Cryotherapy versus Podophyllin in the Treatment of Genital Wart

Document Type : Original Article

Authors

1 Assistant Professor of Dermatology, Qaem Hospital, Mashad University of Medical sciences

2 Assistant Professor of Dermatology, Qaem Hospital, Mashhad university of Medical Sciences

3 Assistant of Dermatology, Qaem Hospital, Mashhad university of Medical Sciences

4 Assistant Professor of Medical Statistics Division, Community Medicine Department . Mashhad university of Medical

Abstract

Introduction: Genital wart is a common sexually transmitted disease caused by human
papiloma virus. Podophyllin is a plant extract, having been traditionally used to treat genital
wart. Podophyllin is an anti- mitotic agent with direct effect on epithelial cells. Liquid
nitrogen is most widely used as cryotherapy agent. Cryotherapy causes cell death, ice
crystals formation in the cell, and cellular components damages. The purpose of this study
was to evaluate the efficacy of podophyllin solution versus liquid nitrogen cryotherapy on
genital warts.
Material and Methods: This clinical trial was performed from Feb 2003 to Dec 2005, on
70 patients with genital wart in Dermatology Clinic, Qaem Hospital. Patients divided into
two groups randomly. Of the total patients, 35 received podophyllin solution and another 35
treated with liquid nitrogen cryotherapy. Study medication was applied once weekly until
the complete clearance of lesion for a maximum duration of 8 weeks. Patients whose warts
cleared completely were observed for up to 10 weeks to determine the recurrence rate.
Result: The mean duration of complete clearance was 3.9 weeks (range 1-7) for
podophyllin and 4.9 weeks (range 1-9) for cryotherapy group (P=0.039). Of podophyllin
and cryotherapy treated patients, whose wart cleared completely and who finished 10 week
follow up period, 26% and 47 % experienced the recurrence of warts, respectively
(P>0.05). Cryotherapy patients experienced a significantly greater number of local
inflammatory reactions than the podophyllin group.
Conclusion: This data indicated that podophyllin solution therapy of genital wart is more
effective, with less recurrence rate and side effects, than liquid nitrogen cryotherapy

Keywords

References

1. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al . Human
papiloma virus is a necessary cause of invasive cervical cancer world wide. J Pathol 1999;
189:12-9
2. Bosch FX, Manos MM, Munoz N, Sherman M, Jansen AM, Peto J, et al. Prevalence of
human papiloma virus in cervical cancer a world wide perspective. International biological
study on cervical cancer (IBSCC) study group. J Natl cancer Inst 1995; 87:796-802
3. Koutsky LA, Galloway DA, Holmes KK. Epidemiology of genital human papiloma virus
infection. Epidemiol Rev 1983; 10:122-63
4. Oriel JO. Natural history of genital warts .Br J Vener Dis 1977; 47:1-13
5. Kinghorn GR. Genital wart: incidence of associated genital infection. Br J Dermatol 1978;
99:405-9
6. Cooper C, Singha HSK. Condylomata acuminate in women: the effect of concomitant genital
infection on response to treatment. Acta Derm venereol (stockh) 1985; 65: 150-3
7. Jablonska S, Majewski S. Immunology of genital papillomavirus infections. In : Gross G,
Jablonska S, Pfister H, Stegner HE, editor. Genital papillomavirus infections. Berlin:
Springer-Verlag; 1990.p.263-81.
8. Sterling JC. Virus infections. In: Burns T, Griffiths C, Breathnach S, Cox N. Rook Textbook
of Dermatology. 7th ed. Massachuset: Blackwell Science; 2004:25.49-50.
9. Sterling JC. Virus infections. In: Burns T, Griffiths C, Breathnach S, Cox N. Rook Textbook
of Dermatology. 7th ed. Massachuset: Blackwell Science; 2004:25.50-51.
10. Koutsky L. Epidemiology of genital human papillomavirus infection. Am J Med 1997;
102:3-8. First citation in article PubMed
11. Herrero R, Hildesheim A, Bratti C, Sherman ME, Hutchinson M, Marales J, et al. Populationbased
study of human paoillomavirus infection and cervical neoplasia in rural Costa Rica. J
Natl Cancer I NST 2000; 92:464-74.
12. Jensen SL. Comparison of podophyllin application with simple surgical excision in clearance
and recurrence of perianal condylomta acuminate. Lancet 1985; 11: 1146-8.
13. Krause SJ, Stone KM. Managment of genital infection caused by human papillomavirus. Rev
of Infec Dis1990; 12: (6):5620-5631
14. Beutner KR, Wiley DJ, Douglas JM, Tyring SK, Fite K, Trofatter K, et al. Genital warts and
their treatment. Clin Infect Dis 1999; 28(1):537-56.
15. Beutner KR, Richwald GA,Wiley DJ, Reitano MV. External genital warts:report of the
American Medical Association Consensus Coference. AMA Expert Panel on External
Genital Warts. Clin Infect Dis 1998; 27:796-806.
16. Wiley DJ, Beutner KR. Genital warts. Clin Evidence 2000; 3:764-74.
17. Handley JM, Horner T, Maw RD, Lawther H, Dinsmore WW. Subcutaneous interferon alpha 2a
combined with cryotherapy vs cryotherapy alone in the treatment of primary anogenital wart: a
randomized observer blind lacebo controlled study. Genitourin Med 1991; 67:297-302.
18. Eron LJ, Alder MB, JM OR, Rittweger K, DePamphilis J, Pizzuti DJ. Recurrence of
condylomata acuminate following cryotherapy is not prevented by systemically administered
interferon. Genitourin Med 1993; 69:91-3.
19. Bashi SA. Cryotherapy versus podophyllin in the treatment of genital wart. Int J Dermatol
1985 Oct; 24(8):535-6.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 10, Issue 2 - Serial Number 2
September 2008
Pages 133-138

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