American podophyllum contains one fourth of the amount reported by an Indian source. Interferes with DNA synthesis by blocking the methylation of deoxyuridylic acid, and inhibits thymidylate synthetase, which subsequently reduces cell proliferation. Advise patients to avoid direct contact with lesions. Advise patients to seek prompt treatment. BP has an increased potential to cause cervical neoplasia, vulvar neoplasia, Bowen disease, and invasive squamous cell carcinoma.
Younger patients tend to have a self-limiting course lasting months.
Patients who are older or immunocompromised can have a protracted course lasting years and, possibly, no resolution. Educate patients regarding the malignant potential of BP and the avoidance of direct sexual contact to decrease transmission of the disease. Vol 1 and 2. Lever's Histopathology of the Skin. Human papillomavirus-associated tumors of the skin and mucosa.