Have White Dots On Side Of Frenulum. No Pain Or Itching. Applied Podophilotoxin. Medical Cure?

Posted on Sat, 23 Mar 2013

Question: I have small white dots on either side of my frenulum. No pain or itching, well defined borders, no redness, slightly raised. Diagnosed with hpv 6 months ago at a different location on the shaft. I had some podophilotoxin left so I applied it to one of the new warts (as I assumed thats what they were). 1 week of application, then one week after the wart is bigger with the original central dot. What could this be?

Answered by Dr. Luchuo Engelbert Bain (27 minutes later)

hi and thanks for the question,
Hypopigmentation or hyperpigmentation of the skin with podophilotoxin are some side effects which are seen in some situations. Podophilotoxin
should be applied to each wart and allowed to air-dry before the treated area comes into contact with clothing; overapplication or failure to air dry can result in local irritation caused by spread of the compound to adjacent areas. The treatment can be repeated weekly, if necessary. To avoid the possibility of complications associated with systemic absorption and toxicity, two guidelines should be followed: 1) application should be limited to <0.5 mL of podophyllin or an area of <10 cm2 of warts per session and 2) the area to which treatment is administered should not contain any open lesions or wounds. The preparation should be thoroughly washed off 1–4 hours after application to reduce local irritation.
Persistent of symptoms or rapidly growing lesions demand reevaluation by your treating physician.
Thanks and best regards,
Luchuo, MD.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Luchuo Engelbert Bain (8 hours later)

Thank you for your prompt reply. Is hypopigmentaton reversible? if so how long does it take to return to normal? The white area is also slightly raised and the same colour as the original wart, for further clarification.

Thanks

Answered by Dr. Luchuo Engelbert Bain (33 minutes later)

Hi and thank s for your query,
As mentioned earlier, I suggest you follow the indications on how to use Podophilotoxin, in order to avoid or minimize most of the side effects.
With respect to the duration of the hypo pigmentation and the reversibility, it actually varies from patient to patient. It varies from a few months after stopping treatment to a year or more. Patients who are do not respond much to this drug can switch to other drugs.
I suggest you consult a family physician or internist if nothing changes after proper use of the drug. For there exist other options.
Thanks and best regards,
Luchuo, MD.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar