Treatment of extensive vulvar condylomata acuminata with topical 5-fluorouracil

Forty-nine nonpregnant women with extensive condylomata acuminata of the vulva were studied to evaluate the effectiveness of topical 5-fluorouracil (5-FU) for treating vulvar condylomata and to compare the results of continuous use with periodic use of the medication. Patients using the continuous regimen were instructed to apply 5% 5-FU cream to the vulva each night for 6 weeks or until a brisk inflammatory reaction occurred. The periodic regimen consisted of applying 5-FU cream on 2 consecutive nights per week for 10 week. Thirty-five patients (71%) responded to 5-FU treatment (20 complete responses, 41%; 15 partial responses, 30%). Fourteen patients (29%) did not respond. The response rates observed in 19 patients using the continuous regimen (eight complete responses, five partial responses, and six treatment failures) were not significantly different from the response rates obtained in 30 patients with the periodic regimen (12 complete responses, 10 partial responses, and eight treatment failures; P greater than .05, chi-squared test). The periodic regimen caused fewer side effects than the continuous regimen. I conclude that topical 5-FU is effective for treatment of vulvar condylomata acuminata and that periodic applications are preferable to continuous applications.