RSS-Feed abonnieren
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1055/s-0041-1732329
Giant Perianal Condyloma Successfully Treated with Podophyllin at 25% in Solid Petrolatum
![](https://www.thieme-connect.de/media/10.1055-s-00050098/202103/lookinside/thumbnails/10-1055-s-0041-1732329_2000179-1.jpg)
Abstract
Purpose Giant perianal condyloma (GPC) is a rare condition. The effective treatment is a multidisciplinary challenge; topical treatments are usually ineffective, and surgical resection has significant morbidity. Podophyllin at 25% in solid petrolatum (25%PSP) can be an effective treatment option for GPC. The aim of the present study was to assess its response and tolerability.
Methods This retrospective, single-center case series evaluated the clinical response of 14 patients with GPC treated with 25%PSP in a public hospital in Buenos Aires between December 2015 and December 2019. After obtaining a full history and performing a physical exam, the lesions were measured and photographed. Biopsies were performed to exclude malignancy, as well as exams to rule out pregnancy. Podophyllin at 25% in solid petrolatum was administered topically in cases of GPC and washed off by the patients at home after 4 hours. The patients underwent at least 4 weekly visits, which included interval history, photodocumentation of the lesions, and provider-applied 25%PSP. The response rate was assessed by comparing measurements and the overall decrease in volume of the GPC based on photos from the first and last sessions. Adverse outcomes were noted.
Results In total, 10 men, 3 women, and 1 transgender woman with GPC unresponsive to prior treatments and a mean age of 34.5 years were included. A total of 12 patients were immunosuppressed. All the perianal lesions were circumferential and measured between 8 cm and 20 cm. Overall, 7 patients had genital condyloma outside of the anus and perianus; the histology showed low-grade squamous intraepithelial lesions in all cases. While on treatment, 7 patients reported dermatitis, and 71% of the patients had ≥ 75% reduction in lesion size.
Conclusions Podophyllin at 25% in solid petrolatum is an effective, well-tolerated topical treatment option for GPC.
Publikationsverlauf
Eingereicht: 02. November 2020
Angenommen: 22. März 2021
Artikel online veröffentlicht:
13. August 2021
© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Trombetta LJ, Place RJ. Giant condyloma acuminatum of the anorectum: trends in epidemiology and management: report of a case and review of the literature. Dis Colon Rectum 2001; 44 (12) 1878-1886 DOI: 10.1007/BF02234473.
- 2 Svidler López L, La Rosa L. Human Papilloma Virus Infection and Anal Squamous Intraepithelial Lesions. Clin Colon Rectal Surg 2019; 32 (05) 347-357 DOI: 10.1055/s-0039-1687830.
- 3 Gilson R, Nugent D, Werner RN, Ballesteros J, Ross J. 2019 IUSTI-Europe guideline for the management of anogenital warts. J Eur Acad Dermatol Venereol 2020; 34 (08) 1644-1653 DOI: 10.1111/jdv.16522.
- 4 Orkin BA. Perineal reconstruction with local flaps: technique and results. Tech Coloproctol 2013; 17 (06) 663-670 DOI: 10.1007/s10151-013-0978-y.
- 5 Uribe N, Rueda C, López M. et al. Management of giant anal condyloma by wide local excision and anoplasty. Colorectal Dis 2012; 14 (11) 1394-1397 DOI: 10.1111/j.1463-1318.2012.03006.x.
- 6 Paddock Laboratories, LLC.. PODOCON 25- podophyllum resin tincture. Accessed June 26, 2020 at: https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=de96dc6ee6d1-4383-9ce1-4d06bac08e00&type=display
- 7 Lacey CJN, Goodall RL, Tennvall GR. et al; Perstop Pharma Genital Warts Clinical Trial Group. Randomised controlled trial and economic evaluation of podophyllotoxin solution, podophyllotoxin cream, and podophyllin in the treatment of genital warts. Sex Transm Infect 2003; 79 (04) 270-275 DOI: 10.1136/sti.79.4.270.
- 8 von Krogh G, Longstaff E. Podophyllin office therapy against condyloma should be abandoned. Sex Transm Infect 2001; 77 (06) 409-412 DOI: 10.1136/sti.77.6.409.
- 9 Nadal SR, Manzione CR, Couto Horta SH, De Moura Galvao V. Tratamento Tópico dos condilomas acuminados perianais em doentes HIV. Rev Bras Coloproctol 1999; 19 (02) 79-82
- 10 Nadal SR, Manzione CR, Horta SHC, Calore EE. Sistematização do atendimento dos portadores de infeccão perianal pelo papilomavirus humano (HPV). Rev Bras Coloproctol 2004; 24 (04) 322-328 https://pdfs.semanticscholar.org/4069/7041fae8c45dc6c6302cf6a0f158c11ea3a2.pdf
- 11 Abbass MA, Valente MA. Premalignant and Malignant Perianal Lesions. Clin Colon Rectal Surg 2019; 32 (05) 386-393 DOI: 10.1055/s-0039-1687835.
- 12 Marino F. Complete healing of perianal giant condyloma (buschke-löwenstein tumor) with imiquimod 5% cream alone. [published online ahead of print, 2020 Jun 30] Tech Coloproctol 2020; 24 (12) 1313-1314 DOI: 10.1007/s10151-020-02280-z.
- 13 Guttadauro A, Chiarelli M, Macchini D. et al. Circumferential anal giant condyloma acuminatum: a new surgical approach. Dis Colon Rectum 2015; 58 (04) e49-e52 DOI: 10.1097/DCR.0000000000000339.
- 14 Filley CM, Graff-Richard NR, Lacy JR, Heitner MA, Earnest MP. Neurologic manifestations of podophyllin toxicity. Neurology 1982; 32 (03) 308-311 DOI: 10.1212/wnl.32.3.308.
- 15 Conard PF, Hanna N, Rosenblum M, Gross JB. Delayed recognition of podophyllum toxicity in a patient receiving epidural morphine. Anesth Analg 1990; 71 (02) 191-193 DOI: 10.1213/00000539-199008000-00013.