Treatment Of Genital Warts Research Articles

Observation of the curative effect of compound brucea Javanica preparation combined with lentinus edodes mycelia polysacharide tablets in the treatment of condyloma acuminatum

目的 观察复方鸦胆子联合香菇菌多糖片治疗男性尖锐湿疣的疗效。 方法 选择黄州区人民医院皮肤性病科门诊2013年3月至2014年5月就诊的尖锐湿疣患者121例为研究对象，将入选患者按随机数字表法分为两组，观察组(61例)给予复方鸦胆子外搽，2次/d，同时内服香菇菌多糖片10 mg，3次/d；对照组60例，单用复方鸦胆子外搽，2次/d。治疗4周后比较两组的治愈率、复发率及不良反应。 结果 随访12周，观察组治愈率为90.5%，复发率0.95%；对照组治愈率为58.3%，复发率41.7%。两组治愈率、复发率比较差异均有统计学意义(χ2＝0.95、7.12，均P<0.05)。 结论 采用复方鸦胆子联合香菇菌多糖片治疗男性尖锐湿疣治愈率高，复发率低，不良反应轻，值得基层医院推广应用。

A Comparative Study of Liquid Nitrogen Cryotherapy as Monotherapy versus in Combination with Podophyllin in the Treatment of Condyloma Acuminata

Condyloma Acuminata (CA) is a common viral sexually transmitted disease. Although various treatment modalities are available for treating CA, but none of them can achieve 100% response rate. In a search for better response rate and less recurrence rate, the combination of cytotoxic agent Podophyllin with ablative liquid nitrogen cryotherapy was evaluated over cryotherapy alone. To evaluate the synergistic effect of Podophyllin as a chemotherapeutic adjunct to an ablative therapy of liquid nitrogen cryotherapy versus liquid nitrogen cryotherapy alone in the treatment of CA. Sixty patients with multiple CA were randomly assigned to two groups in the study. Thirty patients in group A received double freeze thaw cycle of 25 seconds of liquid nitrogen cryotherapy. Thirty patients in Group B were subjected to liquid nitrogen cryotherapy in a similar manner followed by application of not more than 0.5 ml of 25% Podophyllin solution. All patients were followed up at 1, 4, 8, 12 and 24 weeks after the treatment to monitor the response to therapy and evaluation for any recurrence. When the number of unresponsive lesions were more than 30% of original lesions at 4 weeks follow-up, then the whole procedure was repeated again. The complete response rate and the recurrence rate in the Group B in our study were comparable to Group A as the difference was statistically insignificant. But the differentiating point was that the similar results were obtained in Group B with an average1.2 sessions per patient in comparison to an average of 1.67 sessions per patient in Group A. Cryotherapy represents a simple, safe and effective regimen for the treatment of multiple CA which in combination with Podophyllin is even more effective as a single session procedure; thereby shortening the treatment regimen.

Efficacy of imidazolquinoline on treatment of condyloma acuminatum of the buccal mucosa

The condylomata acuminata is a benign epithelial neoplasm induced by papillomavirus, and it is characterized by the proliferation of stratified squamous epithelial tissue that affects the anogenital and oral mucosa. It is considered to be a sexually transmitted disease and has a higher prevalence in individuals infected with human immunodeficiency virus. Various therapies have been used for the removal of lesions, such as cryotherapy, surgical laser and surgical excision, which are painful and scarring. These techniques, however, do not eliminate the virus and relapses are common shortly after treatment. The use of immunomodulators has been proposed to be an alternative treatment, as imidazolquinoline has been shown to be effective in the treatment of lesions in the anogenital region. However, its use in the oral cavity has been the subject of few reports in the literature. Thus, the objective of this study is to describe a case of warts in the labial mucosa of an HIV positive patient using imidazolquinoline 5%.

Treatment for Condyloma Acuminatum with Graves’ disease

Treatment for Condyloma Acuminatum with Graves’ disease

Treatment of genital warts: focus on vaginal dysbiosis

Бактериальный вагиноз является частым спутником папилломавирусной инфекции. Он также может сочетаться с вагинальным кандидозом и склонен рецидивировать, что связано с наличием комменсалов влагалища Atopobium vaginae. Бактериальный вагиноз патогенетически связан с блокадой воспалительной реакции на уровне слизистой влагалища. Поэтому для санации необходимо использовать лекарственные средства, действующее вещество которых эффективно влияет на анаэробы, Gardnerella vaginalis, Atopobium vaginae, дрожжевые грибы, обладает иммуномодулирующими свойствами, не угнетает рост лактобацилл и не образует перекрестной резистентности с другими антибактериальными средствами. Всем указанным требованиям удовлетворяет мирамистин. Проведено изучение эффективности влагалищного применения свечей с мирамистином (препарат тамистол) в комплексном лечении пациенток с остроконечными кондиломами. Всего было обследовано 142 женщины. В I группу вошли 30 практически здоровых женщин, во II группу – 55 пациенток с остроконечными кондиломами (28 участниц подгруппы IIA с бактериальным вагинозом и 27 пациенток подгруппы IIБ с бактериальным вагинозом и хроническим рецидивирующим вагинальным кандидозом). В III группу вошли 57 женщин с остроконечными кондиломами (29 пациенток с бактериальным вагинозом в подгруппе IIIА и 28 женщин с бактериальным вагинозом и хроническим рецидивирующим вагинальным кандидозом в подгруппе IIIБ). Пациенткам II группы проводили химическую деструкцию остроконечных кондилом после ректального использования свечей с рекомбинантным интерфероном в течение 10 дней. Пациенткам III группы дополнительно назначали курс санации влагалища с помощью вагинальных свечей тамистол в течение 10 дней. Результаты выполненного исследования свидетельствуют, что применение свечей тамистол в комплексном лечении пациенток с остроконечными кондиломами значительно повышает эффективность лечебных мероприятий. Восстановление микробного пейзажа влагалища с помощью тамистола снижало необходимость повторных сеансов химической деструкции кондилом и количество рецидивов. Полученные результаты позволяют считать использование иммуномодуляторов и санации влагалища в комплексе лечения папилломавирусной инфекции теоретически обоснованным.

Treatment of condyloma acuminata in pregnant women with cryotherapy combined with proanthocyanidins: Outcome and safety.

Patients with condyloma acuminata (CA) during pregnancy represent a special risk group. The outcomes of many treatment methods for such cases are not satisfactory. The purpose of the present study was to evaluate the treatment outcome and safety of cryotherapy combined with proanthocyanidins (PCs) for CA in pregnant women. In this study, 46 pregnant women with CA were treated with cryotherapy combined with PCs. The lesions were sprayed with liquid nitrogen until the color of the wart changed from flesh colored to purple. A PC-containing formulation was then sprayed onto a non-woven fabric or single-layer gauze and applied to the affected area. The PC treatment was applied for 20 min, 2 or 3 times per day. All patients were followed up at 1 and 3 months. No visible warts remained after the cryotherapy and PC treatment. At the 1-month follow-up, only 1 case of recurrence was identified. At 3 months, 5 cases of recurrence were identified, and the recurrence rate was 10.9%. The satisfaction rate of the patients was 94% at 1 month and 87% at 3 months after treatment. All pregnancies resulted in healthy live births without delivery complications. Cryotherapy combined with PCs is indicated to be a safe and effective procedure and may serve as a treatment option for pregnant women with CA.

Acetowhite Test for Detection of Papilloma Virus Infection in Men Sexual Partner of Women Diagnosed of High Grade Cervical Lesions

Background: Traditionally, men asked urologist for treatment of genital warts caused by low risk Papilloma virus (LR-HPV) but, recently, asymptomatic men also want to know if they are infected by high risk HPV (HR-HPV) and the benefits of HPV vaccine. The aims of this cross-sectional study were: (1) to evaluate acetowhite test usefulness for detection of asymptomatic and subclinical HRHPV infection in a high risk population of men and (2) to assess risk factors of HR-HPV infection in this population. Methods: Healthy men (n=137) sexual partners of women with preneoplastic cervical lesions were recruited. Acetowhite test was performed (5% acetic acid solution, colposcopic examination under 4-fold and 7-fold magnification). Genital samples were obtained for HR-HPV DNA detection from different penile areas. (Linear Array HPV Genotyping Test, Roche Diagnostics, Mannheim, Germany). SPSS 19.0 (IBM, Chicago, USA) was used for statistical analysis. Results: HR-HPV prevalence was 68/137 (49.6%). AW procedure was positive in 36/137 (26.3%) patients. Genital warts were present in 18/137 (13.1%) patients. Acetowhite test showed 25% sensitivity (95% CI: 13.9-36), 72.4% specificity (95% CI: 61.2-83.7), 47.2% predictive positive value (95% CI: 29.5-64.9) and 49.5% negative predictive value (95% CI: 39.2- 59.7) for the identification of HR-HPV infection. Subclinical lesions were detected in 16/68 (23.5%) infected males. Genital warts (p=0.010) were associated with an increased risk for HRHPV infection in men. Conclusion: In our experience, acetowhite procedure sensitivity was low for HR-HPV detection in asymptomatic/subclinical genital infection and it was not specific indicator of HR-HPV infection. Genital warts detection was associated with HR-HPV infection in men.

Multiple Human Papillomavirus Infection Is Associated with High-Risk Infection in Male Genital Warts in Ulsan, Korea.

Further understanding of male human papillomavirus (HPV) infection is necessary to prevent infection in men, as well as transmission to women. In our current study, we investigated patterns of HPV infection and genotype distributions in male genital warts using the Anyplex II HPV28 Detection kit. We reviewed the medical records of 80 male patients who presented to 5 neighborhood clinics in Ulsan, Korea, for the treatment of genital warts between April 2014 and January 2015. All patients underwent HPV genotyping. The prevalence and characteristics of HPV infection were analyzed, and the patterns of HPV infection according to age were assessed. Among the study patients, 13 (16.3%) were negative for HPV infection, 46 (57.3%) were infected with low-risk HPV, and 21 (26.3%) were infected with high-risk HPV. Patients with multiple HPV infection were more likely to have high-risk HPV infection (P = 0.001). The prevalence of HPV infection was much higher in samples obtained by tissue excision due to a definite lesion (P = 0.001). There were no differences in high-risk HPV infection (P = 0.459), multiple HPV infection (P = 0.185), and recurrence at diagnosis (P = 0.178) according to age. HPV-6 and HPV-11 were the most common type overall (39.7% and 13.8%, respectively). HPV-16 and HPV-18 were the most common high-risk infections (both 3.4%). HPV infection is not only commonly encountered in male genital warts, but is also accompanied by high-risk HPV and multiple infections.

성기사마귀환자 326명의 한의학적 치료에 대한 후향적 연구

Purpose : To observe effects of Korean Medicine treatment for genital warts.Methods : In a single private clinic from February 2014 to February 2015, we did retrospective chart review for 326 patients with genital warts who had been treated by Korean Medicine. Korean Medicine treatment included herbal treatment and herbal ointment.Results : A total of 326 patients were enrolled in this study: 62.7%(n=219) male, 32.8%(n=107) female. In the type of diagnosis, new diagnosis was 45.4%(n=148) and recurrent disease was 54.6%(n=178). Complete clearance was achieved 63.2%(n=206) and treatment period was 3.5 months(range:1-9). Partial clearance-good was 15%(n=49), partial clearance-poor was 4.9%(n=16), non response was 16.9%(n=55) and the average treatment period was 4.3 months(range:1-14). In complete clearance group, female and the prevalence of less than 1 year were statistically significant(p<0.05). There was no recurrence of genital warts after TKM treatment during follow-up period(4-13months).Conclusion : This study suggest that Korean Medicine may be an effective treatment for genital warts.

Surgical operation combined with aminolevulinic acid-based photodynamic therapy for the treatment of giant condyloma acuminatum: 12 case reports

Objective To evaluate the clinical efficacy of surgical operation combined with aminolevulinic acid-based photodynamic therapy (ALA-PDT) for the treatment of giant condyloma acuminatum. Methods Totally, 12 patients with giant condyloma acuminatum of the external genitalia and/or perianal region were enrolled, including 7 males and 5 females. Firstly, the warts were removed by surgical operation and bipolar electrocoagulation cautery. After wound healed, ALA-PDT was carried out at the lesional sites once every 7-10 days for 2-4 sessions. Results Within 6 months of follow-up, warts completely disappeared, and the acetowhitening test turned negative in all the 12 patients. Mild erythematous swelling occurred with pain and burning sensation after the operation, but no other adverse reactions such as infection, ulcer, or obvious scarring were observed. Conclusion Surgical operation combined with ALA-PDT is a relatively good choice for the treatment of condyloma acuminatum. Key words: Condylomata acuminata; Photochemotherapy; Aminolevulinic acid; Surgical procedures, operative; Clinical protocols

Correlation of human papillomavirus types with clinical features of patients with condyloma acuminatum in China.

Condyloma acuminatum (CA)-related human papillomavirus (HPV) typing has focused on the prevalence of HPV types. The correlation between HPV types and the clinical features of CA has rarely been documented. The purpose of this study was to investigate the relationship between HPV types and the clinical features of CA. Polymerase chain reaction-restriction fragment length polymorphism was used to type HPV in the CA lesions from 80 Chinese patients with full clinical data. We determined that HPV6 and HPV11 single infections were the most frequent and accounted for 38.7 and 36.3%, respectively. Multiple infections caused by HPV6, HPV11, HPV16, HPV18, and/or HPV31 accounted for the remaining 25%. We were the first to document the HPV11 and HPV31 co-infection in a patient with colon carcinoma infected anal CA in China. The statistical analysis demonstrated that multiple HPV infections predisposed an individual to more warts, larger warts, a longer disease course, and a greater frequency of recurrence. The cases infected with the high-risk type, HPV16, accounted for 60% of the multiple infections and had a higher relapse rate than any other type of HPV infection. Compared with a single HPV type infection, multiple HPV infections in CA were related to a more severe disease and a worse prognosis. These data provide useful information for the treatment and prognosis of CA. Mapping the proportion of CA caused by the virus types pre-vaccination enables the prediction of the vaccination benefits regarding CA burden reduction.

Treatment of condyloma acuminatum using methyl-aminolaevulinic acid for introduce a medical guideline on health public system

s / Photodiagnosis and Photodynamic Therapy 12 (2015) 325–375 343 Results: The few treated cases for the moment show fading lesions in an average of 4 sessions, including an immunocompromised patient had a very quick recovery. Conclusions:Fora country likeEcuador is very important search new cheaper and efficient alternatives for the treatment of health public problems. The results do not present major problems to raise a medical guideline, however this study will be continued and should be replicated in different demographic areas throughout the country collecting statistical data over types of patients, sessions conducted and recurrences. http://dx.doi.org/10.1016/j.pdpdt.2015.07.073 Examining the effect of liposomal lapatinib in combination with PDT for the treatment of malignant gliomas Carl Fisher1,2,3,4, Carolyn Niu1,2,3,4, Warren Foltz1,2,3,4, Girgis Obaid1,2,3,4, Tayyaba Hasan1,2,3,4, Lothar Lilge1,2,3,4 1 Department of Medical Biophysics, University of Toronto, Canada 2 Department of Radiation Oncology, University Health Network, Canada 3 Wellman Center for Photomedicine, Massachusetts General Hospital, USA 4 Division of Molecular Imaging, Princess Margaret Cancer Centre, Canada Malignant gliomas are invasive and difficult to treat tumours. Of this group of tumours, Glioblastoma Multiforme (GBM) is the most common and the most aggressive. Of proposed GBM treatments, ALA-PpIX mediated Photodynamic Therapy (PDT) has been explored and researched into. The goal of our group is to examine whether combining PDT with EGFR kinase inhibitors leads to greater outcomes compared to PDT or EGFR inhibitors alone. The study proposed utilized the human cell line U87 (EGFR positive) in combination with a liposomal based EGFR inhibitor (lapatinib) that was combined with PDT treatment. Pre-PDT animals were scannedwithaBruker7T small animalMRI systemtomeasure cerebral blood flow (CBF) and tumor vascular permeability and began treatment with the liposomal lapatinib conjugation. Post-PDT animal were scanned at regular intervals to measure CBF and tumour size between the two groups. In the initial pilot study, liposomal lapatinib combined with PDT lead to significant increases in survival compared to PDT alone and demonstrated differences in both CBF and tumour response to PDT. Ongoing studies are focused on increasing the number of animals and get quantitativemeasures of CBF and cerebral blood volume both preand post-PDT. http://dx.doi.org/10.1016/j.pdpdt.2015.07.074 Sonochemical internalization using 5-aminolevulinic acid enhances the cytotoxic effect of bleomycin Tomohiro Osaki1, Yoshihiro Uto2, Masahiro Ishizuka3, Toru Tanaka3, Nobuyasu Yamanaka4, Tsukasa Kurahashi4, Kazuo Azuma1, Yusuke Murahata1, Takeshi Tsuka1, Norihiko Ito1, Tomohiro Imagawa1, Yoshiharu Okamoto1 1 Department of Veterinary Clinical Medicine, School of Veterinary Medicine, Tottori University, Japan 2 Department of Life System, Institute of Technology and Science, Graduate School, Tokushima University, Japan 3 SBI Pharmaceuticals Co., Ltd., Japan 4 ITO Physiotherapy & Rehabilitation, Japan Photochemical internalization (PCI) is a technology to improve the intracellular delivery ofmacromolecules andbasedon the same principle as photodynamic therapy (PDT). PCI is based on the use of photosensitizers located in endocytic vesicles that upon activation by light induce rupture of endocytic vesicles and release the macromolecules into cytosol. Bleomycin (BLM) is used for chemotherapeutic agent for PCI. The limitation of PDT and PCI is the penetration of light in the tissue. It is difficult to treat deepseated tumor with PDT and PCI. Sonodynamic therapy (SDT) is also an antitumor strategy that kills tumor cells by ultrasound and photosensitizer. Ultrasound can penetrate deep tissue and excite photosensitizer. We hypothesized that ultrasound could excite photosensitizers used for PCI, and this newmethod could improve the intracellular delivery of macromolecules. We defined this new method as sonochemical internalization (SCI). In this study, we examined whether internalization of BLM by ultrasound and 5aminolevulinic acid (5-ALA) was able to destroy tumors. In vitro and in vivo study, a significant cytotoxic effect of SCI of BLM using 5-ALA was observed. It was considered that SCI might act as an ultrasound-directed drug-delivery system by triggered release of endocytosed macromolecules into cytosol as PCI. http://dx.doi.org/10.1016/j.pdpdt.2015.07.075 Acridine orange as radiosensitizer to improve cell damage caused by radiotherapy in breast cancer cells line Cintia Teles de Andrade, Jose Dirceu Vollet-Filho, Layla Pires, Vanderlei Salvador Bagnato, Cristina Kurachi Sao Carlos Institute of Physics, University of Sao

Podophyllin induced urethral stricture in a young Nigerian male

Urethral stricture is an abnormal narrowing or loss of distensibility due to fibrosis in the peri-urethral tissues. Some substances can induce chemical urethritis severe enough to cause stricture. We present a case of long segment anterior urethral stricture in a young Nigerian patient cause by self-application of podophyllin for the treatment of genital warts.

P183 Trichloroaceitic acid (TCA) – a forgotten treatment for genital warts?

Background/introduction Genital warts (GWs), are the most common STI in the UK. They can have a huge psychological impact on patients and can be very difficult to clear. There has been little research and few RCTs comparing treatments. In Glasgow, TCA is reserved for patients that standard treatments have failed. Aim(s)/objectives To describe the use of TCA as a treatment for persistent and recurrent GWs and to review the local practice and protocol. Methods We conducted a retrospective case review of all patients who received TCA in 2013 in our integrated sexual and reproductive health service with follow-up to the end of 2014. Patients were identified by prescriptions of TCA on our electronic patient record. Results TCA was used on all types of warts in a variety of multiple locations. 20 out of 27 patients achieved clearance with TCA in 2013 (74%) and of these, 5 experienced recurrence in 2014 (25%). Patients with some level of immunosuppression may benefit from TCA treatment and respond earlier than those with a fully functioning immune system. Discussion/conclusion TCA is an effective treatment for persistent and recurrent GWs; either used alone or with an adjuvant therapy, with relatively few side-effects. It can provide patients who have exhausted many/all other treatment options, positive results and improve mental well-being. This audit also highlights the importance of improved documentation of warts by our staff and closer adherence to the existing clinic protocol for the management of GWs.

HPV-induced anal lesions

Human papillomavirus (HPV) infections belong to the most common sexually transmitted infections. To date, more than 200 completely classified HPV-types have been reported, and those belonging to the genus alpha predominantly infect the anogenital region. Condylomata acuminata are caused by the two low-risk types HPV6 and HPV11 in more than 90 % of cases. Treatment of genital warts might be either ablative (e.g. electrocautery, surgical excision, or laser therapy) or topical (e.g. podophyllotoxine, trichloroacetic acid, or imiquimod), and depends on the size, location, morphology and anatomical region. Recurrences after treatment are frequent. Therefore, combination therapies (e.g. topical and ablative) play an important role in daily routine. HIV-infected individuals, especially HIV-positive MSM, have a strongly increased risk for anal dysplasia and anal cancer. Condylomata acuminata and a large proportion of anal dysplasia and anal carcinoma are preventable by prophylactic HPV-vaccination.

Uso de recursos y costos asociados al diagnóstico y tratamiento de las verrugas genitales en instituciones públicas de salud en México

AimsTo estimate resource use and economic impact in relation to genital wart diagnosis and treatment in the Mexican health system. Material and methodsUsing the Delphi method, 12 specialists from public institutions were interviewed to determine the type of resources and the frequency of their use in the treatment of genital warts. A base case for men and another for women were estimated, utilizing the resources for which a consensus had been reached. The costs of each of the resources were obtained from the IMSS Purchasing Portal and different health sector cost tabulations. ResultsA consensus among the panelists was only reached for: the ELISA test (92%), the VDRL test (100%), cervical cytology (83%), imiquimod (83%), and consultation with a specialist (100%). The base case costs were $2,611.19 and $2,790.69 MXN for men and women, respectively. ConclusionsThe pattern of medical resource use was able to be determined through the Delphi panel and the results made a first approximation of the costs associated with genital wart diagnosis and treatment in Mexico possible.

Low prevalence of oral and nasal human papillomavirus in employees performing CO2-laser evaporation of genital warts or loop electrode excision procedure of cervical dysplasia.

Risk of human papillomavirus (HPV) transmission during laser vaporisation of genital warts or loop electrode excision procedure is controversial. An oral rinse, a nasal swabs, history of HPV related diseases and data on HPV exposure were collected from 287 employees at departments of dermato-venerology and gynaecology in Denmark. A mucosal HPV type was found among 5.8% of employees with experience of laser treatment of genital warts as compared to 1.7% of those with no experience (p = 0.12). HPV prevalence was not higher in employees participating in electrosurgical treatment or cryotherapy of genital warts, or loop electrode excision procedure compared with those who did not. HPV 6 or 11 were not detected in any samples. Hand warts after the age of 24 years was more common among dermatology than among non-dermatology personnel (18% vs. 8.0%, p = 0.03). Mucosal HPV types are infrequent in the oral and nasal cavity of health care personnel, however, employees at departments of dermato-venereology are at risk of acquiring hand warts.

Treatment of Basal Cell Carcinoma by Topical 25% Podophyllin Solution

Background: Basal cell carcinoma is the most common malignancies of the skin. Numerous modalities of treatment are available. Podophyllin is an antimitotic and caustic agent that has been used in treatment of genital warts. Objective: To test the effectiveness and safety of topical 25% podophyllin in treatment of basal cell carcinoma. Patients and Methods: Thirty eight patients with basal cell carcinoma enrolled in this open labeled interventional study that had been enrolled in Department of Dermatology-Baghdad Teaching Hospital, Baghdad, from January 2010 to October 2011. History and physical examination was performed to all patients regarding all demographics detail related to the disease. Exclusion criteria: were pregnancy, recurrent tumors, aggressive deep subtypes, morpheaic type, and size more than 2 cm2 in diameter. Biopsies for all patients were done for histopathological examination at the first visit, and after clinical cure of the lesions. Lesions were treated with 25% topical podophyllin solution once weekly for 6 weeks. Follow up after clinical cured was done every 3 months up to 18 months to recording any sign and symptom of recurrent. Results: Thirty five patients with basal cell carcinoma completed the study: 28 (80%) males and 7(20%) females with males to females ratio 4:1, their ages ranged from 30 - 87 (64.114 ± 12.68) years, and the duration of the disease ranged from 2 months to 30 years (6.88. ± 4.83) years. The size of lesions ranged from 0.8 - 1.9 (1.454 ± 0.239) cm. The total podophyllin applications number ranged from 2 - 6 (4.65 ± 1.055) sessions. The total numbers of treated lesions were 100 lesions: 64 (64%) nodular, 31(31%) pigmented, 3(3%) Basosquamous, and 2 (2%) superficial. Ninety six (96%) lesions in 32 patients showed complete cure with 2 - 6 sessions, while 4 lesions in 3 patients showed partial response with 6 sessions. Biopsy from 21 cured lesions in 21 patients showed complete clearness apart from one with residual malignant cells. All the patients did not show clinical recurrence, during the follow up period up to 18 months. Inflammatory reactions were noted in all treated lesions as redness, edema and juicy skin 36 - 72 hours after topical podophyllin applications. After 3 - 5 days, the reaction became more exaggerated and ulceration developed, ended with crust formation. No evidence of systemic side effects was seen and this had been confirmed clinically and by laboratory during the sessions and one month later. Minimal or no scarring was noticed. Conclusions: Topical 25% podophyllin solution is a new, effective therapeutic modality in treatment of basal cell carcinoma which gives 96% cure, and it is highly recommended as alternative therapy in all type of basal cell carcinoma, single and multiple and for all ages especially for elderly patients and those who have surgeries phobia.

The use of podophyllotoxin for treatment of genital warts

Objective The aim of the study was to determine the clinical profile of genital warts (GWs) among Egyptians and evaluate the therapeutic effect of podophyllotoxin. Background External GWs are caused by proliferation of squamous epithelial cells secondary to human papillomavirus infection. It is sexually transmitted and affects sexually active adults and adolescents. The reason for its occurrence in children without evidence of sexual abuse is still unclear. There are several treatment options, but none has been proven to be the most efficacious. Patients and methods All patients complaining of GWs were recruited from the Dermatology Outpatient Clinic of Menoufia University Hospital during the period from March to September 2011. The patients were investigated for HIV and syphilis. Cervical Pap smear, colposcopy, and anoscopy were performed. Biopsies were taken from every patient to confirm the diagnosis. Podophyllotoxin 0.5% solution was used for treatment. Results A total of 140 cases of GWs were found among patients attending the Dermatology Outpatient Clinic, and included 100 female and 40 male patients (132 adults and eight children). A total of 120 patients received podophyllotoxin treatment and 20 were excluded as they were pregnant. Response to podophyllotoxin was variable and ranged from complete cure to absolute resistance. Conclusion Podophyllotoxin was well tolerated and had a good cure rate.

Preliminary study of intralesional bleomycin injection for the treatment of genital warts.

Preliminary study of intralesional bleomycin injection for the treatment of genital warts.