Topical Treatment For Genital Warts
Genital warts manifest as solitary or clustered
, keratotic papules and plaques. They may be flat, or dome-shaped, cauliflower-shaped, or pedunculated. Genital warts can occur on the penis, groin, cervix, urethral meatus, vagina, anus, pubis, and oral cavity. Their contour can be flat, cribriform, or verrucous and their color white, skin colored, pink, purple, red, or brown.
Neoplastic lesions (e.g., verrucous carcinoma), inflammatory lesions (e.g., lichen nitidus), and normal physical findings (e.g., pearly penile papules) can mimic genital warts. The performance of physical examination using bright light and magnification aids in the diagnosis of genital warts.
Biopsy is recommended only when verrucous papules and plaques thought to be genital warts are not responsive to therapy, manifest with induration, are fixed to underlying structures, have ulceration, grow suddenly or increase pigmentation, or change in appearance. Acetic acid solutions (the acetowhite test) applied to warts to highlight them have a low positive predictive value for diagnosing genital warts.
Treatments for genital warts can be classified as topical, surgical, destructive, or immunomodulatory. There are systemic treatments of warts that involve interferon (IFN), retinoids (isotretinoin), and cimetidine but they are not analyzed here. There is vaccine for the prevention of infection with high-risk HPV subtypes.
As one of the most popular topical treatments, podophyllotoxin contains purified podophyllin in a standardized concentration in cream, gel, or solution preparations that can be self applied by the patient. Studies show that podophyllotoxin is more effective than podophyllin. Although data suggest that it is safer than podophyllin, podophyllotoxin is contraindicated during pregnancy.
Self-applied podophyllotoxin solution is three times more likely to be associated with short term cure than podophyllin, and podophyllotoxin cream is twice as likely. Both podophyllotoxin preparations are also more cost-effective than podophyllin. Podophyllotoxin solution is used for penile lesions; cream or gel formulations are easier to use for vaginal and anal lesions.
Podophyllotoxin is applied twice daily for 3 consecutive days, then discontinued for 4 consecutive days. This one week cycle of treatment may be repeated until there is no visible wart tissue or for a maximum of four cycles. If there is incomplete response after four treatment cycles, discontinue treatment and consider alternative treatment. Safety and effectiveness of more than four treatment cycles has not been established.
There is no evidence to suggest that more frequent application will increase efficacy, but additional applications do increase the rate of local adverse reactions and systemic absorption. Cost (by weight), number of actual treatment applications, and compliance aside, podophyllotoxin appears to be preferred over podophyllin.
The most inexpensive medical therapy for HPV by weight is podophyllin. The expense of a product, however, does not dictate its cost effectiveness. Although the average treatment cost for a course of podophyllotoxin was more than that for podophyllin, the overall cure rate with podophyllotoxin was 66 percent as opposed to 34.6 percent with podophyllin. Podophyllotoxin is the most cost-effective medical treatment for simple and extensive warts.
Selection of a treatment modality may depend on the number, size, and location of lesions. There is little certainty that one approach is more effective than another, although costs differ. Podophyllotoxin should be limited to instances where side effects are discounted. Determining the best treatment for genital warts takes into account efficacy, needs, preferences, financial resources and convenience to the patient.
An alternative antiviral treatment is now available which represents a very promising solution to the growing epidemic of genital warts. HPVCurative is a new, highly effective and potent way to cure genital warts. It is valued for its role in the realm of genital warts cures, and has provided total clearance of the infection time after time.
HPVCurative contains certified organic medicinal plant extracts and antiviral essential oils, which have demonstrated the ability to act as an HPV cure in laboratory tests. Users of this treatment experience rapid elimination of genital warts without scarring or recurrence. The treatment is painless and provides superb results when compare to other HPV cures.
HPVCurative eliminates genital warts and restores skin tissue to the state it was in prior to the infection. Since the treatment can effectively remove genital warts and wart-like substances on the genitals, acid or surgical HPV cures may soon become a thing of the past. To learn more, please go to http://www.bcured.net.
by: bcured
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