Use Of Podophyllin Research Articles

A cross-sectional survey of treatment choices for anogenital warts

This was a cross-sectional survey that collected data relating to management of anogenital warts (AGW) during a single-patient visit only at genitourinary medicine clinics. Single-agent use of cryotherapy, podophyllotoxin and trichloroacetic acid (TCA) were the most common treatment modalities, accounting for over two-thirds of all modalities used. Podophyllin, alone or in combination with other agents, was used for about 20% of first-line treatments. Podophyllin was included in about 15% of all treatment modalities. Guidelines for the management of AGW continue to recommend the use of podophyllin, but this may need to be modified in the light of recent publications. Podophyllin, TCA, podophyllotoxin or combinations of these agents are commonly used to treat keratinized warts. About 11% of all treatments involved a combination of two or more agents.

Genital burns from home use of podophyllin

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.

Quercetin and kaempherol: an argument against the use of podophyllin?

Topical application of podophyllin is a routine procedure in patients with ano-genital warts. Podophyllin is a crude plant extract and is therefore not a well-defined product. It may contain variable amounts of the active lignan podophyllotoxin and the majority of the dry weight of podophyllin is made up of substances never identified. The purpose of the study was to estimate in podophyllin 20% the amounts of two mutagenic substances, quercetin and kaempherol. Using high-pressure liquid chromatography the amounts of quercetin and kaempherol were determined in 3 batches of podophyllin 20%. Quercetin and kaempherol constitutes 2.5-3.8% and 6.0-6.4% of podophyllin dry substance, respectively. Podophyllotoxin constitutes in comparison 12.7-13.8% of podophyllin dry substance. As approximately 10% of the amount of dry substance in podophyllin 20% is composed of two mutagenic flavonoids, quercetin and kaempherol, efforts should be focused on the production of a well-defined purified podophyllotoxin preparation that may replace podophyllin for clinic use in patients with genital warts. Self-medication with purified podophyllotoxin 0.5% may be considered as first-line treatment in well-instructed patients with external genital warts.

Is Podophyllin Safe for Use in Pregnancy?-Reply

In Reply.— I would like to thank Dr Sundharam for his comments concerning my article on the use of podophyllin. I had hoped that my somewhat controversial stance would generate useful discussion about an area of therapeutics that I felt was largely unresolved. The original article was considerably longer and more detailed. Because of spacing restrictions, it was shortened, and I feel that, as a result, the full impact of my argument was not presented. I amnotproposing that podophyllin is safe for use in pregnancy. I am simply saying that, in my opinion, it has not been proven unsafe. These two positions are quite different. I reviewed the literature and analyzed the reports and showed that, in each case, there was no proof that podophyllin was responsible. In all cases there were important histories of substance abuse, general anesthetics, or surgical intervention that may have played an important part. I

Hazards of topical mitotic blocking agents.

To the Editor.— With regard to the correspondence between Gaylarde and Sarkany and Kligman (112:556, 1976) as to the advisability of using colchicine ointment in psoriasis, the article by Belisario 1 is relevant. He cites five cases of severe hematopoietic depression leading to death in three, and one death associated with internal toxicity in patients treated topically with demecolcine (Colcemid [Britain]) ointment for skin cancers. Demecolcine is N -desacetyl methylcolchicine. Both demecolcine and colchicine are derived from the meadow saffron plant and block mitoses in metaphase. Demecolcine was reported to be 30 times less toxic than colchicine. The cytotoxic effects of podophyllin, another mitotic blocking agent, and colchicine are similar. 2 One death has resulted from the topical use of podophyllin for condyloma acuminata of the vulva. 3 While I agree with Kligman that one must take risks to alleviate the agony of psoriasis, it would appear that the hazards

Giant condylomata of Buschke and Lowenstein.

To the Editor.— In their interesting article on giant condylomata acuminata (Arch Derm 100 :185-186, 1969), Drs. Becker, Walder, and Larson incorrectly paraphrased a statement made by the late Gerald F. Machacek and myself (Arch Derm 8 2:41-47, 1960), as follows: Topical agents, such as podophyllin and parenteral antibiotics are ineffective and fulguration of local lesions has led to rapid recurrence. We did not adjudge the effectiveness of any topical medication except podophyllin, nor did we think at that time, as I still do not, that electrosurgery is necessarily ineffective therapy. Further, in no way could fulguration (lead) to rapid recurrence; at worst it might fail to cure. Penectomy also fails some patients, and it certainly leaves them vastly more aggrieved than does unsuccessful electrosurgery, which at least leaves something to work on. Our points concerning the use of podophyllin for Buschke and Lowenstein tumors were two: (1) It is

The use of Podophyllin in the Treatment of Papillomatosis of the Bladder

No AccessJournal of Urology1 Aug 1959The use of Podophyllin in the Treatment of Papillomatosis of the Bladder Edward J. Richardson Edward J. RichardsonEdward J. Richardson More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)65866-XAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "The use of Podophyllin in the Treatment of Papillomatosis of the Bladder." The Journal of Urology, 82(2), pp. 234–235 © 1959 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByHotchkiss R and Rouse A (2018) Papillomatosis of the Bladder and Ureters, Preceded by Condyloma Acuminata of the Vulva: A Case ReportJournal of Urology, VOL. 100, NO. 6, (723-725), Online publication date: 1-Dec-1968.Lewis H, Wolf P and Pierce J (2018) Condyloma Acuminatum of the BladderJournal of Urology, VOL. 88, NO. 2, (248-251), Online publication date: 1-Aug-1962.Weyrauch H and Crossfield J (2018) Dissemination of Bladder Neoplasms by Endoscopic ElectroresectionJournal of Urology, VOL. 87, NO. 3, (391-397), Online publication date: 1-Mar-1962.Firstater M (2018) Podophyllin in the Treatment of Vesical PapillomasJournal of Urology, VOL. 86, NO. 5, (565-567), Online publication date: 1-Nov-1961. Volume 82Issue 2August 1959Page: 234-235 Advertisement Copyright & Permissions© 1959 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Edward J. Richardson More articles by this author Expand All Advertisement PDF DownloadLoading ...

Podophyllin treatment for plantar warts.

It is the purpose of this report to describe the successful use of podophyllin in treatment of 13 patients with verruca plantaris, of whom 11 were cured. The patients remained ambulatory during the treatment, and no discomfort was encountered. There has been no recurrence after four to six months' observation of the 11 cured patients. In 1948, Kurtin and Yantef 1 first reported the successful use of podophyllin in the treatment of plantar warts. Their method consisted of paring down the wart until bleeding points were encountered. The surrounding area was coated with collodion, and a drop of a 25% solution of podophyllin in liquid petrolatum was then placed into the concavity. A 2-in. (5-cm.) strip of well-flamed tape was placed over the lesion to macerate the area. This treatment was repeated at eight-day intervals, usually for three to four treatments. These authors reported 60% cures in a small series

Podophyllotoxin treatment of Microsporum audouini scalp infections.

THE CLINICAL importance of podophyllotoxin 1 has been an outgrowth of extensive use of podophyllin (podophyllum resin) within recent years. Kaplan 2 in 1942 reported the topical application of podophyllin, the resin obtained from the root of Podophyllum peltatum, to be effective against condyloma acuminatum. Topical use of podophyllin has been found of value also in granuloma inguinale, 3 basal-cell carcinoma, 4 and scalp infections due to Microsporum lanosum and M. audouini. 5 Podophyllin inhibits mitosis and acts as a direct cellular toxin. 6 Sullivan, 7 using chemical, biologic, and pathologic methods, found podophyllotoxin to be the active principle of podophyllin. Podophyllotoxin is a complex tricyclic substance with the formula C 22 H 22 O 8 , and may be inactivated by alkaline hydrolysis in both aqueous and alcoholic solutions. It inhibits the cellular respiration, in vitro, of rat lymph nodes, thymus, kidney tumor, spleen, liver, brain, and testis. 8 The

Lichen simplex chronicus (Vidal) treated successfully with podophyllin.

THE PURPOSE of this paper is to report the results of treatment with podophyllin (resin of podophyllum N. F.) in seven cases of circumscribed neurodermatitis. The patients had been treated previously with little or no response to orthodox measures, including roentgen therapy. Although the series of cases is small, the response was sufficiently impressive to recommend the use of podophyllin as a treatment worthy of further trial. However, the impression should not be gained that the seven cases were consecutive. The patients were selected from a larger group treated since March 20, 1947 because they were observed for a sufficiently long period for careful evaluation of the results. A uniformly good result should not be expected. The history, pharmacology and mode of action of podophyllin have already been thoroughly discussed by Sullivan1and Sullivan and King,2who need not be repeated here. MATERIALS AND METHODS Forms of Podophyllin.

The Successful Treatment of Granuloma Inguinale, with Special Reference to the Use of Podophyllin

No AccessJournal of Urology1 Oct 1942The Successful Treatment of Granuloma Inguinale, with Special Reference to the Use of Podophyllin Gilbert Charles Tomskey, George W. Vickery, and Paul Lionel Getzoff Gilbert Charles TomskeyGilbert Charles Tomskey More articles by this author , George W. VickeryGeorge W. Vickery More articles by this author , and Paul Lionel GetzoffPaul Lionel Getzoff More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)70727-6AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1942 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 48Issue 4October 1942Page: 401-406 Advertisement Copyright & Permissions© 1942 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Gilbert Charles Tomskey More articles by this author George W. Vickery More articles by this author Paul Lionel Getzoff More articles by this author Expand All Advertisement PDF DownloadLoading ...