podophyllin and Vulvar-Neoplasms

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

A study of 37 women with typical condylomas and so-called squamous micropapilloma was undertaken to determine their response to systemic interferon and/or podophyllin treatment. Thirty lesions were classified as condylomas and 9 as squamous micropapillomas; two women had both lesions. Twenty-six (87%) of 30 condylomas responded, whereas only 1 (11%) of the 9 cases of micropapillomatosis showed a partial response (P less than .001) to podophyllin and/or interferon. Twenty-six biopsies from condylomas in which sufficient DNA was available for analysis contained human papillomavirus (HPV) DNA sequences that hybridized to an HPV 6 + 16 probe mix under nonstringent conditions. In contrast, HPV DNA sequences could not be detected in any of the nine cases of micropapillomatosis. Immunoperoxidase studies performed on these lesions failed to demonstrate viral capsid antigen. Thus, despite certain similarities in the clinical presentation and microscopic features of condylomas and squamous micropapillomas, it is not clear at present whether micropapillomas are HPV-related lesions.

Topics: Condylomata Acuminata; DNA, Viral; Drug Therapy, Combination; Female; Humans; Interferon Type I; Neoplasm Recurrence, Local; Papilloma; Papillomaviridae; Podophyllin; Vulvar Neoplasms

A retrospective analysis of 45 cases of condyloma acuminata seen at the gynecology clinic of the University of Nigeria Teaching Hospital between January 1976 and December 1985 was carried out. The prevalence of condyloma acuminata was found to be highest in the single, young and sexually active age group. There was no definite trend in the yearly incidence of vulval warts. Marked association with moniliasis and trichomoniasis was found. Gonorrhea was detected in two patients, but there was no confirmed case of syphilis seen. The mainstay of treatment was the application of 25% podophyllin resin in benzoin tincture either alone or in combination with cold knife excision or diathermy excision. The overall response to all methods of treatment was 64% while treatment with podophyllin alone gave a success rate of 80% and 60% in mild and moderate cases, respectively. The overall incidence of condyloma acuminata was 2.7 per 1000 women seen.

Topics: Adult; Condylomata Acuminata; Developing Countries; Female; Hospitals, Teaching; Humans; Incidence; Nigeria; Podophyllin; Pregnancy; Pregnancy Complications, Neoplastic; Prevalence; Retrospective Studies; Vulvar Neoplasms

Topics: Administration, Topical; Adolescent; Anesthesia, Epidural; Condylomata Acuminata; Diagnostic Errors; Female; Humans; Laser Therapy; Morphine; Podophyllin; Vaginal Neoplasms; Vulvar Neoplasms

We report on a comparative clinical study on 0.5% condyline solution and cream versus 20% podophyllin solution given to 75 patients suffering from condylomata acuminata. Podophyllin was applied once a week during a 6 weeks hospital care; therapy with condyline was carried out by the patients at home twice a day during 4 consecutive days. After therapy, full remission was obtained in 17 out of the 25 patients (68%) treated with condyline solution, in 17 out of the 26 patients (65%) treated with condyline cream, and in 8 out of the 24 patients (38%) treated with podophyllin. 8 biopsies taken from 6 patients did not reveal any atypical "podophyllin cells". Part of the patients showed transitional irritation, sometimes with erosions, which occurred more often after condyline treatment than after podophyllin therapy. This side effect of the cytotoxic drug, however, is to be expected.

Topics: Adolescent; Adult; Aged; Condylomata Acuminata; Dose-Response Relationship, Drug; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Penile Neoplasms; Podophyllin; Podophyllotoxin; Vulvar Neoplasms

Topics: Adult; Female; Hemangioma; Humans; Male; Podophyllin; Skin Neoplasms; Vulvar Neoplasms

A case is reported of apparent podophyllum toxicity. The patient was a 17-year-old female Indian who had received some 3 to 8 cc of a 20 percent mixture of podophyllum resin in compound tincture of benzoin (approximately equal to 0.4 gm of podophylotoxin) as an application to her vulvar condylomata. She returned to the hospital 20 hours after application in a comatose state. On examination she demonstrated severe toxicity including bone marrow, liver, and central nervous system. She required a charcoal hemoperfusion at the University of Colorado, and six months after the event has several neurologic and physiologic sequelae. Podophyllum is a potentially severely toxic drug. Great care must be taken when treating patients with this drug. A large mass of condylomata or the status of pregnancy should be relative contraindications to the use of podophyllum.

Topics: Adolescent; Condylomata Acuminata; Female; Hemoperfusion; Humans; Malabsorption Syndromes; Podophyllin; Pregnancy; Vulvar Neoplasms

The toxicity of topically applied podophyllin in a 16-year-old girl is presented. Coma requiring respiratory support and major neurologic complications as well as hematologic and hepatic toxicity was observed. Therapy with a new modality, charcoal hemoperfusion, resulted in resolution of the acute toxicity, leaving a peripheral neuropathy which had not completely resolved after 4 months. The pharmacology and suggested treatment measures for the toxicity of this rarely reported agent are reviewed.

Topics: Administration, Topical; Adolescent; Charcoal; Chemical Phenomena; Chemistry; Condylomata Acuminata; Female; Hemoperfusion; Humans; Podophyllin; Podophyllotoxin; Skin; Vulvar Neoplasms

Topics: Abscess; Bartholin's Glands; Condylomata Acuminata; Cryosurgery; Cysts; Electrosurgery; Female; Fluorouracil; Humans; Immunotherapy; Laser Therapy; Podophyllin; Testosterone; Vulva; Vulvar Diseases; Vulvar Neoplasms

Topics: Adult; Carcinoma, Squamous Cell; Condylomata Acuminata; Female; Humans; Neoplasm Metastasis; Podophyllin; Precancerous Conditions; Vulvar Diseases; Vulvar Neoplasms

Topics: Administration, Topical; Adult; Condylomata Acuminata; Female; Humans; Perineum; Podophyllin; Vaginal Neoplasms; Vulvar Neoplasms

Topics: Antineoplastic Agents; Condylomata Acuminata; Drug Combinations; Female; Humans; Microscopy, Electron; Plant Extracts; Podophyllin; Solutions; Styrax; Vaginal Neoplasms; Vulvar Neoplasms

Topics: Female; Humans; Metronidazole; Papilloma; Podophyllin; Trichomonas Vaginitis; Vaginal Neoplasms; Vulvar Neoplasms

Topics: Adult; Condylomata Acuminata; Female; Genital Diseases, Female; Humans; Podophyllin; Precancerous Conditions; Vulva; Vulvar Neoplasms

Topics: Adult; Arthritis, Infectious; Condylomata Acuminata; Cystoscopy; Female; Humans; Kidney; Nephrectomy; Papilloma; Podophyllin; Ureteral Neoplasms; Urinary Bladder; Urinary Bladder Neoplasms; Urography; Virus Diseases; Vulvar Neoplasms

Topics: Condylomata Acuminata; Female; Humans; Papilloma; Podophyllin; Pregnancy; Pregnancy Complications; Vulvar Neoplasms

Topics: Condylomata Acuminata; Disease; Female; Humans; Podophyllin; Vulva; Vulvar Diseases; Vulvar Neoplasms