0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54
Condyloma Acuminata Confusion & Delirium 389➣Liquid nitrogen cryotherapy followed by application of podo-
phyllin
➣Podophyllin 10–25% in tincture of benzoin (Should be washed
off in 3–6 hours)
➣Trichloroacetic acid
➣Podofillox 0.5% applied at home per patient
➣Electrodessication or carbon dioxide laser
■All destructive therapies carry risk of blistering, ulceration, scarring
and infection
■Immune modulating therapies
➣Topical imiquimod applied per patient 3×weekly
Major side effect is local irritation
➣Intralesional interferon-alpha
➣Major side effect is irritation, pain and systemic complaints such
as fever, malaise, lethargyfollow-up
■Frequent visits every 3 to 6 weeks to assess response and re-treat as
appropriate
complications and prognosis
■Most common complications are treatment-related – i.e., blistering,
ulceration and pain.
■Many lesions require multiple treatments.
■Treatment may last months.
■Recurrence is fairly common.
■Eventual remission from clinically evident lesions is common; how-
ever, recurrence may occur after remission.
■Follow patients with Pap smears and examinations.Confusion & Delirium.................................
MICHAEL J. AMINOFF, MD, DSc
history & physical
■Acute change in mental status; disorientation commonly dispropor-
tionate to other deficits; reduced attention span; may be drowsiness;
agitation or excitement common in delirium; hallucinations typi-
cally visual or auditory
■Other cognitive & behavioral deficits may occur
■Speech often tangential