Tanweer A. Syed’s research while affiliated with University of North Carolina at Chapel Hill and other places

Background: Genital warts are a well-recognized clinical entity and a disease of great antiquity that differ from skin warts both histologically and antigenically. It is a common sexually transmitted disease of high prevalence all over the world. Women are more likely to be unaware of such warts because it is harder for them to examine their genitalia. Objective: The purpose of this multicenter, double-blind, placebo-controlled study was to compare the clinical efficacy and tolerance of 0.3% and 0.5% podophyllotoxin in a cream emulsion (castor oil, BP as vehicle) to cure genital condylomata in women. Methods: Preselected (n = 80) Asian females (mean age 23.6 years), harboring 544 warts (mean 6.8 in number), ranging from 1 to 9 mm in size (mean 2.1 mm) with biopsy-proven diagnosis of condylomata acuminata were randomly allocated to three groups (30 + 30 + 20). At home the patients applied the given trial medication themselves (using the finger) twice a day, for 3 consecutive days per week, and if not cured the same course was extended to 3 more weeks, in total 24 topical applications for 4 weeks. The patients were examined on a weekly basis, and a total regression of warts (biopsy-proven) was evaluated as complete cure. Results: By the end of the study, the placebo group (20 patients, bearing 124 warts) did not show any regression or clinical efficacy, while 41/60 patients (68.3%) and 349/420 warts (83%) were cured in the 0.3% and 0.5% treatment groups (placebo vs. active groups p Conclusion: Along with mild, tolerable side effects the study demonstrates that 0.5% podophyllotoxin cream is more efficacious than 0.3% (p

Background: Molluscum contagiosum is generally a self-limiting benign skin disease that affects mostly children and young adults. Objective: The purpose of this multicenter, double-blind, placebo-controlled study was to compare the clinical efficacy and tolerance of 0.3% and 0.5% podophyllotoxin in a hydrophilic cream base to cure molluscum contagiosum in Asian males. Methods: Preselected patients (n = 150), age range 10-26 years (mean: 15.4), harboring 1,125 lesions (mean: 7.5), with size ranging from 2 to 8 mm in diameter (mean spot size 3.2 mm) and biopsy-proven diagnosis of molluscum contagiosum, were randomly allocated to three parallel groups. Twenty-four (16%) patients had atopic dermatitis. Patients self-administered placebo, 0.3% or 0.5% podophyllotoxin cream, twice daily for 3 consecutive days, and if total elimination was not achieved with one trial (6 topical applications), the same treatment was extended to 3 more weeks (24 topical applications in 4 weeks). The duration of the study was 12 weeks with 6 months (on monthly basis) follow-up. By the end of the treatment 80 patients (52, 92 and 16% patients in the 0.3%, 0.5% and the placebo groups, respectively) were evaluated as completely cured. During the treatment 92 patients (61.3%) did not complain of any allergic or localized adverse symptoms. Tolerable moderate to mild frequent side effects were pruritus (20.6%) and erythema (18%), with no dropouts. No recurrence was seen after 9 months of follow-up. Response to the trial medications appeared to be directly proportional to the concentration of podophyllotoxin (p < 0.001). Self-medication was well accepted by all the patients. It was concluded that the 0.5% podophyllotoxin cream preparation was more efficacious than the 0.3% incorporation (p < 0.001) and can be considered a safe, home-based first line of therapy to cure molluscum contagiosum.

The purpose of this comparative open study was to determine the clinical efficacy of 0.3% podophyllotoxin both in 70% ethanolic solution and cream preparations on genital warts. Three parallel trial preparations, 0.3% solution, 0.3% and 0.15% cream, were randomly allocated to 60 circumcised Asian males (mean age 19.5 years), with the diagnosis of genital condyloma. Patients applied the trial preparation twice a day for 3 consecutive days. If total elimination was not achieved with one trial, it was extended to 3 similar cycles, in total of 4 weeks duration. Response was calculated with a response rate formula. After 3 weeks of treatment all the patients in the 0.3% solution group were evaluated as cured, with mild localized erythema and burning sensation. In the 0.3% cream preparation group, 75% of the patients were cured, and the remaining 25% were found to be cured after 4 treatments. In the 0.15% cream preparation group, 70% of the patients were evaluated as completely cured after 4 weeks. Non-objective, moderate to mild localized adverse symptoms were reported by both the active cream groups. Three of 54 patients (90%) with complete cure showed relapses after 16 weeks. It was concluded that 0.3% podophyllotoxin is more efficacious in ethanolic solution than in cream preparations.

The purpose of this comparative open study was to determine the clinical efficacy of 0.3&percnt; podophyllotoxin both in 70&percnt; ethanolic solution and cream preparations on genital warts. Three parallel trial preparations, 0.3&percnt; solution, 0.3&percnt; and 0.15&percnt; cream, were randomly allocated to 60 circumcised Asian males (mean age 19.5 years), with the diagnosis of genital condyloma. Patients applied the trial preparation twice a day for 3 consecutive days. If total elimination was not achieved with one trial, it was extended to 3 similar cycles, in total of 4 weeks duration. Response was calculated with a response rate formula. After 3 weeks of treatment all the patients in the 0.3&percnt; solution group were evaluated as cured, with mild localized erythema and burning sensation. In the 0.3&percnt; cream preparation group, 75&percnt; of the patients were cured, and the remaining 25&percnt; were found to be cured after 4 treatments. In the 0.15&percnt; cream preparation group, 70&percnt; of the patients were evaluated as completely cured after 4 weeks. Non-objective, moderate to mild localized adverse symptoms were reported by both the active cream groups. Three of 54 patients (90&percnt;) with complete cure showed relapses after 16 weeks. It was concluded that 0.3&percnt; podophyllotoxin is more efficacious in ethanolic solution than in cream preparations.Copyright © 1993 S. Karger AG, Basel