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Efficacy and Safety of Topical Podophyllin 5% Ointment in Patients with Mild Plaque-Type Psoriasis

Authors: Khalifa E.Sharquie --- Adil A.Noaimi --- Wesal K. Al-Janabi*
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 2 Pages: 251-258
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: BACKGROUND: Psoriasis is a common chronic condition of the skin that is resistant to many therapies. There is a need for the development of novel non-steroidal topical drugs for the treatment of psoriasis.OBJECTIVE: To assess the efficacy and safety of topical podophyllin 5% ointment in patients with mild plaque-type psoriasis.PATIENTS AND METHODS: Sixty two patients with mild plaque-type psoriasis were enrolled in this study. They were dividedinto 3 groups: GroupA (21patients)were treated with podophyllin 5% ointment every other day,while Group B(20patients)were treated with clobetasol propionate 0.05%ointment twice daily and21 patients in Group C were treated with Vaseline twice daily for 8 weeks as a control group.Efficacy was evaluated every 2 weeks for 8weeks using Psoriasis Area and Severity Index (PASI)score and relapse was recorded after cessation of treatment in those patients who achieved goodresponse during 8 weeks follow up period.RESULTS: A total of 62patients were 44(70.9%) males and 18(29.0%) females, with: male: female ratio 2.3:1.Their ages ranged from 18-65 (37.5±12.9) years. Their baseline PASI score ranged from 1.29(5.2±2.4).Attheendof8weeksoftherapy:nostatisticallysignificantdifferenceinPASIreductionbetweenGroupA(66.3±20.7) and Group B(68.1±34.2) treated patients, P-value =0.831 and both of themwere statistically significant higher PASI reduction than patients with Group C,34.1±28.8, P-value=<0.001.Regarding the percentage of patients who achieved good response, there was nostatistically significant difference between Group Aand Group B, 95.3% versus 70% ( Pvalue=0.083)and both of them achieved a statistically significant higher percentage of patientswith good response than Group C,47.6%, P-value=<0.001. Although the percentage of patientswith complete clearance (PASI≥90%) in the Group Awas much less, 9.5%, than that of Group B,65% (statistically significant, P-value=< 0.001), the total relapse rate during 8 weeks follow up wasmuch lower among Group Apatients, 25% versus 70%, P-value=0.043.On the other hand nocomplete clearance was achieved in the Group Cand their relapse rate was 80%.Regarding side effects: Group A, 9.5% of patients developed hypopigmentation, Group B, 10% ofpatients developed pyoderma and Group C, no side effects were reported. There was no statisticallysignificant difference among the three groups regarding the frequency of side effects (P = 0.355).CONCLUSION: Podophyllin 5% ointment on every other day regimen was as effective as clobetasole 0.05%ointment twice daily at the end of 8 weeks treatment with no side effects and with a much lowerrelapse rate.


Article
The Effectiveness & Safety of Topical Podophyllin Therapy in Condylomata Acuminata in Iraqi Infants and Young Children
ألثآليل ألجنسية لدى ألرضع وألأطفال العراقيين (محلول البودوفيلين الموضعي كعلاج فعال)

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Abstract

AbstractBackground: Condylomata acuminata an infection caused by Human papilloma virus. The incidence of anogenital warts among children is rising. Still anogenital warts can be the only manifestation of child sexual abuse. Human papilloma virus typing dose not provide definitive evidence for or against sexual abuse.Objective: To evaluate this condition among Iraqi children and to report the experience with podophyllin.Method: Condylomata acuminata was studied in eighteen infants and young children, attending the Department of Dermatology & Venereology- Baghdad Teaching Hospital in Period from January 1996 to January 2000.Results: The ages of patients ranged from 6 – 84 months (mean ± SD23.66 ± 20.30 months), 11 females and 7 males. The duration of the disease ranged from 3 – 8 months (5.83 ± 1.24 months). The clinical pictures were mostly a cauliflower like warts affecting the genital area, anal and perianal areas. Sexual abuse was not confirmed in any case. Family history of genital warts was denied among all family members apart from one girl that her mother had verruca vulgaris on their fingers. Fifteen percent Podophyllin in tincture benzoin was an effective therapy and all lesions had disappeared after 1 – 3 applications (1.77 ± 0.73 months) once weekly with no sign of relapse through several months of follow up.Conclusion: The present work is compatible with the increase in the frequency of genital warts among infants and young children all over the world. Since there was no history of sexual abuse in affected patients, we believe that genital warts result from direct contact with other members of the family, who are either not aware of the presence of warts or they have latent infection. Podophyllin seems to be the drug of choice for all patients who responded quickly to this mode of therapy. This experience with podophyllin in this age group has not been reported in the published literatures.Key Words: Condylomata acuminata, infants & young children, Podophyllin

الملخص ألهدف:تقييم الثاّليل الجنسية عند الرضع والاطفال العراقيين وتسجيل البودوفيلين كطريقة لعلاج الثاّليل الجنسية عند الاطفال.ألطريقة:تمت دراسة الثاّليل الجنسية في ثمانية عشر من الاطفال الرضع تراوحت اعمارهم بين 0.6-7 سنوات مع معدل الاعمار 1.7±0.6سنة كان المرضى يتكونون من عشر اناث وسبع ذكور. وقد تم اخذ تاريخ المرض من اباء المرضى وفحصهم سريريا. تم استخدام البودوفلين 15% بمعدل استعمال واحد في الاسبوع وقد تمت المتابعة خلال عدة اشهر.ألنتائج:سريريا كان المرضى يعانون من ثاّليل على شكل زهرة القرنابيط (Cauliflower Like) في المناطق التناسلية الشرجية وحول الشرجية. لم يتأكد ألأستغلال الجنسي في اي حالة. ولم يكن هناك اي تاريخ مرضي لحالة مشابهة في عوائل المرضى .تم استعمال محلول البودوفلين 15% موضعيا وكان علاجا فعالا اختفت جميع الاّفات بعد 1-3 استعمالات . لم تكن هناك اي حالة ارتجاع بعد عدة اشهر من المتابعة.خاتمة: جاءت هذه الدراسة متوافقة مع زيادة الاصابة بالثاّليل الجنسية بين الرضع والاطفال في العالم. لم يتأكد الأستغلال الجنسي في اي حالة, لذلك نعتقد ان الثاّليل الجنسية جاءت من التلامس مع افراد عوائلهم, الذين لم يكترثوا لوجود الثاّليل او الاصابة المستترة.يبدو البودوفلين كعلاج فعال لكل المرضى الذين استجابوا بسرعة لهذا العلاج. هذه التجربة مع البودوفلين في هذا العمر من المرضى لم تسجل سابقا في الدوريات المنشورة.

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