ANAL WARTS AND TREATMENT WITH INTERFERON
-----------------------------------------------------------


I have a young gay male patient, 25 years old, with recurrent condyloma 
accuminata in the same place, three times.  Had responded to topical nitrogen, 
podophyllin, trichloroacetic acid and electrocautery, SUCCESSFULLY, but has 
always recurred several months after.  He is HIV negative.

Is biopsy indicated?  He is very resistant to the idea.

Has anyone had experience with intraanal intralesional interferon?

Your input would be helpful


Warren Winkelman, MD
Department of Dermatology
Montreal General Hospital
-------------------------

I also have a patient with intractable intra-anal warts. Whose product, 
what dosage, and means of application are being used.
Jeff Marmelzat, M.D. 
--------------------

I probably would biopsy it. Most rectal SCCs have HPV in them and I've been
surprised a couple of times when a wart turned into an SCC after a few
treatments.

Ive used IFNa several timesaround the rectum and on the hands and feet of 
HIV patients with intractable warts. It worked well in all.

Guy Webster, MD PhD 
-------------------

  As Gus Rees used to say, "Warts have ruined the rputaution of more good 
doctors than any other condition."
  
  Genital warts are best treated (IMHO) with gentle 
electrodessication. The dead/dessicated wart releases antigen into the 
system which over time will build up cellular immunity. If one gives 
tagamet 400mg T.I.D. for 6 weeks beginning at the time of dessication the 
results are better than dessication alone. The procedure is less painful 
than LN2. Don't give up! 

Haines ELy MD
-------------