Ano-perineal condyloma in a girl aged 2 years, 8 months and treatment with podophyllin in combination with glycyrrhizinic acid and trichloroacetic acid. Case report.

Abstract

Introduction: Anogenital condylomas or warts are secondary to an infection caused by the human papillomavirus in specific sites, such as the skin of the anogenital region, in the vaginal and anal mucosa. It is a rare sexually transmitted infection in pediatric age, very common among sexually active adults and adolescents; The cause in infants, without ruling out sexual abuse, could be: 1. At the time of birth, in the neonatal stage and during the first years; 2. Autoinoculation or hetero-inoculation of the genitals of other children, adults, family members such as the mother or caregivers. It could manifest as small papillomas or warty growths on the anogenital skin, on the mucosa of the vagina or anus. This case has clinical importance since conventional treatments present short-term recurrences and many of them are not well tolerated by young patients. There are aggressive treatments such as cryosurgery; the use of expensive medications such as Imiquimod; However, recurrences are very common with these conventional treatments.

Objective: To describe the use of a treatment regimen with podophyllin in combination with glycyrrhizinic acid and trichloroacetic acid, in a pediatric patient diagnosed with anoperineal condyloma, to help reduce recurrences, costs and, above all, psychological effects. that painful methods cause in young patients.

Case presentation: The patient presents sharp, verrucous lesions in the ano-perineal region; and, after having been operated on in a health center for several days by topicalizing a 5% trichloroacetic acid solution combined with 50% podophyllin on the lesions; However, the condition worsened, with the lesions extending close to the genital area. After which he came to our consultation, where in addition to the previous combination, plus the addition of topical glycyrrhizinic acid and achieving remission of the lesions after 30 days.

Conclusions and recomendations: The combination of a corrosive substance, trichloroacetic acid, with a substance that stops cell multiplication such as podophyllin; and glycyrrhizinic acid, which decreases virus replication at an early stage, prevents the release of the virion from its capsid and thus its penetration into the cells. The application of this triple therapy improved the results for condylomatosis in pediatric patients.