podophyllin and Genital-Neoplasms--Female

Topics: Antineoplastic Agents; Condylomata Acuminata; Cryosurgery; Electrosurgery; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Interferons; Laser Therapy; Male; Papillomaviridae; Podophyllin; Podophyllotoxin; Trichloroacetic Acid

Topics: Antiviral Agents; Bleomycin; Condylomata Acuminata; Cryosurgery; Dinitrofluorobenzene; Electrocoagulation; Female; Fluorouracil; Formaldehyde; Genital Diseases, Female; Genital Diseases, Male; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Immunotherapy; Laser Therapy; Male; Podophyllin; Salicylates; Warts

Three major classes of interferons have been identified (alpha, beta, and gamma). All three have been tested in clinical trials in condylomata acuminata, or genital warts, with positive results. Administration by topical, intralesional, intramuscular, and subcutaneous routes results in regression of human papillomavirus genital disease. Significant reduction in measurable lesions occurs in some patients within days of initiation of therapy. Responses appear to be both time and dose dependent. Although disease resolution is highly variable from patient to patient, approximately 75 to 80 percent of all persons show clear clinical benefit at low doses. Biologic side effects of interferons are tolerated well at these doses and occur following systemic or local administration of interferon. In general, the interferons are emerging as active and safe therapeutic agents for genital human papillomavirus infections. This study reviews in detail the series of clinical trials conducted with one of these agents, interferon alpha n1. Results of four small and two major controlled trials in refractory genital warts have proved that this interferon provides significant clinical benefit for the majority of subjects with severe disease. Current studies show that it can be combined safely and effectively with other conventional treatment modalities, such as laser or podophyllin.

Topics: Clinical Trials as Topic; Combined Modality Therapy; Condylomata Acuminata; Drug Administration Schedule; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Interferon Type I; Laser Therapy; Male; Pilot Projects; Podophyllin; Random Allocation

Topics: Adolescent; Adult; Age Factors; Anus Neoplasms; Child; Condylomata Acuminata; Cryosurgery; Dichloroacetic Acid; Electrosurgery; Female; Genital Neoplasms, Female; Humans; Infant, Newborn; Male; Podophyllin; Pregnancy; Pregnancy Complications, Neoplastic; Recurrence; Sex Factors; Sexually Transmitted Diseases; Trichloroacetic Acid

Thirty-seven patients with previously untreated perianal condylomata acuminata were randomly treated by application of 25 per cent podophyllin or scissor excision. The result of treatment was assessed by an independent observer. At 6 weeks, scissor excision completely cleared the warts from 16 of 18 patients (89 per cent) compared with 15 of 19 patients (79 per cent) treated with podophyllin. Following complete clearance by surgery, two patients had recurrent warts at 18 weeks and a further single patient at 42 weeks, giving a cumulative recurrence rate of 19 per cent. In contrast, five of 15 patients whose warts were cleared by podophyllin had recurrent warts at 18 weeks and a further four at 42 weeks representing a cumulative recurrence rate of 60 per cent (X2 = 3.95, d.f. = 1, P = 0.05). At 42 weeks six patients (32 per cent) were free of disease in the podophyllin group compared with 13 (72 per cent) in the scissor excision group (X2 = 4.6, d.f. = 1, P = 0.03). Scissor excision is therefore preferable to podophyllin application in the treatment of perianal condylomata acuminata.

Topics: Adult; Anal Canal; Anus Neoplasms; Condylomata Acuminata; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Genitalia; Humans; Male; Middle Aged; Podophyllin; Prospective Studies; Random Allocation

Three major classes of interferons have been identified (alpha, beta, and gamma). All three have been tested in clinical trials in condylomata acuminata, or genital warts, with positive results. Administration by topical, intralesional, intramuscular, and subcutaneous routes results in regression of human papillomavirus genital disease. Significant reduction in measurable lesions occurs in some patients within days of initiation of therapy. Responses appear to be both time and dose dependent. Although disease resolution is highly variable from patient to patient, approximately 75 to 80 percent of all persons show clear clinical benefit at low doses. Biologic side effects of interferons are tolerated well at these doses and occur following systemic or local administration of interferon. In general, the interferons are emerging as active and safe therapeutic agents for genital human papillomavirus infections. This study reviews in detail the series of clinical trials conducted with one of these agents, interferon alpha n1. Results of four small and two major controlled trials in refractory genital warts have proved that this interferon provides significant clinical benefit for the majority of subjects with severe disease. Current studies show that it can be combined safely and effectively with other conventional treatment modalities, such as laser or podophyllin.

Topics: Clinical Trials as Topic; Combined Modality Therapy; Condylomata Acuminata; Drug Administration Schedule; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Interferon Type I; Laser Therapy; Male; Pilot Projects; Podophyllin; Random Allocation

The efficacy and tolerance of human lymphoblastoid interferon (Wellferon) were studied in an open label trial of 17 patients with resistant and persistent condyloma acuminata. Patients were treated intramuscularly with 5 X 10(6) U (5 MU)/m2 daily for 28 days followed by thrice weekly injections for two weeks. Sixteen patients were considered evaluable; eight experienced complete clearance, seven had significant reduction (greater than 50%) in lesion size, and one showed no response during the course of this trial. Biologic side effects of interferon occurred in all patients during initial dosing and diminished during thrice weekly therapy. Intramuscular injections and associated side effects were tolerated well. This study shows that systemic human lymphoblastoid interferon is active in treating severe recurrent genital warts in women with a history of recalcitrant disease.

Topics: Adolescent; Adult; Blood Cell Count; Clinical Trials as Topic; Condylomata Acuminata; Dinitrochlorobenzene; DNA, Viral; Fatigue; Female; Fever; Genital Neoplasms, Female; Headache; Humans; Immunoglobulins; Interferon Type I; Lymphocytes; Middle Aged; Nausea; Papillomaviridae; Podophyllin

This article describes an approach to the evaluation and treatment of condyloma acuminatum (anogenital warts) that is based on the results of new clinical research on the biology of the human papillomavirus. A more extensive diagnostic protocol, including routine cervicovaginal examination and Papanicolaou smear, is proposed for female patients because of the close association of genital human papillomavirus infections with cervical carcinoma. Two highly effective therapies, cryosurgery and carbon dioxide laser photocoagulation, are described and compared with older regimens. Recent developments in immunotherapy for resistant condyloma acuminatum are also discussed.

Topics: Clinical Trials as Topic; Condylomata Acuminata; Cryosurgery; Electrocoagulation; Female; Fluorouracil; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Immunotherapy; Interferons; Laser Therapy; Male; Ointments; Papanicolaou Test; Podophyllin; Urethral Neoplasms; Uterine Cervical Neoplasms; Vaginal Neoplasms; Vaginal Smears

Topics: Condylomata Acuminata; Female; Fluorouracil; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Laser Therapy; Male; Podophyllin

Topics: Condylomata Acuminata; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Immunoblotting; Male; Podophyllin

Topics: Condylomata Acuminata; Cryosurgery; Electrocoagulation; Female; Fluorouracil; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Injections, Intramuscular; Injections, Subcutaneous; Interferon Type I; Laser Therapy; Male; Podophyllin; Trichloroacetic Acid

The histologic changes of podophyllin-treated condylomata acuminata were studied at 24-hour, 48-hour, and 7-day intervals. The 24-hour specimens had scattered individual atypical cells, whereas 48-hour specimens demonstrated small focal areas of atypia. Seven-day specimens exhibited very mild atypia of cells. All treated specimens had inflammation-necrosis ranging from scattered inflammatory cells to degeneration of the squamous epithelium.

Topics: Administration, Topical; Condylomata Acuminata; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Male; Podophyllin

25 patients (2 females, 23 males, 20 to 40-year-old) suffering from condylomata acuminata (19 genital, 2 anal, and 4 genitoanal lesions) were locally treated with salicylic acid containing 5-fluorouracil (Verrumal) once a day. This therapy resulted in complete healing within 12 days on an average. 5 patients showed a relaps after 2 weeks to 5 months and were treated again. The treatment failed in a 40-year-old patient suffering from condylomata acuminata genitalis.

Topics: Administration, Topical; Adult; Condylomata Acuminata; Female; Fluorouracil; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Male; Neoplasm Recurrence, Local; Podophyllin

Topics: Adolescent; Child; Child, Preschool; Condylomata Acuminata; Electrocoagulation; Female; Fluorouracil; Freezing; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Infant; Male; Nitrogen; Podophyllin

The medical records of 48 patients who underwent laser vaporization of therapy-resistant or recurrent condylomata acuminata were studied with regard to history of immunosuppression, location of original lesion, type and duration of therapy, and whether magnification devices were used prior to or during therapy. The genitalia of the patients' sexual partners were examined in all cases in which the condylomata recurred after initial control of the lesions with conventional methods. In 46 of the 48 cases, possible reasons for the failure of conventional therapy could be found: unresponsive to chemical therapy (11 patients); reinfection by the sexual partner (4); immunosuppression (8); several factors (6); and incomplete eradication of the lesion (20). Thirty-eight of the 48 patients (79%) were treated successfully with one-time laser ablation of the lesions. Six patients with recurrent condylomata after laser therapy underwent a second laser treatment, and four of the six patients (total, 87%) have remained free of disease. The laser appears to be an effective method of treatment for recurrent or persistent condylomata acuminata provided that (1) the patient is not immunosuppressed, (2) the potentially infected sexual partner is examined and treated, if necessary, and (3) the external genitalia, including the anus, vagina and cervix, are carefully examined colposcopically to rule out the persistence of small lesions.

Topics: Adolescent; Adult; Aged; Condylomata Acuminata; Female; Genital Neoplasms, Female; Humans; Laser Therapy; Middle Aged; Podophyllin; Recurrence

Four cases of condylomata acuminata in children (two boys, two girls) are reported. Three children had perianal warts and one vulvar warts. One of the four children had been sexually assaulted, but a history of sexual contact was absent in the other three. Surgical excision was undertaken in one case and the others responded well to the local application of 25% podophyllin in benzoin tincture compound. In the absence of sexual contact, a non-coital mode of transmission of infection could be a possibility.

Topics: Child; Condylomata Acuminata; Female; Genital Neoplasms, Female; Humans; Infant; Male; Podophyllin; Rectal Neoplasms

Topics: Adult; Anus Neoplasms; Condylomata Acuminata; Cryosurgery; Female; Genital Neoplasms, Female; Genital Neoplasms, Male; Humans; Male; Podophyllin

A young woman presented with podophyllin intoxication following topical application of podophyllin resin to genital condylomata acuminata. The disorder was marked by hallucinatory psychosis, bone marrow depression, and mild hepatic dysfunction. The psychosis and systemic disturbances resolved within 3 weeks, but were followed by autonomic and sensorimotor peripheral neuropathy. This case illustrates the transient central neurotoxicity and persistent peripheral neurotoxicity of podophyllin.

Topics: Adult; Autonomic Nervous System Diseases; Condylomata Acuminata; Delusions; Female; Genital Neoplasms, Female; Hallucinations; Humans; Nervous System Diseases; Neural Conduction; Podophyllin; Psychoses, Substance-Induced

Topics: Condylomata Acuminata; Cryosurgery; Female; Genital Neoplasms, Female; Humans; Immunotherapy; Podophyllin; Pregnancy; Trichloroacetic Acid

Topics: Adult; Child; Condylomata Acuminata; Female; Genital Neoplasms, Female; Humans; Male; Ointments; Penile Neoplasms; Podophyllin

Topics: Antineoplastic Agents; Breast Neoplasms; Carcinoma; Female; Genital Neoplasms, Female; Humans; Ovarian Neoplasms; Podophyllin; Sarcoma; Uterine Neoplasms

Topics: Aftercare; Alkaloids; Alkylating Agents; Antibiotics, Antineoplastic; Antimetabolites; Bone Neoplasms; Breast Neoplasms; Colchicine; Cyclophosphamide; Female; Genital Neoplasms, Female; Hormones; Humans; Neoplasm Metastasis; Ovarian Neoplasms; Peptide Hydrolases; Peptides; Pleurisy; Podophyllin; Uterine Cervical Neoplasms; Uterine Neoplasms; Vinblastine

Topics: Antineoplastic Agents; Cyclophosphamide; Female; Genital Neoplasms, Female; Humans; Isoenzymes; L-Lactate Dehydrogenase; Ovarian Neoplasms; Perchlorates; Phytotherapy; Plants, Medicinal; Plants, Toxic; Podophyllin; Podophyllum; Tryptophan; Uterine Cervical Neoplasms; Uterine Neoplasms

Topics: Adult; Aged; Cyclophosphamide; Female; Genital Neoplasms, Female; Humans; Middle Aged; Palliative Care; Pelvic Neoplasms; Phytotherapy; Plants, Medicinal; Plants, Toxic; Podophyllin; Podophyllum

Topics: Antimitotic Agents; Antineoplastic Agents; Carcinoma; Female; Genital Neoplasms, Female; Geriatrics; Humans; Neoplasms; Podophyllin; Podophyllum; Toxicology

Topics: Drug Therapy; Female; Genital Neoplasms, Female; Humans; Pathology; Podophyllin; Podophyllum

Topics: Antineoplastic Agents; Female; Genital Neoplasms, Female; Humans; Podophyllin; Podophyllotoxin; Podophyllum