A multi center real world observation to evaluate the efficacy of cryotherapy versus local hyperthermia for the treatment of plane warts

Abstract

Most plane warts are recalcitrant to treatment. Both cryotherapy and local hyperthermia have been applied to treat plane warts. However, no direct comparative study on their respective efficacy and safety has ever been performed. To assess the efficacy and safety of local hyperthermia at 43 ± 1°C versus liquid nitrogen cryotherapy for plane warts. Sequential patients with plane warts entered the study, either receiving cryotherapy or local hyperthermia therapy at the discretion of the patients and the recommendations of consultants. Cryotherapy with liquid nitrogen was delivered in two sessions 2 weeks apart, while local hyperthermia was delivered on three consecutive days, plus two similar treatments 10 ± 3 days later. The temperature over the treated skin surface was set at 43 ± 1°C for 30 min in each session. The primary outcome was the clearance rates of the lesions 6 months after treatment. Among the 194 participants enrolled, 183 were included in the analysis at 6 months. Local hyperthermia and cryotherapy achieved clearance rates of 35.56% (48/135) and 31.25% (15/48), respectively (p = 0.724); recurrence rates of 16.67% (8/48) and 53.33% (8/15) (p = 0.01); and adverse events rates of 20.74% (28/135) and 83.33% (40/48), respectively (p < 0.001). Cryotherapy had a higher pain score (p < 0.001) and a longer healing time (p < 0.001). Local hyperthermia at 43°C and cryotherapy had similar efficacy for plane warts. Local hyperthermia had a safer profile than cryotherapy but it required more treatment visits during a treatment course. More patients preferred local hyperthermia due to its treatment friendly nature.

Successful Treatment of Multiple Plantar and Periungual Warts by Local Hyperthermia Treatment: A Case Report

“…In treating multiple HPV-associated warts, when one targeted wart was radiated, warts in the rest of the untreated area would also shed. 6 A study compared the efficacy and safety of local hyperthermia at 43 ± 1°C versus liquid nitrogen cryotherapy for plane warts during 6 months, and the results suggested that although local hyperthermia and cryotherapy achieved similar clearance rates, local hyperthermia had the lower recurrence and adverse events rates, and was preferred by more patients due to its treatment-friendly nature. 7 Similar results were also reported by Izadi et al, 8 they demonstrated that the clearance rate was 79.2% in the thermotherapy group, which is higher than 58.3% in the cryotherapy group; besides, the rate of scarring in the thermotherapy group was also lower.…”

Successful Treatment in a Child with Refractory Periungual Warts by Local Hyperthermia: A Case Report

“…When the irradiation wart subsided, this treatment was close to success. In addition, some studies have shown that local hyperthermia has a higher clearance rate for warts and a lower recurrence rate than cryotherapy, 8 which is particularly suitable for treating PW in children and pregnant women.…”