podophyllin and Hand-Dermatoses

The pathological transformation of the skin into a thick and hard callus due to repetitive trauma or friction is commonly known as corn. Although a variety of medical and operative treatment choices have been proposed, an ideal treatment method is yet to be defined. Effectiveness of tangential excision together with topical cantharidin has been evaluated. We used Canthacur-PS as an adjunct to excision in an outpatient setting. Canthacur-PS is a commercially available topical solution that includes 1% cantharidin, 30% salicylic acid and 5% podophyllin. The treatment has been applied to 72 patients. We found that 65 patients (90.3%) had corn on their feet and seven patients (9.7%) on their hands. Thick, hard and hyperkeratotic skin area was scraped with the help of a no. 15 blade. The solution was applied on and around the periphery (up to 1–2 mm) of the lesion with a cotton swab, and kept closed for 5 days with an antibiotic dressing. All the patients had been followed up for at least 1 year and evaluated by clinical examination and patient satisfaction query. One session of treatment succeeded in 57 (79.2%) corn patients. Two sessions in nine corn patients (12.5%), three sessions in five corn patients (6.9%) and four sessions in one patient (1.4%) were needed. Only one recurrence (1.4%) was seen. No scar formation or other side-effects were seen. Our findings show that this treatment method is a simple, minimally invasive and reliable treatment for calluses.

Topics: Administration, Topical; Adult; Callosities; Cantharidin; Chemotherapy, Adjuvant; Combined Modality Therapy; Dermatologic Agents; Female; Follow-Up Studies; Foot Dermatoses; Hand Dermatoses; Humans; Male; Middle Aged; Patient Satisfaction; Podophyllin; Recurrence; Salicylic Acid; Treatment Outcome; Young Adult

Human papilloma virus (HPV)-related cutaneous manifestations occur with increased frequency and severity among HIV-infected persons. In this report, we describe an HIV-infected man with persistent, severe cutaneous hand warts that did not respond to multiple therapies, including liquid nitrogen cryotherapy, topical dinitrochlorobenzene, topical podophyllin, and intralesional interferon-alfa injections. Approximately 1 year after starting a potent protease inhibitor-containing antiretroviral regimen, the patient's recalcitrant cutaneous warts markedly diminished in size, even though the patient did not receive any specific therapy for the warts after starting aggressive antiretroviral therapy. The patient continued on a potent protease inhibitor-containing antiretroviral regimen and, approximately 2 years later, the warts completely resolved. Our patient's dramatic clinical improvement of cutaneous HPV infection that followed protease inhibitor-containing antiretroviral therapy provides a clear-cut example that protease inhibitor-containing combination antiretroviral therapy can produce significant clinical benefit.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-HIV Agents; Antiviral Agents; Cryosurgery; Dinitrochlorobenzene; Hand Dermatoses; HIV Infections; HIV Protease Inhibitors; Humans; Indinavir; Interferon-alpha; Keratolytic Agents; Male; Papillomaviridae; Papillomavirus Infections; Podophyllin; Treatment Outcome; Tumor Virus Infections; Warts

Topics: Cautery; Cresols; Curettage; Dermatologic Agents; Foot Dermatoses; Hand Dermatoses; Humans; Keratolytic Agents; Ointments; Podophyllin; Trichloroacetic Acid; Warts