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At least 253 records · Page 14Linked to original sources
PubMed2006

Meta-analysis of 5% imiquimod and 0.5% podophyllotoxin in the treatment of condylomata acuminata.

BACKGROUND: Genital warts are a common sexually transmitted disease caused by human papillomaviruses. Podophyllotoxin 0.5%, approved for patient self-administration, has been used most extensively in the treatment of genital warts. Imiquimod, a novel immune response modifier capable of inducing interferon-alpha and a variety of cytokines, has been examined as a potential treatment for genital warts. But 0.5% podophyllotoxin and 5% imiquimod have not been compared in any extensive and formal studies, although they are the common topical agents for genital warts. OBJECTIVE: To evaluate the efficacy and safety of topical 5% imiquimod and 0.5% podophyllotoxin in the treatment of genital warts. METHODS: We searched Medline (1966 to June 2005), Embase (1974 to June 2005) and the Cochrane Controlled Trials Register (issue 3, 2005). Randomized controlled trials of 5% imiquimod or 0.5% podophyllotoxin in the treatment of genital warts were collected. Two reviewers extracted the data and independently assessed the quality of the included medical literature. Then, meta-analysis was conducted. RESULTS: Twelve studies including 3 placebo-controlled trials of imiquimod and 9 placebo-controlled trials of podophyllotoxin were included. The clinical cure rates of imiquimod and podophyllotoxin were 50.34 and 56.41%, respectively, without statistically significant differences between the two (p > 0.05). A combined analysis of the 3 studies on imiquimod showed a statistically significant difference to the placebo group [pooled odds ratio (OR) 11.65, 95% confidence interval (CI) 6.05-22.44], as did a combined analysis of the 9 studies on podophyllotoxin (pooled OR 16.70, 95% CI 7.06-39.48). The most common adverse events of imiquimod were erythema, erosion, excoriation, itching and burning; those of podophyllotoxin were burning, pain, erosion, itching and inflammation. CONCLUSION: Imiquimod and podophyllotoxin possess similar curative effects on condylomata acuminata but podophyllotoxin has more serious adverse effects.

Aminoquinolines↗
PubMed1991

Subclinical human papilloma virus infection in condylomata acuminata patients attending a VD clinic.

In 37 (77%) of 48 patients with external genital warts, application of 5% acetic acid revealed areas of acetowhite epithelium. The lesions were not clinically apparent before acetic acid was applied but were easily detected without the use of a colposcope. In a control group of 20 patients with chlamydial urethritis and no history of genital warts, none had acetowhite genital lesions. Histological examination of biopsy specimens from the flat acetowhite lesions showed HPV infection with koilocytosis in 29 (78%) and in 3 (8%) intra-epithelial neoplasia grade II-III. Using in situ hybridization with commercially available biotinylated DNA probes, HPV types 16/18 could be detected in 7 (24%) patients with koilocytosis and in 3 (100%) patients with dysplasia. Simultaneous infection with HPV types 6/11, 16/18, and 31/33/35 was found in 8 of the 13 HPV DNA-positive patients. It is concluded that subclinical HPV-induced acetowhite lesions are common among patients with genital warts and that these flat lesions may be associated with a high grade of dysplasia. Consequently, routine use of the acetic acid test on the genital epithelium is recommended in patients with condylomata acuminata in order to diagnose and treat all HPV-infected areas.

Ambulatory Care Facilities↗
PubMed1994

Self-treatment using 0.25%-0.50% podophyllotoxin-ethanol solutions against penile condylomata acuminata: a placebo-controlled comparative study.

OBJECTIVE: To compare the efficacy of 0.50% and 0.25% podophyllotoxin preparations against previously untreated penile warts. DESIGN: The study was performed as a double-blind, placebo-controlled investigation on 57 males randomly allocated to one of three groups of 19 males in each, receiving either the placebo solution (70% ethanolic vehicle) or one of the two podophyllotoxin preparations for 1-2 self-treatment courses b.i.d. for three days, separated by a one-week drug-free interval. SETTING: The STD out-patient clinic of the Department of Dermatovenereology at Southern Hospital of Stockholm, Sweden. RESULT: The placebo solution merely exerted a marginal influence on the warts while a primary cure was documented in 72% (13/18) and 81% (13/16) of altogether 34 evaluable men who treated their warts with 0.25% and 0.50% podophyllotoxin, respectively. Follow-up investigation (range 5-23 weeks) was possible for 24 of 26 podophyllotoxin treated men who were primarily cured. Some degree of relapse occurred in nine of them (38%). Of these relapses, warts occurred on previously untreated sites only in three cases (33%), and in another four (44%) relapse was associated with regrowth on treated sites as well as on new sites. When analysing the debulking potential of podophyllotoxin, it appeared that 0.25% podophyllotoxin eradicated 184 of originally 217 warts (85%); the corresponding figure for 0.50% podophyllotoxin was as high as 130 of 135 lesions (96%). Side effects were generally mild-moderate and well tolerated. CONCLUSION: The results underscore the potential usefulness of low-dose podophyllotoxin preparations as first-line chemotherapy of condylomata acuminata for home-treatment. The efficacy from topical use of 0.25% podophyllotoxin detected in the study is certainly of a magnitude signifying that podophyllotoxin concentrations lower than 0.50% deserve further investigation if the drug may be incorporated into alternative vehicles such as creams or ointments.

Adolescent↗
PubMed1993

[Cutaneous condylomata acuminata of an unusual site and extent. Successful CO2 laser therapy].

We report on a 33-year-old patient with unusually extensive and predominantly cutaneous condylomata acuminata spreading from the penis over the mons pubis to the entire lower abdominal wall but almost completely sparing the genital mucous membranes. Single lesions were found on the left arm and on the buttocks. Southern blot hybridization detected HPV-6a DNA sequences within the fibroepithelial tumours. Carbon dioxide laser treatment resulted is cosmetically acceptable healing without recurrence.

Abdominal Neoplasms↗
PubMed1988

Combination of laser plus 5-fluorouracil for the treatment of extensive genital condylomata acuminata.

Although laser is effective in the treatment of genital condylomata, patients with extensive lesions frequently require more than one treatment. The present study was undertaken to investigate whether the cure rate achieved by a single laser treatment could be improved by adding topical 5% 5-fluorouracil (5-FU). Twenty patients with extensive genital condylomata were treated with laser alone. Twenty patients comparable to the first group in age, number, size, and distribution of the condylomata were treated by laser and 5-FU. The first application of 5% 5-FU cream was carried out at the end of the laser treatment by the surgeon in the operating room. The patients were instructed to apply 5-FU cream once weekly to the vulva and once every two weeks to the vagina by using an applicator filled to one-third with 5-FU cream. Seven patients (35%) without 5-FU were found to have persistent condylomata at the first follow-up examination eight to 12 weeks after the single laser treatment. Two additional patients were noted to have disease six and nine months after laser treatment. The combination of laser and 5-FU failed in two cases (10%), both identified at the first visit. The difference is statistically significant (P less than .025, chi-square test). Two patients exposed to 5-FU experienced chemical vulvitis. It is concluded that the combination of a single laser treatment and 5-FU has acceptable side effects and results in a higher cure rate than a single laser treatment without 5-FU.

Combined Modality Therapy↗