Comparison of podophyllin application with simple surgical excision in clearance and recurrence of perianal condylomata acuminata.

60 patients with first-episode perianal condylomata acuminata were randomly assigned to podophyllin application or surgical excision. 58% of the male patients were homosexual and 33% of the female patients regularly had anal intercourse. Podophyllin completely cleared warts from 23 of 30 (76.6%) patients compared with 28 of 30 (93.3%) for surgical excision. After wart clearance the cumulative recurrence rates were 18% for surgical excision and 43% for podophyllin at 3 months (p less than 0.05), 22% and 56% at 6 months (p less than 0.01), 26% and 56% at 9 months (p less than 0.01), and 29% and 65% at 12 months (p less than 0.01). All patients were treated as outpatients and all surgical procedures were carried out under local anaesthesia. Both regimens were well tolerated.