BackgroundWarts are one of the most common infections in humans. Plantar warts are a subtype of non-genital warts, and several procedures and topical treatments have been used in its treatment. Cryotherapy is one of the most popular modalities, but it is time-consuming and remission rates vary in different studies. CO2 laser was the first laser used for treating warts. To date, no clinical trial has been done to compare CO2 laser with cryotherapy in the treatment of plantar warts.Patients and MethodsThis randomized controlled trial was performed in order to compare the efficacy and number of sessions needed to treat plantar warts in 60 patients who had received no previous treatment in the previous 3 months. They were randomly allocated to the cryotherapy or CO2 laser group. The number of sessions needed for response and the recurrence rate after a 3-month follow-up was compared in the 2 groups.ResultsSixty patients with plantar warts were randomly allocated to either the CO2 laser or cryotherapy groups. Median age was 25 (range=18–53) and 27 (range= 18–75) years in the cryotherapy group and CO2 laser groups, respectively. Both groups were matched for age and sex (56% male and 44% female in the cryotherapy group and 34% male and 66% female in the CO2 laser group). The median number of sessions needed for complete resolution of the warts in the CO2 laser and cryotherapy groups were 1 (range=1–2) and 3 (range=1–12), respectively. The difference in the number of sessions was statistically significant between the 2 groups (P-value≤0.001). Recurrence rates after a 3-month follow-up was not statistically significant (P-value= 0.069).ConclusionThe number of sessions needed to treat plantar warts was less using CO2 laser than cryotherapy; therefore, this modality can be a good addition to the already existing anti-wart armamentarium.
Several types of human papillomaviruses induce warts. Warts are one of the most common infections in childhood with a reported prevalence of up to 20%. Warts are divided clinically into genital and nongenital forms. Plantar warts are common nongenital warts. In this series, five pediatric cases treated with CO2 laser for their plantar warts are presented. One patient was a known case of Hodgkin's lymphoma. Three of our patients had history of unsuccessful treatments with other modalities, while the other had received no previous treatment. CO2 laser with continuous mode (focused and defocused) was used. In our cases, only one session was enough for clearance of the warts. All the patients were visited 1 week and 3 months after treatment to assess the efficacy and any possible recurrences. Follow‐up showed that all the patients remained in remission up to 3 months posttreatment with no adverse events.
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