NEW YORK (Reuters Health) Dec 27 – The crude extract of the Podophyllum plant is toxic, mutagenic, and teratogenic, according to a review article by European investigators, and should not be used for the treatment of condylomata acuminata.
In contrast, the purified, active anti-wart ingredient of the plant, podophyllotoxin, is safe and effective.
Dr. Geo von Krogh, of Karolinska Hospital in Stockholm, Sweden, and Dr. Eric Longstaff, of Pre-clinical Development Services Ltd, in Stockport, UK, point out that podophyllum does not comply with World Health Organization guidelines for herbal remedies. It can cause painful burns and ulcerations, and fatal or near fatal intoxication may result from using the resin over a large area or following subdermal injection.
As the authors report in Sexually Transmitted Infections for December, extremely large condylomata can be "drenched" with podophyllotoxin 0.5% without causing adverse reactions. Clinical trials have shown that it is up to 82% effective in eradicating penile warts and 50% to 77% effective in the treatment of vulval warts.
The purified toxin blocks microtubule assembly of the mitotic apparatus by binding to tubulin. Studies have shown no evidence of oncogenic or teratogenic properties.
Sex Transm Infect 2001;77:409-412.
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