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Journal of Medical Case Reports Mar 2022Buschke-Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma...
BACKGROUND
Buschke-Löwenstein tumor is a giant condyloma acuminata infection that is characterized by degeneration, invasion, and recurrence. It is associated with human papilloma virus infection. It develops around the genital and perineal area, sometimes causing a large budding ulcerated lesion. Although human immunodeficiency virus infection is frequent in Africa, there are few descriptions of Buschke-Löwenstein tumor diagnosis and its management. Screening for other sexually transmitted infections must be systematic among these patients.
CASE PRESENTATION
We report herein the case of a 21-year-old African origin male patient who developed a perineal swelling. Physical examination showed evidence of a huge exophytic tumor made up of budding pinkish vegetations, with serrated crests, a ''butterfly wing'' structure, and a cauliflower-like appearance crowned with centrifugal circinate lesions. Multiple condylomatous lesions of the anal margin were also present. The patient tested positive for human immunodeficiency virus (cluster of differentiation 4 count of 119 cells/mm) and hepatitis B infections. Real-time polymerase chain reaction revealed human papilloma virus-16 and other high-risk human papilloma virus deoxyribonucleic acid. The diagnosis of Buschke-Löwenstein tumor was made on mass biopsy, and the patient underwent multidisciplinary intervention (surgery, podophyllin application, and antiretroviral therapy). Medium-term evolution was, however, fatal due to opportunistic infection.
CONCLUSION
Buschke-Löwenstein tumor is a rare tumor associated with human immunodeficiency virus infection. It is more frequent in male human immunodeficiency virus-positive patients. There is a need to screen for other sexually transmitted infections. In most cases, the treatment is surgical, in association with local therapies. However, recurrences are common.
Topics: Acquired Immunodeficiency Syndrome; Adult; Buschke-Lowenstein Tumor; HIV; HIV Infections; Humans; Male; Papillomavirus Infections; Young Adult
PubMed: 35303943
DOI: 10.1186/s13256-022-03339-1 -
Indian Dermatology Online Journal 2022Podophyllin is a cytotoxic material extracted from and and is widely used for the treatment of genital warts. This article reviews the chemistry of podophyllin and its...
Podophyllin is a cytotoxic material extracted from and and is widely used for the treatment of genital warts. This article reviews the chemistry of podophyllin and its active components along with the mechanism of action in various dermatoses. Furthermore, the documented uses of podophyllin in various dermatological disorders have been described along with the side effects of the drug. Based on the available literature, a clinical guideline is being proposed so as to minimize the side effects. Further studies should be carried out on its use in a lower concentration in other dermatoses, especially premalignant and malignant skin diseases.
PubMed: 35198500
DOI: 10.4103/idoj.idoj_225_21 -
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 -
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 -
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 -
Revista Do Instituto de Medicina... 2019HPV clinical manifestations have their characteristics modified by the use of combined antiretroviral therapy (cART), although its incidence is unaffected by cART. We...
HPV clinical manifestations have their characteristics modified by the use of combined antiretroviral therapy (cART), although its incidence is unaffected by cART. We report an unusual presentation of oral HPV infection and discuss an effective treatment for disseminated HPV lesions. A 52-year-old male of Asian-origin, HIV-seropositive, presented with extensive nodular lesions throughout the oral mucosa extending to the oropharyngeal region. Biopsy followed by histopathological examination and HPV genotyping were performed. The treatment was initiated with topical application of podophyllin and trichloroacetic acid. HPV lesions in oral mucosa are generally easy to handle. Extensive lesions can make it difficult to choose an effective treatment that meets the patient's particularities and medication availability.
Topics: AIDS-Related Opportunistic Infections; Anti-Retroviral Agents; Humans; Male; Middle Aged; Mouth Diseases; Papillomavirus Infections; Podophyllin; Trichloroacetic Acid
PubMed: 31618374
DOI: 10.1590/S1678-9946201961054