Genital burns from home use of podophyllin

Abstract

A 50-year-old male, without any significant past medical history, presented to the Emergency Department (ED) with complaint of scrotal burns. The patient was seen in clinic 1 week prior to the ED visit and given a topical treatment for genital warts. The preparation was a 25% suspension of podophyllin in benzoin. The patient applied the solution once daily for 3 days by using the dropper that came with the bottle. The patient had difficulty containing the solution when applying it to the affected area and the solution would often spread over his scrotal area and upper legs. The patient first noticed the burns 5 days after the first application of podophyllin (2 days following discontinuation of use). Physical exam revealed an apparently healthy male. Vital signs were blood pressure 150/100, heart rate 117, respiratory rate 16, and temperature 36.8 C. His HEENT, heart, and lung exam were unremarkable. His genitourinary exam revealed partial thickness burns to his penis, scrotum and upper legs with near total skin denudation (Fig. 1). He also had bilateral inguinal lymphadenopathy. The following are his laboratory values: WBC 5900 hemoglobin 17.2 g, platelets 292,000, sodium 139 meq./L, potassium 4.2 meq./ L, chloride 102 meq./L, bicarbonate 29 BUN 8 mg/dL, creatinine 1.0 mg/dL glucose 79 mg/dL AST 20 IU/L, ALT 19IU/L, PT 10.7 INR 1.0 PTT 27.6. The patient was evaluated by the burn team and discharged home with local wound care.