An Armamentarium of Wart Treatments

Abstract

Patients and clinicians experience the frustration of cutaneous viral warts caused by infection with the human papilloma virus (HPV).Warts appear in various forms on different sites of the body and include common warts (verruca vulgaris), plane or flat warts, myrmecia, plantar warts, coalesced mosaic warts, filiform warts, periungual warts, anogenital warts (venereal or condyloma acuminata), oral warts and respiratory papillomas. Cervical infection with HPV is now known to cause cervical cancer if untreated. A review of the medical literature reveals a huge armamentarium of wart monotherapies and combination therapies. Official evidence-based guidelines exist for the treatment of warts, but very few of the reported treatments have been tested by rigorous blinded, randomized controlled trials.Therefore, official recommendations do not often include treatments with reportedly high success rates, but they should not be ignored when considering treatment options. It is the purpose of this review to provide a comprehensive overview of the wart treatment literature to expand awareness of the options available to practitioners faced with patients presenting with problematic warts. Warts of the genital tract carry a much more ominous and pernicious threat for women in particular. It has been estimated that up to 70% of sexually active women become infected during their lifetime with human papillomavirus (HPV), the infective agent that causes warts. 3-5 A causal role for HPV infections in cervical cancer has been documented beyond reasonable doubt. HPV DNA is present in virtually all cervical cancer cases worldwide, with it being detected in 99.7% of an international series of cervical cancers by genetic amplification techniques and in 100% of cases as confirmed by histological review. 6,7 Cervical cancer is the most frequent common cancer in developing countries and the second most common cancer in women worldwide. 3 The association between HPV infection and cervical cancer is so strong that HPV is now considered the first positive cause of any human cancer ever identified. 3This raises the level of concerns over HPV prevention, screening and treatment from that of a nuisance condition to that of a major public health concern. Attention is beginning to focus on the viral factors that determine persistence and neoplastic progression to cancer and the possible role of HPV in other nongenital cancers (e.g., skin, upper aerodigestive tract). [8][9][10][11][12][13][14][15][16][17] Patients with warts seek advice from general practitioners, pharmacists, naturopaths, allied health professionals, family or friends, dermatologists, gynecologists, obstetricians and pediatricians for treatment and may present with recalcitrant warts that have been previously treated with anything from folk remedies to hypnosis to over-the-counter medications to more aggressive clinic-based treatments. Unfortunately, even with years of medical literature on this subject, high-quality, level I evidence for the efficacy of almost all treatments is no...

A Two-week Interval Is Better Than a Three-week Interval for Reducing the Recurrence Rate of Hand-foot Viral Warts after Cryotherapy: A Retrospective Review of 560 Hand-foot Viral Warts Patients

“…Warts are spread by contact, either directly from person to person, or indirectly via fomites left on surfaces. Autoinoculation, therefore, can occur by scratching, shaving, or traumatizing the skin 5 . So, applying the keratolytics, a corrosive agent or some antiviral agent such as imiquimod, during the re-epithelization period after cryotherapy might be useful to prevent development of an HPV reservoir.…”

“…Clearing the wart may be accomplished through necrotic destruction of HPV-infected keratinocytes or by inducing local inflammation that triggers an effective cell-mediated immunity 5 .…”

Warts in children: diagnosis and current treatment options

“…11 The wide array of options for treatment of warts may be confusing for doctor and patient alike. However, when choosing an appropriate treatment, factors to consider include the patient's and parents' wishes, the type and extent of warts, and the self-limiting nature of the virus.…”

“…As yet, no treatment for cutaneous warts has proven to be 100 per cent effective 11 and the self-limiting nature of warts makes it difficult to conduct well-controlled studies.…”

Laryngeal Verruca Vulgaris Presenting with Dysphonia: A Case Report

“…El, kol ve bacaklarda görülmekle birlikte, vücudun herhangi bir bölgesine cilt yüzeyinde ya da daha nadiren mukozal membranlarda yerleşebilirler (1). Morfolojik olarak düz veya saplı, hiperkeratotik, deri renginde papül veya nodüllerdir.…”