II. Indications
III. Background
- Use by clinicians started in the 1940s
- Podophyllotoxin is a purified form of Podophyllin
IV. Preparation
- Podophyllin 15-25% solution in tincture of Benzoin
V. Technique
- Apply with cotton applicator
- Apply test first to small area of warts
- Allow solution to dry after application
- Wash off in 1-4 hours (earlier if burning)
- Repeat application at 1 week intervals for 3-6 weeks
VI. Precautions
- Perform only in office, not at home
- Do not apply more than 0.5 ml
- Severe local irritation if
- Prolonged, excessive applications, high concentration
- Under prepuce can be very irritating
- Avoid during pregnancy (FDA pregnancy category X)
- Do not use in infants
- Do not treat large area at one time
- Limit application area to <10 cm^2
- Limit amount applied to <0.5 ml per treatment
- Risk of systemic absorption leading to toxicity
- Toxicity may result in Convulsions or death
- Do not apply to mucosa (e.g. vagina, Cervix, anus)
- Risk of dysplasia
VII. Efficacy
- Similar efficacy to other agents for warts