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Experimental and Therapeutic Medicine Jun 2022Giant condyloma acuminatum (GCA), or Buschke-Löwenstein tumor (BLT), represents an infrequent sexually transmitted disease (STD), caused by human papillomavirus (HPV),...
Giant condyloma acuminatum (GCA), or Buschke-Löwenstein tumor (BLT), represents an infrequent sexually transmitted disease (STD), caused by human papillomavirus (HPV), especially genotype 6 or 11. There are numerous risk factors for HPV, such as multiple sexual partners, homosexuality, prostitution, chronic genital infections, as well as the lack of proper hygiene. HPV infection is a field infection, where large areas of cells at a tissue surface are affected by the HPV virus; therefore, once the GCA is excised, treatment of the whole affected genital area needs to be undertaken. The treatment is classified into topical therapy (podophyllin, 5-FU, radiotherapy, topical photodynamic therapy), excisional therapy (CO laser, cryotherapy, electrotherapy, surgery) and immunotherapy (imiquimod). However, the 'gold standard' therapy is represented by wide surgical excision without grafting, since it is considered that healing is an improved approach, because there is no risk of recurrences on fibrotic tissue. A total of 7 cases of the BLT with comorbidities and particularities are presented and it is recommended that it be taken into consideration that the incidence of the disease is increasing, emphasizing the importance of an early diagnosis, as well as an adequate treatment.
PubMed: 35495587
DOI: 10.3892/etm.2022.11320 -
Journal of Medical Case Reports Apr 2023Topical anesthetics are commonly used over the counter, and one of the adverse effects of these medications is methemoglobinemia, which is a serious and life-threatening...
BACKGROUND
Topical anesthetics are commonly used over the counter, and one of the adverse effects of these medications is methemoglobinemia, which is a serious and life-threatening condition.
CASE PRESENTATION
We describe a 25-year-old Persian male presenting with generalized weakness, dizziness, headache, and cyanosis. In addition, he had genital warts starting 3 weeks ago, which were self-treated with podophyllin, resulting in itching and pain. He used over-the-counter topical anesthetics, including benzocaine and lidocaine, to reduce the symptoms. According to the lab data, signs and symptoms of methemoglobinemia and hemolysis were diagnosed. Considering the hemolysis, ascorbic acid was used for treatment. The patient was discharged after 5 days with normal arterial blood gas and pulse oximetry and no signs and symptoms.
CONCLUSION
This case highlights that self-administration of some topical anesthetics may lead to potentially fatal conditions.
Topics: Male; Humans; Adult; Benzocaine; Methemoglobinemia; Anesthetics, Local; Lidocaine; Hemolysis; Methylene Blue
PubMed: 37076913
DOI: 10.1186/s13256-023-03898-x -
The British Journal of Venereal Diseases Jun 1981One hundred and forty male patients with ano-genital warts were randomly allocated to a double-blind study of 10% and 25% podophyllin in tincture of benzoin compound.... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
One hundred and forty male patients with ano-genital warts were randomly allocated to a double-blind study of 10% and 25% podophyllin in tincture of benzoin compound. One hundred and nine patients attended for a three-month period of surveillance. Only 24 (22%) patients were free of warts after having podophyllin treatment alone, 12 each after treatment with 10% and 25% podophyllin. There was no significant difference in the number of applications needed with each treatment. Neither hypersensitivity nor chemical ulceration occurred.
Topics: Anus Diseases; Clinical Trials as Topic; Double-Blind Method; Genital Diseases, Male; Humans; Male; Podophyllin; Random Allocation; Warts
PubMed: 7016248
DOI: 10.1136/sti.57.3.208 -
Genitourinary Medicine Aug 1988The increasing incidence of genital warts has led to more public awareness of this infection and its possible sequelae. Currently available treatment remains... (Comparative Study)
Comparative Study
The increasing incidence of genital warts has led to more public awareness of this infection and its possible sequelae. Currently available treatment remains unsatisfactory, and there is pressure to develop effective and convenient alternatives. Podophyllotoxin is standardised and stable, whereas podophyllin has a variable composition. In an open comparison of self applied podophyllotoxin 0.5% versus podophyllin 20% applied by a doctor to treat external penile warts, podophyllotoxin was more effective and gave quicker resolution than podophyllin. Side effects were similar for both preparations, and few patients experienced complications severe enough to stop treatment. Podophyllotoxin can therefore be used safely and effectively for home treatment monitored at an outpatient clinic and provides a useful alternative to treatment with podophyllin at overburdened genitourinary medicine clinics.
Topics: Adult; Condylomata Acuminata; Humans; Male; Middle Aged; Penile Neoplasms; Podophyllin; Podophyllotoxin; Self Administration
PubMed: 3169757
DOI: 10.1136/sti.64.4.263 -
Journal of the American Academy of... May 1992The mechanisms of action for local treatments used against condylomata acuminata are unknown, but most are believed to cause physical destruction of infected tissue. (Comparative Study)
Comparative Study
Detection with the polymerase chain reaction of human papillomavirus DNA in condylomata acuminata treated in vitro with liquid nitrogen, trichloroacetic acid, and podophyllin.
BACKGROUND
The mechanisms of action for local treatments used against condylomata acuminata are unknown, but most are believed to cause physical destruction of infected tissue.
OBJECTIVE
Our purpose was to determine whether liquid nitrogen, trichloroacetic acid (TCA), and podophyllin damage HPV DNA found in condylomata acuminata.
METHODS
Fourteen genital warts were excised from 14 patients and divided. One part was treated with liquid nitrogen, the second and third parts were treated with TCA and podophyllin, respectively, and the remainder served as a control. DNA was then extracted from tissue by proteolytic digestion and amplified by the polymerase chain reaction. Dot blots were performed with the use of radiolabeled consensus and HPV type-specific probes.
RESULTS
HPV DNA was amplified and detected in 100% of untreated specimens, in 92% of specimens treated with liquid nitrogen, and in 15% and 7% of specimens treated with podophyllin and TCA, respectively.
CONCLUSION
TCA and podophyllin damage HPV DNA more effectively than does liquid nitrogen.
Topics: Biopsy; Condylomata Acuminata; Cryosurgery; DNA, Viral; Evaluation Studies as Topic; Humans; Immunoblotting; Nucleic Acid Hybridization; Papillomaviridae; Podophyllin; Polymerase Chain Reaction; Trichloroacetic Acid
PubMed: 1316388
DOI: 10.1016/0190-9622(92)70097-y -
Gut Sep 1996
Review
Topics: Cathartics; Colonic Diseases; Humans; Podophyllin; Substance-Related Disorders
PubMed: 8949659
DOI: 10.1136/gut.39.3.486 -
Bulletin of the New York Academy of... Jul 1973
Review
Topics: Administration, Topical; Adolescent; Age Factors; Anti-Inflammatory Agents; Boric Acids; Child; Child, Preschool; Female; Glucocorticoids; Hexachlorophene; Humans; Infant; Infant, Newborn; Male; Mercury Poisoning; Permeability; Phenols; Pituitary-Adrenal System; Podophyllin; Resins, Plant; Resorcinols; Salicylates; Skin Absorption; Toxicology; Triamcinolone
PubMed: 4575969
DOI: No ID Found -
Sexually Transmitted Infections Aug 2003To evaluate the efficacy and cost effectiveness of self applied podophyllotoxin 0.5% solution and podophyllotoxin 0.15% cream, compared to clinic applied 25% podophyllin... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
OBJECTIVES
To evaluate the efficacy and cost effectiveness of self applied podophyllotoxin 0.5% solution and podophyllotoxin 0.15% cream, compared to clinic applied 25% podophyllin in the treatment of genital warts over 4 weeks.
METHODS
We conducted a randomised controlled trial in 358 immunocompetent men and women with genital warts of 3 months' duration or less.
RESULTS
In the principal analysis both podophyllotoxin solution (OR 2.93, 95% CI 1.56 to 5.50) and podophyllotoxin cream (OR 1.97, 95% CI 1.04 to 3.70) were associated with significantly increased odds of remission of all warts compared to podophyllin. We performed two further analyses. When subjects defaulting from follow up were assumed to have been cured odds of remission of all warts were also significantly increased both for podophyllotoxin solution (OR 3.04, 95% CI 1.68 to 5.49) and for podophyllotoxin cream (OR 2.46, 95% CI 1.38 to 4.40). When subjects defaulting from follow up were assumed not to have been cured odds of remission of all warts were significantly increased for podophyllotoxin solution (OR 1.92, 95% CI 1.13 to 3.27), but not for podophyllotoxin cream (OR 1.17, 95% CI 0.69 to 2.00). Local side effects were seen in 24% of subjects, and recurrence of warts within 12 weeks of study entry in 43% of all initially cleared subjects, without statistically significant differences between the treatment groups. Direct, indirect, and total costs were similar across the three treatment groups. Podophyllotoxin solution was the most cost effective treatment, followed by podophyllotoxin cream, with podophyllin treatment being the least cost effective.
CONCLUSIONS
Self treatment of anogenital warts with podophyllotoxin showed greater efficacy and cost effectiveness than clinic based treatment with podophyllin.
Topics: Adolescent; Adult; Aged; Anus Neoplasms; Condylomata Acuminata; Cost-Benefit Analysis; Drug Costs; Female; Humans; Immunocompromised Host; Keratolytic Agents; Male; Middle Aged; Ointments; Podophyllotoxin
PubMed: 12902571
DOI: 10.1136/sti.79.4.270 -
Genitourinary Medicine Oct 1991to compare the response to treatment and recurrence rate of condylomata accuminata using subcutaneous injection of interferon alfa 2a 1.5 million units three times... (Clinical Trial)
Clinical Trial Comparative Study Randomized Controlled Trial
OBJECTIVES
to compare the response to treatment and recurrence rate of condylomata accuminata using subcutaneous injection of interferon alfa 2a 1.5 million units three times weekly for four weeks, or podophyllin resin 25% applied to lesions twice weekly for up to six weeks.
DESIGN
Randomised open study.
SETTING
Multicentre European study in genitourinary medicine, dermatovenereology, and gynaecology departments.
PATIENTS
87 males and 67 females with condylomata acuminata for less than six months and no history of previous treatment.
MAIN OUTCOME MEASURES
Complete clearance of lesions and evidence of recurrence at three months and nine months after treatment commenced.
RESULTS
A complete response was achieved at three months in 15 of 64 (23%) in the interferon treated group, and 31 of 69 (45%) in the podophyllin treated group (p = 0.003). At nine months 10 of 13 patients in the interferon group and 22 of 30 patients in the podophyllin group remained completely clear of lesions.
Topics: Administration, Topical; Adolescent; Adult; Aged; Condylomata Acuminata; Female; Humans; Injections, Subcutaneous; Interferon alpha-2; Interferon-alpha; Male; Middle Aged; Patient Acceptance of Health Care; Podophyllin; Recombinant Proteins; Recurrence
PubMed: 1743712
DOI: 10.1136/sti.67.5.394 -
Oral Surgery, Oral Medicine, Oral... Nov 2010The aim of this study was to present a new topical treatment protocol for oral hairy leukoplakia (OHL), consisting of a 25% podophyllin resin with a 1% penciclovir cream... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVE
The aim of this study was to present a new topical treatment protocol for oral hairy leukoplakia (OHL), consisting of a 25% podophyllin resin with a 1% penciclovir cream (PP), and to compare this topical treatment protocol's efficacy with that of 2 other topical treatment protocols: a 25% podophyllin resin (P) and a 25% podophyllin resin with a 5% acyclovir cream (PA).
STUDY DESIGN
Forty-two human immunodeficiency virus-positive patients with 69 OHL lesions were randomly treated using P, PA, or PP (14 patients in each topical treatment protocol). Clinical healing was determined when the white plaque could no longer be seen in the primary location of the lesion. Topical treatment performance was evaluated by clinical healing within each week of topical treatment protocol as well as by the recurrence of the lesion. Statistical survival analysis was performed using a Cox proportional hazards model.
RESULTS
Approximately 55% of the patients presented with clinical healing of OHL within 7-8 weeks of each topical treatment protocol. After the sixth week, the PA treatment protocol presented a faster clinical healing rate of OHL. Recurrence was observed in 3 and 7 OHL lesions treated with P and PP treatment protocols, respectively.
CONCLUSIONS
The PP treatment protocol proved to be effective; however, the PA treatment protocol was more effective in the clinical healing rate for OHL than P and PP after the sixth week of treatment, and no recurrent OHL was observed in the PA treatment group.
Topics: Acyclovir; Administration, Topical; Adult; Antifungal Agents; Antineoplastic Agents, Phytogenic; Antiviral Agents; Candidiasis, Oral; Double-Blind Method; Female; Follow-Up Studies; Guanine; HIV Infections; HIV Seropositivity; Heterosexuality; Humans; Leukoplakia, Hairy; Male; Middle Aged; Neoplasm Recurrence, Local; Podophyllin; Proportional Hazards Models; Remission Induction; Time Factors; Tongue Neoplasms; Treatment Outcome; Young Adult
PubMed: 20813564
DOI: 10.1016/j.tripleo.2010.05.015