An unusual and serious complication of topical wart treatment with monochloroacetic acid

Abstract

Numerous chemical agents are used in the topical treatment of warts. Monochloroacetic acid (MCAA) is one of these agents, which is used in low or high concentrations in most European countries. MCAA is a strong organic acid which is irritating and corrosive to the skin and has a high systemic toxicity. In addition to wart treatment, it is used for industrial purposes, such as the synthesis of certain organic chemicals. We present a case of joint deformity manifesting after the use of a preparation containing MCAA for topical wart treatment. This underlines the need to reassess the safety of MCAA use for topical wart treatment.

The Overlapped Triple Circle Pulse Technique with Nd:YAG Laser for Refractory Hand Warts

“…Epithelization occurred 7-10 and 10-14 days post-treatment in warts with a small and large crust, respectively (Figs. [2][3][4][5][6][7][8]. Nail dystrophy and severe post-treatment scarring were not observed in any of the patients.…”

“…With such commonly used treatment methods as cryotherapy, salicylic acid, lactic acid, monochloroacetic acid, and formic acid, control of the precise depth of treatment depth is not possible. [1][2][3] As such, aggressive treatment of hand warts can easily lead to unintended tissue damage, resulting in aesthetic and functional deformity 1,4 that requires complex reconstruction, including skin grafts and flaps. Consequently, clinicians treating hand warts often favor conservative treatments in an effort to avoid damaging normal tissue surrounding the wart, which commonly results in incomplete and superficial treatment.…”

A full-thickness chemical burn to the hand using formic acid-based anti-wart treatment: a case report and literature review

“…When reviewing the literature, we identified further reports of other common anti-wart treatments whose use have been associated with chemical burns, including salicylic acid, 19 monochloroacetic acid 4,20 and glutaraldehyde. 21 Table 1 details data from all reported cases, including patient characteristics, agent used, theorised reason for injury, resulting injury and outcome.…”

Third degree formic acid chemical burn in the treatment of a hand wart: a case report and review of the literature

“…Cryotherapy devices have been incriminated in frostbite injuries (Ramsey et al 2007; Sammut et al 2008), and cases of chemical burn after use of salicylic acid and monochloroacetic acid have been described (Chapman et al 2006; Tiong and Kelly 2009). Some of the chemical burns were limited to full-thickness skin, but others showed deeper lesions such as tendon rupture (Yates et al 1988), injuries to the germinal nail matrix, and complete destruction of the growing cartilage (Baser et al 2008). These cases of deeper injuries were found in children between 10 and 14 years of age.…”