Condylomata acuminata

Brockmeyer NH, Poflhoff A, Bader A, Hochdorfer B, Schlottmann R, Rasokat H, Altmeyer P, Kreuter A (2006) Treatment of condylomata acuminata with pegylated interferon alfa-2b in HIV-infected patients. Eur J Med Res 11 27-32... 

Anogenital warts (condylomata acuminata) are caused by the human papillomavirus and are usually sexually transmitted. The average incubation period is 2-3 months. During pregnancy, the warts may become more widespread, favouring an even more rapid growth. Spontaneous resolution may occur. However, they tend to recur in some patients. 

PodophyUotoxin (Podofllox) is available alone and as the main cytotoxic ingredient in podophylUn (25% podophyllum resin), a mixture of toxic chemicals derived from May apple plants. The active ingredients inhibit cell mitosis. The drugs are used to treat condylomata acuminata. The most common toxic effects are skin irritation and less commonly, ulceration. Systemic... 

Cidofovir is approved for the treatment and prophylaxis of CMV retinitis in AIDS patients. It has also been used in the treatment of acyclovir-resistant (viral thymidine kinase-dehcient) HSV infections, polyomavirus-associated progressive multifocal leukoencephalopathy, condylomata acuminata (anogenital warts), and mollus-cum contagiosum. 

Warts/condylomata acuminata Topical Apply 3 times/wk before normal sleeping hours leave on skin 6-10 hr Remove following treatment period. Continue therapy for maximum of 16 wk. 

Condylomata acuminata Interferon alfa-2b-. Intralesional 1 million units/lesion 3 times/wk for 3 wk. Use only 10-million-unit vial, reconstitute with no more than 1 ml diluent. Use tuberculin (TB) syringe with 25-or 26-gauge needle. Give in evening with... 

Mechanism of Action Abiologic response modifier that inhibits viral replication in virus-infected cells, suppresses cell proliferation, increases phagocytic action of macrophages, and augments specific cytotoxicity of lymphocytes for target cells. Therapeutic Effect Inhibits viral growth in condylomata acuminata. 

Genital warts (condylomata acuminata) Topical Apply 0.5% solution or gel ql2h in the morning and evening for 3 days, then withhold for 4 days. Repeat cycle up to 4 times. 

Genital warts (condylomata acuminata) Topical Apply 10% 25% solution in compound benzoin tincture to dry surface. Use 1 drop at a time allowing drying between drops until area is covered. Total volume should be limited to less than 0.5 ml per treatment session. 

Indications Treatment of patients with hairy-cell leukemia, malignant melanoma, follicular non-Hodgkin s lymphoma (NHL), AIDS-related Kaposi s sarcoma, chronic hepatitis C, and the skin disorder, condylomata acuminata... 

Interferons have been studied for numerous clinical indications. In addition to HBV and HCV infections (see Antihepatitis Agents), intralesional injection of interferon alfa-2b or alfa-n3 may be used for treatment of condylomata acuminata (see Chapter 61). 

IFN-a may be used for the treatment of condylomata acuminata (venereal or genital warts), malignant melanoma, hairy cell leukemia and hepatitis B and C, and other types of cancer including skin, kidney and bone cancers. 

Podophyllum peltatum (may apple, or American mandrake) and P. emodi are. respectively, American and Himalayan plants, widely separated geographically but used in both places as cathartics in folk medicine (94). An alcoholic extract of the rhizome known as podophyllin was included in many pharmacopoeias for its gastrointestinal effects it was included in the U.S.P., for example, from 1820 to 1942. At about this time the beneficial effect of podophyllin, applied topically to benign tumors known as condylomata acuminata, was demonstrated clinically (96). This usage was not inspirational, given that there are records of topical application in the treatment of cancer by the Penobscot Indians of Maine and, subsequently, by various medical practitioners in the United States from the 19th century (96). The crude resinous podophyllin is an irritant and unpleasant mixture unsuited to systemic administration. 

Interferon alfa-2b Intron A (Schering-Plough) Hairy cell leukemia AIDS-related Kaposi s sarcoma chronic hepatitis, types B and C condylomata acuminata malignant melanoma follicular lymphoma non-Hodgkins lymphoma... 

Imiquimod is an immune response enhancer that induces production of interferon and several other cytokines. It is used, in formulations containing 5%, to treat external genital and perianal warts/condylomata acuminata in adults (1). As imiquimod-treated warts regress, serum concentrations of interferon-alfa, interferon-beta, interferon-gamma, and tumor necrosis factor rise (2). Trials of imiquimod have failed to identify any particular systemic or laboratory abnormalities. 

Tyring SK, Arany I, Stanley MA, Tomai MA, Miller RL, Smith MH, McDermott DJ, Slade HB. A randomized, controlled, molecular study of condylomata acuminata clearance during treatment with imiquimod. J Infect Dis 1998 178(2) 551-5. 

Malignant diseases hairy cell leukemia, chronic myelogenous leukemia, cutaneous T cell lymphoma, follicular lymphoma, multiple myeloma, Kaposi s sarcoma, diffuse melanoma, renal cell carcinoma, carcinoid tumors Viral diseases condylomata acuminata, chronic active hepatitis B and C... 

Poor oral absorption, should be given SC or IM. Injected intralesionally for condylomata acuminata. 

Interferon alfa 2b (interferon alfa-2b [usan] Alferon Intron A Viraferon Sch 30500) is a recombinant (rbe) version, and is extensively used by injection as an anticancer agent to treat hairy cell leukaemia, condylomata acuminata, AIDS-related Kaposi s sarcoma, follicular lymphoma, chronic myelogenous leukaemia, lymph or liver metastases of carcinoid tumour, as an anticancer adjunct in malignant melanoma also, in the maintenance of remission in multiple myeloma chronic active hepatitis B, chronic hepatitis C. 

Trade names Podofilox Warix Warticon (Stiefel) Indications Topical treatment of condylomata acuminata. Category Antiviral Half-life N/A... 

Interferon, a biological response modifier with antineoplas-tic properties, is indicated in the treatment of condylomata acuminata (see also Figure 107). 

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