Cryotherapy versus Podophyllin in the Treatment of Genital Wart

Genital wart is a common sexually transmitted disease caused by human papiloma virus. Podophyllin is a plant extract, having been traditionally used to treat genital wart. Podophyllin is an anti- mitotic agent with direct effect on epithelial cells. Liquid nitrogen is most widely used as cryotherapy agent. Cryotherapy causes cell death, ice crystals formation in the cell, and cellular components damages. The purpose of this study was to evaluate the efficacy of podophyllin solution versus liquid nitrogen cryotherapy on genital warts. This clinical trial was performed from Feb 2003 to Dec 2005, on 70 patients with genital wart in Dermatology Clinic, Qaem Hospital. Patients divided into two groups randomly. Of the total patients, 35 received podophyllin solution and another 35 treated with liquid nitrogen cryotherapy. Study medication was applied once weekly until the complete clearance of lesion for a maximum duration of 8 weeks. Patients whose warts cleared completely were observed for up to 10 weeks to determine the recurrence rate. The mean duration of complete clearance was 3.9 weeks (range 1-7) for podophyllin and 4.9 weeks (range 1-9) for cryotherapy group (P=0.039). Of podophyllin and cryotherapy treated patients, whose wart cleared completely and who finished 10 week follow up period, 26% and 47 % experienced the recurrence of warts, respectively (P>0.05). Cryotherapy patients experienced a significantly greater number of local inflammatory reactions than the podophyllin group. This data indicated that podophyllin solution therapy of genital wart is more effective, with less recurrence rate and side effects, than liquid nitrogen cryotherapy.