(b)
Avoid large areas being treated at one time.
(c)
Avoid contact with eyes.
CAUTION:
Use extreme caution with pregnant women. Systemic toxicity and fetal
death have occurred after intervaginal application in pregnant women.
(d) Wash off the treated area 3 to 4 hours after each application. With
subsequent applications, you may wait up to 12 hours to wash off the treated area.
(3) If the warts do not respond to podophyllum, remove the venereal warts
by electrocauterization.
(4)
Extensive lesions may require surgical excision and even partial penile
amputation.
(5) Circumcision may prevent recurrence of venereal warts in males.
Relapse in males and females is frequent.
e. Additional Considerations.
(1)
Advise the patient to avoid sex with an infected partner.
(2)
Suggest the patient wash the genitalia regularly with soap and water.
(3) Female patients should avoid feminine hygiene sprays, frequent
douching, tight pants, nylon underpants, or panty hose to prevent vaginal infection.
2-10. CHANCROID
Chancroid may be defined as a venereal disease characterized by painful genital
ulcers and inguinal adenitis (inflammation of a lymph node or gland). This infection
affects males more often then females and occurs worldwide but more often in tropical
countries.
a. Etiology. The cause of chancroid lesions is Hemophilus ducreyi which is a
short, nonmotile, gram-negative streptobacillus. Chancroid lesions are transmitted
through sexual contact. Males who are uncircumcised and have poor hygiene are
especially at risk.
b. Signs and Symptoms. Following a three to five day incubation period, small
painful papules may appear. These papules may break down and become shallow
ulcers with ragged undermined edges. The papules usually appear on the groin or
inner thigh. In the male, a papule may appear on the penis. Papules on the female
may appear on the vulva, the vagina, or the cervix. Sometimes, papules may erupt on
the tongue, lip, breast, or navel. The lesions develop as follows:
MD0580
2-18