podophyllin and Syphilis

Treatment of perianal condyloma acuminata is frustrating because most treatment options are fraught with high recurrence rates and patient discomfort. We propose that surgical excision followed by vaccination with an autogenous condyloma acuminata vaccine is the most effective therapy available in primary and recurrent perianal condyloma acuminata.. Eighty-three patients with perianal condyloma acuminata were treated from 1985 to 1992. Treatment was divided for patients as follows: surgical excision, 20; bichloroacetic acid, 10; podophyllin and interferon A, 5; excision followed by autogenous condyloma acuminata vaccination twice weekly using 0.1 ml subcutaneously for three weeks increasing to 1.0 ml subcutaneously for seven weeks, 43. Syphilis was diagnosed in seven patients; two were human immunovirus-positive. All but three patients were male. Of those patients treated with the vaccination protocol, 25 had primary and 18 had recurrent disease.. Recurrence rates were: excision alone and bichloroacetic acid, 50 percent; podophyllin and interferon A, 85 percent; whereas only 4.6 percent recurred when treated with excision and vaccination. Mean follow-up was 13 (range, 6-23) months. All patients treated with the vaccination protocol tolerated the full course of therapy.. We believe that excision of perianal condyloma acuminata followed by autogenous condyloma acuminata vaccination for approximately ten weeks is the most effective and definitive treatment option and, moreover, should be considered in all patients with perianal condyloma acuminata.

Topics: Adult; Anus Diseases; Combined Modality Therapy; Condylomata Acuminata; Dichloroacetic Acid; Female; Follow-Up Studies; HIV Infections; Humans; Interferon-alpha; Male; Middle Aged; Papillomaviridae; Podophyllin; Recurrence; Retrospective Studies; Syphilis; Viral Vaccines

A delineation of the medical problems associated with anal sexual eroticism has been presented. Our method of approach to both the patient and the various disease states has been described. Treatment of the most commonly encountered condition, condyloma acuminata, has been detailed. Precautionary measures to be taken and possible diagnostic pitfalls have been mentioned.

Topics: Anal Canal; Anus Diseases; Anus Neoplasms; Condylomata Acuminata; Enterobacteriaceae; Female; Foreign Bodies; Gonorrhea; Humans; Male; Podophyllin; Rectal Diseases; Sexual Behavior; Syndrome; Syphilis; Ulcer; Urinary Fistula; Warts

Topics: Aerospace Medicine; Anti-Bacterial Agents; Benzalkonium Compounds; Chancroid; Condylomata Acuminata; Doxycycline; Drug Resistance, Microbial; Drug Therapy, Combination; Gonorrhea; Granuloma Inguinale; Herpesviridae Infections; Hospitals, Special; Humans; Lymphogranuloma Venereum; Male; Molluscum Contagiosum; Podophyllin; Probenecid; Sexually Transmitted Diseases; Sulfisoxazole; Syphilis; United States; Urethritis; Vietnam