Podophyllin poisoning. Systemic toxicity following cutaneous application

The toxicity of topically applied podophyllin in a 16-year-old girl is presented. Coma requiring respiratory support and major neurologic complications as well as hematologic and hepatic toxicity was observed. Therapy with a new modality, charcoal hemoperfusion, resulted in resolution of the acute toxicity, leaving a peripheral neuropathy which had not completely resolved after 4 months. The pharmacology and suggested treatment measures for the toxicity of this rarely reported agent are reviewed.