podophyllin and Papillomavirus-Infections

External genital warts (EGWs) are sexually transmitted benign epidermal growths caused by the human papillomavirus (HPV), on the anogenital areas of both females and males. About 50% to 60% of sexually active women aged 18 to 49 years have been exposed to HPV infection, but only 10% to 15% will have genital warts.. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for external genital warts? What are the effects of interventions to prevent transmission of external genital warts? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).. We found 55 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.. In this systematic review we present information relating to the effectiveness and safety of the following interventions: bi- and trichloroacetic acid; condoms; cryotherapy; electrosurgery; imiquimod; intralesional, topical, or systemic interferons; laser surgery; podophyllin; podophyllotoxin; surgical excision; and vaccines.

Topics: Condylomata Acuminata; Double-Blind Method; Humans; Papillomaviridae; Papillomavirus Infections; Papillomavirus Vaccines; Podophyllin

Although cutaneous warts are one of the most common skin conditions affecting children, their management can be challenging, especially in complex cases and even more so during a single emergency department encounter. Anogenital warts require particular attention because of their possible but nonspecific association with sexual abuse. This review will focus on cutaneous warts and anogenital warts, with a discussion of their recognition and treatment, especially in the emergency department. The medicolegal implications of anogenital warts in children are also reviewed.

Topics: Adolescent; Child; Child Abuse, Sexual; Condylomata Acuminata; Cryotherapy; Diagnosis, Differential; Emergency Service, Hospital; Female; Humans; Keratolytic Agents; Medicine, Traditional; Papillomavirus Infections; Papillomavirus Vaccines; Pediatrics; Podophyllin; Salicylic Acid; Skin Diseases; Uterine Cervical Neoplasms; Warts

Human papillomaviruses (HPV) are found in most human epithelia and some tumors. Most HPV strains associated with cutaneous lesions belong to three types, named alpha, beta and gamma. Although the causal link between genital human papillomavirus infection and cervical neoplasia is well established, the role of beta-HPV in non melanoma skin cancers is unclear. HPV mainly causes benign cutaneous lesions on the hands and soles. Genital HPV infection is the most common sexually transmitted infection. It is generally asymptomatic. The genitals can be infected by two low-risk HPV types (6 and 11), which are responsible for benign anogenital warts (condylomata acuminata). The implications of anogenital warts in children are highly controversial as regards sexual abuse. Treatments (chemical, physical or immunological) are lengthy, expensive, inconvenient and often painful. Recurrence is frequent because of HPV persistence in perilesional skin.

Topics: Adult; Child; Condylomata Acuminata; Cryotherapy; Curettage; Female; Humans; Infant, Newborn; Keratolytic Agents; Male; Middle Aged; Papillomavirus Infections; Penile Diseases; Podophyllin; Recurrence; Time Factors; Uterine Cervical Diseases; Warts

Anogenital cancers, in particular cancer of the cervix, and common, genital and laryngeal warts are primarily caused by infection with human papillomaviruses. Traditionally, the primary goal of treatment is to remove the neoplasia by various surgical approaches; however, all of these have high rates of recurrence. Only a few non-surgical treatments have found their way into clinical practice, and none of them is generally recommended because of side effects, limited efficacy and recurrences. This article summarizes the research on pharmaceutical and immunological approaches that may find a place in clinical practice to complement or replace surgical treatments.

Topics: Aminoquinolines; Antimetabolites; Antiviral Agents; Cidofovir; Cytosine; Drug Design; Fluorouracil; Humans; Imiquimod; Indoles; Interferon Inducers; Interferons; Organophosphonates; Organophosphorus Compounds; Papillomavirus Infections; Podophyllin; Viral Vaccines

A 9-year-old black girl with vertically acquired human immunodeficiency virus (HIV) and no history of condyloma acuminata presented with a 4-year history of enlarging and spreading dark brown flat papules in the perineum. Some of the lesions were confluent and extended from the clitoris to the labia majora and posteriorly to the buttocks and perianal region. A biopsy of one of the lesions showed bowenoid features. Our patient had a normal Pap smear, but vaginal and cervical biopsy specimens revealed human papillomavirus type 16. Therapy with topical imiquimod cream every other day was started, but little improvement was noted after 2 months. Application of 25% podophyllin every 4 to 8 weeks was added, and improvement was noted within 1 month. After 1 year of treatment, the patient had complete resolution of all lesions, and she has had no further appearance of lesions. Our case emphasizes the need for increased awareness of the potential for development of bowenoid papulosis in HIV-positive children as well as the successful treatment of our patient with topical therapy alone.

Topics: Acquired Immunodeficiency Syndrome; Adult; Aminoquinolines; Antineoplastic Agents, Phytogenic; Bowen's Disease; Child; Female; Humans; Imiquimod; Infectious Disease Transmission, Vertical; Maternal-Fetal Exchange; Papillomaviridae; Papillomavirus Infections; Perineum; Podophyllin; Pregnancy; Pregnancy Complications, Infectious; Remission Induction; Skin Neoplasms; Tumor Virus Infections; Vulvar Neoplasms

Although many treatments are available for genital warts caused by human papillomavirus (HPV), none are uniformly successful in the treatment of this disease. Most current treatment options work by destroying affected tissue, either by a cytotoxic or a physically ablative mode of action. Interferons have antiviral, antiproliferative, and immunomodulatory activities, but these have not translated into a high level of cure rates against warts. With all current treatments, recurrent warts are common. Therapies currently being investigated include a 5-fluorouracil/epinephrine collagen gel that achieves high concentrations of 5-fluorouracil at the site of injection. Other new treatment modalities focus on activating the host's immune system or improving the delivery of therapeutic compounds to the affected site. Imiquimod, a novel immune-response modifier, induces interferon and a number of other endogenous cytokines. A cream formulation containing 5% imiquimod resulted in good total clearance rates and generally tolerable side effects in controlled clinical trials of patients with external genital warts. Perhaps the most effective means for managing HPV disease would be a vaccine that prevents the occurrence of genital warts. Although it is unlikely that such a vaccine will be introduced in the near future, preliminary studies indicate that it may be possible to develop suitable prophylactic and therapeutic vaccines.

Topics: Adjuvants, Immunologic; Aminoquinolines; Antimetabolites; Antiviral Agents; Condylomata Acuminata; Cryotherapy; Drug Therapy, Combination; Electrosurgery; Fluorouracil; Humans; Imiquimod; Injections, Intralesional; Interferons; Keratolytic Agents; Laser Therapy; Papillomaviridae; Papillomavirus Infections; Podophyllin; Podophyllotoxin; Tumor Virus Infections

The treatment of genital warts remains frustrating since it is often painful, expensive, and unsuccessful. Moreover, little is known about the infectivity and natural history of exophytic genital warts or subclinical genital infection with human papillomavirus. The traditional goals of therapy for sexually transmitted diseases--eradication of infection, elimination of symptoms, prevention of long-term sequelae, and interruption of transmission--are currently not attainable for or applicable to genital warts. The medical literature from January 1988 to August 1993 was reviewed for recent studies on the treatment of exophytic warts. The following treatments were included in the reviewed studies: podofilox (which was recently approved by the Food and Drug Administration), podophyllin, cryotherapy, topical 5-fluorouracil, intralesional interferon, systemic interferon, and laser surgery. No single treatment modality was superior to another, and recurrence rates associated with all modalities were high. Treatment of genital warts should be guided by preferences of the patient, and a specific therapeutic regimen should be chosen with consideration of expense, efficacy, convenience, and potential for adverse effects.

Topics: Condylomata Acuminata; Cryotherapy; Female; Fluorouracil; Humans; Interferons; Laser Therapy; Male; Papillomaviridae; Papillomavirus Infections; Podophyllin; Podophyllotoxin; Sexual Partners; Tumor Virus Infections

After an overview on the diffusion and transmission of the Human Papilloma Virus infection, the authors' attention is focused on clinical and therapeutic aspects of the disease. Following the most recent findings on congenital transmission, problems related to prophylaxis and therapy are discussed.

Topics: Adolescent; Adult; Cryosurgery; Electrocoagulation; Female; Fluorouracil; Humans; Interferons; Laser Therapy; Papillomaviridae; Papillomavirus Infections; Podophyllin; Podophyllotoxin; Pregnancy; Pregnancy Complications, Infectious; Trichloroacetic Acid; Tumor Virus Infections

Topics: Animals; Antisense Elements (Genetics); Forecasting; Humans; Papillomaviridae; Papillomavirus Infections; Podophyllin; Podophyllotoxin; Tumor Virus Infections

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

BACKGROUND Plantar warts are benign skin tumors caused by the human papillomavirus (HPV). There are multiple treatments, but none ensure absolute success. Successful treatment depends on several factors, such as the location, number of lesions, HPV biotype, and the patient's health condition. This report presents a 53-year-old woman who had multiple recalcitrant plantar warts with HPV biotype 27 that were treated using a cantharidin-podophyllin-salicylic acid (CPS) formulation after 2 failed treatments. CASE REPORT A 53-year-old woman was seen on October 25, 2021. She had 6 plantar warts due to HPV biotype 27, which was confirmed by polymerase chain reaction using a sample of hyperkeratosis scales obtained from the wart after debridement. Five cryotherapy sessions were applied, without clinical improvement. Two sessions of nitric-acid-zinc complex were then applied, from which the patient reported severe pain, without clinical improvement. Finally, 3 sessions of CPS formulation were applied, and the HPV remitted in all warts. CONCLUSIONS Conservative treatments, such as cryotherapy, have not been effective in a case of multiple recalcitrant plantar warts. The combined action of the 3 compounds of CPS formulation was key in the resolution of this case. Plantar wart treatment should be easy to apply, effective, fast, and efficient. In cases of recalcitrant or numerous warts, treatment should be more aggressive from the beginning if the patient's lifestyle allows it. It would be interesting to conduct randomized clinical trials to find out which patients could be indicated for the CPS formulation as a first line of treatment.

Topics: Alphapapillomavirus; Cantharidin; Female; Humans; Middle Aged; Papillomaviridae; Papillomavirus Infections; Podophyllin; Salicylic Acid; Treatment Outcome; Warts

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

Condyloma acuminatum are caused by human papillomavirus. Giant condyloma acuminatum is a locally invasive, destructive, and large sized mass. Risk factors for the development of giant condyloma acuminatum include an immunodeficient state, such as human immunodeficiency virus infection, post-organ transplantation, or post-allogeneic bone marrow transplantation. However, reports of giant condyloma after bone marrow transplantation are extremely rare (0.3 to 1.3%). The standard treatment for giant condyloma acuminatum is recommended as wide surgical resection due to its high rate of success and low rate of recurrence.. A 31-year-old Korean man presented to our hospital with anal discomfort for more than one month due to a protruding mass. He had a history of BCR-ABL-positive acute lymphoblastic leukemia and had undergone an allogenic stem cell transplantation. Gross findings revealed a large perianal cauliflower-like mass over 7cm in size with invasion of the anal orifice. He was diagnosed with giant anal condyloma occurring after an allogeneic bone marrow transplantation. However, we achieved successful treatment using a combination of topical podophyllin and cryotherapy and transanal surgical excision, followed by bleomycin irrigation.. We report an extremely rare case of giant condyloma acuminatum of anus due to human papillomavirus type six in a patient with acute lymphoblastic leukemia following an allogeneic bone marrow transplantation. The tumor was successfully treated with a combination of topical podophyllin and cryotherapy and transanal surgical excision, followed by bleomycin irrigation.

Topics: Adult; Antibiotics, Antineoplastic; Antineoplastic Agents, Phytogenic; Anus Neoplasms; Bleomycin; Bone Marrow Transplantation; Condylomata Acuminata; Cryotherapy; Human papillomavirus 6; Humans; Male; Papillomavirus Infections; Podophyllin; Transplantation, Homologous; Treatment Outcome

Topics: Aged; Anus Diseases; Condylomata Acuminata; Female; Humans; Papillomaviridae; Papillomavirus Infections; Podophyllin; Postmenopause

External genital warts (EGWs) are visible warts that occur in the perigenital and perianal regions. They are due primarily to non-oncogenic human papillomavirus (HPV) types, usually types 6 and 11. Physical examination assisted by bright light and magnification is the recommended approach for primary diagnosis. Biopsy is indicated when EGWs are fixed to underlying structures or discolored or when standard therapies are not effective. Recurrences are common, and there is no single treatment that is superior to others. Among women with atypical squamous cells, molecular HPV testing may be useful in determining who should be referred for colposcopy. Condoms may provide some protection against HPV-related diseases and thus are recommended in new sexual relationships and when partnerships are not mutually monogamous. Because the efficacy of cesarean section in preventing vertical transmission of HPV infection from women with EGWs to their progeny has not been proved, it is not recommended.

Topics: Aminoquinolines; Antineoplastic Agents; Condylomata Acuminata; Cryotherapy; Education; Electrosurgery; Female; Floxuridine; Humans; Imiquimod; Interferons; Laser Therapy; Male; Papillomaviridae; Papillomavirus Infections; Podophyllin; Podophyllotoxin; Tumor Virus Infections

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: Aminoquinolines; Antineoplastic Agents; Caustics; Cryotherapy; Electrosurgery; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Imiquimod; Laser Therapy; Male; Papillomaviridae; Papillomavirus Infections; Podophyllin; Tumor Virus Infections

Topics: Condylomata Acuminata; Contraindications; Female; Humans; Papillomaviridae; Papillomavirus Infections; Podophyllin; Pregnancy; Pregnancy Complications, Infectious; Tumor Virus Infections

Topics: Humans; Keloid; Laryngeal Neoplasms; Larynx; Papilloma; Papillomavirus Infections; Podophyllin; Podophyllum; Precancerous Conditions