Answers
Samar Razaq in Difficult Cases in Primary Care, 2021
This scenario describes labial adhesions, a not too uncommon scenario in young girls. The adhesions start from the posterior vulva and may extend across its entirety until only the urethral meatus is the visible structure. Differentiating between labial adhesions and congenital vaginal agenesis is important. The underlying cause is not always clear but it is likely to be due to local irritation resulting in fusion of the labial folds. Treatment of adhesions is not always necessary, as the problem may resolve spontaneously as the child reaches puberty and produces endogenous oestrogen. However, this child seems to be affected by the problem and hence a small amount of oestrogen cream applied twice a day for 2 weeks is indicated. This will usually resolve the problem without the need for further courses. Genital hygiene and salt baths are recommended to prevent further episodes of localised irritation leading to a recurrence of the problem. Surgery is very rarely needed. Podophyllotoxin is used in the treatment of genital warts.
Dermal and Transdermal Drug Delivery Systems
Tapash K. Ghosh in Dermal Drug Delivery, 2020
Calluses, corns and warts generally manifest as hyperkeratinization of the skin. It follows that actives which are keratolytic or which dissolve the intracellular keratin should be useful in the management of such conditions. The formulations currently available to treat these skin problems are predominantly topical solutions, gels or creams of salicylic acid or DTPs in the form of adhesive (rubber or karaya) matrices containing salicylic acid, which are applied as pads or disks to the affected area. Salicylic acid collodion preparations, which are nitrocellulose solutions that dry on the skin to leave a film, are also available. Salicylic acid may be formulated alone or with other components that also promote keratolysis (most commonly lactic acid). Podophyllotoxin is available as an alcohol-based topical solution or cream for warts affecting the genital areas. Imiquimod is also available in cream form for the same indication.
Viral Sexually Transmitted Diseases
Laurence R. Sands, Dana R. Sands in Ambulatory Colorectal Surgery, 2008
Treatment for condyloma is mainly office based. Since HPV is not curable, treatment focuses on cytodestruction of the lesions by any number of methods. Podophyllin is a resin extracted from the podophyllum plant whose active ingredient is podophyllotoxin, which is an antimitotic agent that causes tissue necrosis. The resin is applied to the wart and left to dry for four to six hours, and is then washed off. This is done once per week for four to six consecutive weeks by a physician. Podophyllin has demonstrated a clearance rate of 30% to 60% with a recurrence rate of 30% to 60%. The use of podophyllin is limited secondary to local and systemic toxicity. Podophyllotoxin has been isolated and approved for home treatment. It is less toxic and has a higher clinical clearance rate after application twice per day for three consecutive days. It has similar recurrence rates to podophyllin (13,14).
ROS-Activated homodimeric podophyllotoxin nanomedicine with self-accelerating drug release for efficient cancer eradication
Published in Drug Delivery, 2021
Cancer is a major threat to human health. Chemotherapy is one of the primary treatment modalities available for cancer patients. However, the present status of chemotherapy is far from being satisfactory, which is seriously limited to the poor water solubility and the side effects (Zuo et al., 2020). Podophyllotoxin (POD), a natural aryltetralin lignan, is an extract of Podophyllum hexandrum, which has been demonstrated to be effective against cancer (Feng et al., 2020; Zhao et al., 2021). POD can specifically bind to tubulin in the cell division process, inhibiting the formation of mitotic spindles (Zhang et al., 2018; Kumbhar et al., 2020). There is evidence that poor water solubility and highly off-target toxicity hinder POD application in clinics (Ou et al., 2019; Liu et al., 2020). Hence, it is imperative to develop a simple delivery system to decrease POD toxicity and improve its antitumor effects efficiently.
The effects of anticancer medicinal herbs on vascular endothelial growth factor based on pharmacological aspects: a review study
Published in Nutrition and Cancer, 2021
Sajad Fakhri, Fatemeh Abbaszadeh, Masoumeh Jorjani, Mohammad Hossein Pourgholami
From the pharmacological mechanism point of view, Sang et al., showed the inhibitory potency of deoxy podophyllotoxin (DPT) against the tube formation of VEGF-induced HUVEC (82). Quinazoline linked 4β-amidopodophyllotoxin conjugates also made a decrement in the expression of modulator proteins of such tumor microenvironments, including VEGF-A, AKT-1, STAT-3, p-ERK, and ERK1/2 in individuals with breast cancer (83). As Jiang et al. reported, DPT also demonstrated angiogenesis inhibitory effects on chick chorioallantoic membrane and rat aortic ring (84). Similar studies also confirmed the antiangiogenic influences of Podophylotoxins. Altogether, introduce the anti-VEGF and antiangiogenic effects of Podophylotoxins as their main mechanisms of action against cancer.
Our experience using 1064 nm Nd:YAG in palmoplantar warts
Published in Journal of Cosmetic and Laser Therapy, 2022
Hai Thi Thu Le, Cuong Truong Van, Minh Nguyen Thi, Firas Al-Niaimi
Currently, several treatment modalities are available to treat cutaneous warts including abrasive methods (physical methods: cryotherapy, curettage, surgery, carbon dioxide laser; chemical agents: salicylic acid, formic acid, monochloroacetic acid, and cantharidin) or non-abrasive methods (antimitotic agents: 5-fluorouracil, bleomycin; antiviral agents such as cidofovir; immunotherapy: interferon, imiquimod, and contact allergens). A compound topical product comprising 1% cantharidin, 5% podophyllotoxin, and 30% salicylic acid (CPS) has also been shown to be effective in recalcitrant plantar warts (5). These methods, however, have been associated with pain, scarring, and prolonged recovery (1,6). Different types of lasers have been evaluated for treatment of warts. Carbon dioxide (CO2) laser is considered a good ablative treatment, producing cure rates of up to 75% in resistant common warts (7). Among non-ablative modalities, PDL can be used first-line; PDL carried the advantages of higher safety, less pain, and greater compliance. However, it required more treatment sessions compared with Nd:YAG laser to achieve complete clearance of the lesions (8). Recently, alternative other types of laser treatments for warts have been reported, such as using the non-ablative photothermal effect of the long-pulsed 1064 nm Nd:YAG laser (LPNYL) to destroy the HPV virus and cause hemocoagulation in the target diseased tissue. This latter approach has attracted attention as being safe and effective for the treatment of warts.
Related Knowledge Centers
- Alkaloid
- Enzyme
- Genital Wart
- Lignin
- Microtubule
- Molluscum Contagiosum
- Toxin
- Papillomavirus Infection
- Podophyllum Resin
- Molecular Binding