Podophyllin Resin

Aka: Podophyllin Resin, Podophyllin

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