cell Proliferation; Cell Survival; Colorectal Neoplasms; HCT116 Cells; Humans; Mice; Mice, Inbred BALB C; Mice, Nude; Podophyllin; Radiation-Sensitizing Agents; Reactive Oxygen Species; Xenograft Model Antitumor Assays
PubMed: 34948311
DOI: 10.3390/ijms222413514 -
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 -
Skinmed 2021Dermatologists are at risk of occupational exposures to human papilloma virus (HPV); however, the required precautions during each treatment modality of warts are not...
Dermatologists are at risk of occupational exposures to human papilloma virus (HPV); however, the required precautions during each treatment modality of warts are not standardized. A self-administered online survey to investigate awareness and current practice of precautions during treatment of warts among dermatologists in Saudi Arabia was administered. A total of 228 responses were received. The most commonly used procedures for genital/other mucosal warts were liquid nitrogen (90%), electrocautery (57%), and in-clinic-administered podophyllin (51.3%). For cutaneous (non-genital) warts, the most commonly used methods for therapy were liquid nitrogen (95%) and electrocautery (77.6%). Of the respondents, 96% wore gloves while examining genital warts and 83.3% wore gloves while examining non-genital warts. The use of surgical masks during different procedures was variable from 27.7% to 76.7%. Only 38.6% always disinfected liquid nitrogen canister following use, while 49% always disinfected the electrocautery probe following use. Of the respondents, 34.65% had HPV infection, and of these, 55.7% developed warts during dermatology practice. There are variable precautions among dermatologists when dealing with HPV and further recommendations are warranted. As physicians, we gave our suggestions based on the literature review and our own opinions.
Topics: Condylomata Acuminata; Dermatologists; Humans; Papillomaviridae; Papillomavirus Infections; Saudi Arabia
PubMed: 34526201
DOI: No ID Found -
European Journal of Obstetrics,... Sep 2021Human papilloma viruses (HPV) are small epitheliotropic DNA viruses, of which there are 200 genotypes, 40 of which are known to cause genital infections and are also...
Human papilloma viruses (HPV) are small epitheliotropic DNA viruses, of which there are 200 genotypes, 40 of which are known to cause genital infections and are also oncogenic. HPV is the most common sexually transmitted infection. Clinical features vary from asymptomatic (identified at routine cervical cancer screening) to large lesions on the vulva, vagina, cervix and some extragenital sites. Its prevalence in pregnancy varies from 5.5% to 65% depending on age, geography and gestational age (increasing with gestational age). Infection in pregnancy has been associated with adverse outcomes such as spontaneous miscarriage, preterm birth, placental abnormalities and fetal growth restriction. However, the evidence for these adverse outcomes is varied. Besides being oncogenic (and thus associated with cancer of the cervix in pregnancy), vertical transmission to the fetus/neonate can cause neonatal infections, especially juvenile-onset recurrent oral and respiratory papillomatosis (JORRP). Where there are very large lesions on the vulva, delivery may be obstructed. Diagnosis in pregnancy is mainly by viral PCR or from the clinical appearance of the characteristic lesions on the vulva. Treatment is local by either surgical or laser excision or application of trichloroacetic acid. Podophyllin/podophyllotoxin is contraindicated in pregnancy. HPV Infection is not an indication for caesarean delivery as this has not been shown to prevent vertical transmission. For those diagnosed at routine cervical cancer screening, management should follow guidelines for cervical cancer screening in pregnancy. Vaccination is currently not recommended for pregnant women, although studies on those inadvertently vaccinated in pregnancy have not shown any adverse effects on either the fetus or mother.
Topics: Alphapapillomavirus; Early Detection of Cancer; Female; Humans; Infant, Newborn; Papillomaviridae; Papillomavirus Infections; Placenta; Pregnancy; Premature Birth; Uterine Cervical Neoplasms
PubMed: 34385080
DOI: 10.1016/j.ejogrb.2021.07.053 -
Journal of Complementary & Integrative... Jan 2021Royle [= (Royle) T.S. Ying] is an important, endemic medicinal plant species of Himalaya. It is used in Unani System of Medicine under the name of '. The drug was not... (Review)
Review
Royle [= (Royle) T.S. Ying] is an important, endemic medicinal plant species of Himalaya. It is used in Unani System of Medicine under the name of '. The drug was not mentioned in previous literatures, but the first time it introduced in Unani Medicine by a great scholar Hakim Najmul Ghani. He has mentioned its uses and benefits in his classical book . In Unani Medicine the plant species has been used to treat various ailments like constipation, fever, jaundice, liver disorders, syphilis, diseases of lymph glands etc. In Kashmir Himalaya it is used to treat various diseases by local medicinemen, but now it is listed in rare drugs. Various pharmacological studies have been done such as antioxidant, antimicrobial, anti-inflammatory, antifungal, radio-protective etc., recently it has also been reported that podophyllotoxin or podophyllin can be used to treat some forms of cancers also.
Topics: Medicine, Unani; Plants, Medicinal; Podophyllotoxin; Podophyllum
PubMed: 33544520
DOI: 10.1515/jcim-2020-0178 -
Dermatologic Therapy Jan 2021There are a wide variety of treatments for plantar warts, but none has been shown to be effective in all patients. We aimed to perform a systematic review of the... (Review)
Review
There are a wide variety of treatments for plantar warts, but none has been shown to be effective in all patients. We aimed to perform a systematic review of the efficacy of different topical treatments on plantar warts. Systematic electronic searches (Pubmed, Cochrane Library, Embase, and Web of Science) were conducted in April 2020. Meta-analyses, systematic reviews, and retrospective or prospective clinical trials of the effects of topical and nonsurgical treatments of plantar warts were included. Two authors performed the study selection and data extraction. Any discrepancies between the two reviewers were discussed with a third reviewer. Forty-four studies were included. The average cure rates of the most frequent treatments were variable across the studies: cryotherapy (45.61%), salicylic acid (13.6%), cantharidin-podophyllin-salicylic acid formulation (97.82%), laser (79.36%), topical antivirals (72.45%), intralesional bleomycin (83.37%), and intralesional immunotherapy (68.14%). Twenty-two studies (50%) had a level of evidence 1b and grade of recommendation A, five studies (11.4%) had a level of evidence 2b and grade of recommendation B, two studies (4.5%) had a level of evidence 3b and grade of recommendation B, and 15 studies (34,1%) with a level of evidence 4 and grade of recommendation C. First-choice treatments for common warts, such as cryotherapy and salicylic acid, have low-cure rates for plantar warts. Other treatments, such as CPA formulation, immunotherapy, and intralesional bleomycin, which have compassionate use, have higher cure rates. This review should stimulate future high-quality research to evaluate these specialized treatments.
Topics: Cryotherapy; Humans; Prospective Studies; Retrospective Studies; Salicylic Acid; Warts
PubMed: 33263934
DOI: 10.1111/dth.14621 -
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 -
Revista Internacional de Andrologia 2021The treatment of condyloma is generally a challenge in clinical practice. Although the spontaneous resolution rate is high, a significant proportion of patients seek...
The treatment of condyloma is generally a challenge in clinical practice. Although the spontaneous resolution rate is high, a significant proportion of patients seek treatment, not because of symptomatology, but mainly for aesthetic issues and concerns related to the transmission or worsening of existing lesions. The available treatments should be applied only for clinically evident macroscopic lesions. Ideally, available therapies should have rapid action onset and clearance, resolve symptoms, reduce recurrence rate and viral load, be effective in treating small lesions, and be well tolerated. However, none of the currently available treatments is clearly more effective than the others and there is no ideal treatment for all patients or for all condyloma. Therefore, the therapeutic decision should be based on the clinician's experience, available resources, lesion morphology, size, number and location, primary or recurrent lesions, disease severity, patient preference and expectations, patient's immune competence, convenience, tolerance, cost of treatment and results of previous therapies. The available treatments are divided into three groups: applied by the patient himself (imiquimod 3.75 or 5%, podophyllotoxin .5%, synecatekines 10% or 15%), applied by the health care provider (bi- and tricloacetic acids 80%-90%, intralesional interferon alpha, cryotherapy, surgical removal, electrofulguration, laser ablation) and experimental or alternative therapies (topical cidofovir, intralesional bleomycin, photodynamic therapy). Treatment methodologies can be further divided into their action - ablative or destructive treatment (cryotherapy, electrofulguration, laser ablation, surgical excision), cytotoxic or proapoptotic treatments (podophyllotoxin .5%, 5-fluoruracil, bleomycin) and immunomodulatory treatments (imiquimod 3.75% or 5%, synecatekines 10% or 15%, intralesional interferon alpha). The overall success rate of the various treatments available ranges from 23% to 94%. Only treatments that include cryotherapy or surgical excision are suitable in condyloma with any anatomical location and that have the highest success rate in monotherapy. Recurrences are common regardless of the treatment received. In contrast, immunomodulatory therapies despite having lower initial clearance rates appear to have higher probabilities of cure in the medium term, with low recurrence rates. Some treatments may be combined with each other and the effectiveness of combined therapies appears to be superior to monotherapy (proactive sequential treatment). The consensuses for the treatment of HPV also consider special situations: immunocompromised patients, meatus and intraurethral lesions and treatment of the partner.
Topics: Adjuvants, Immunologic; Aminoquinolines; Andrology; Antimetabolites; Antiviral Agents; Condylomata Acuminata; Consensus; Cryotherapy; Decision Making; Humans; Immunologic Factors; Interferons; Keratolytic Agents; Papillomavirus Infections; Podophyllin; Podophyllotoxin; Portugal; Practice Guidelines as Topic; Warts
PubMed: 32684426
DOI: 10.1016/j.androl.2020.01.007