Comparative evaluation of topical 10% potassium hydroxide and 30% trichloroacetic acid in the treatment of plane warts

Abstract

Background:Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV). Plane warts are caused by HPV types 3, 10, 28, and 41, occurring mostly in children and young adults. Among the treatment modalities, topical application of trichloroacetic acid (TCA) is age old. Potassium hydroxide (KOH) has a keratolytic effect on virus-infected cells. It is less irritating, less painful, less scar forming, and can be safely used in children too. Hence, it could be a better topical agent in the treatment of plane warts.Aims and Objectives:To compare the safety and efficacy of topical 10% KOH with 30% TCA in the treatment of plane warts.Materials and Methods:Sixty consecutive patients with plane warts were randomly assigned into two arms of thirty patients each; arm A received topical 10% KOH and arm B received topical 30% TCA as a once weekly application until the complete clearance of warts or a maximum period of 12 weeks.Results:Statistically no significant difference (P = 0.07) was found between the objective therapeutic response to 10% KOH and 30% TCA at the end of study (12 weeks). However, subjective response to 10% KOH was better and statistically significant (P = 0.03). There was no recurrence of warts seen on follow-up for 3 months of complete responders in both the arms.Conclusion:10% KOH is found to be equally effective in the treatment of plane warts compared to 30% TCA with the advantage of faster onset of action and tendency of completely clearing warts with fewer side effects.

Plane Warts: An Overview

“… Types of human papillomavirus (HPV) that cause plane warts and other subgroups of beta-papillomaviruses are more common among immunocompromised persons, especially those who have been on organ transplant waiting lists (15).  Extremely severe or long-lasting warts may raise concerns about a potential immune deficiency since they might be the first sign of less severe immunosuppressed conditions including lymphoma, idiopathic CD4 lymphocytopenia, or HIV infection (16).  Treatment  Several potential therapies are being explored (13).…”

Cryotherapy versus CO2 laser in the treatment of plantar warts: a randomized controlled trial

“…Local destructive methods are used more often than immunomodifiers . They include cryotherapy [ 15 ], trichloroacetic acid [ 16 ], lactic acid, salicylic acid, electrosurgery, curettage, surgery with scalpel or scissors [ 17 ], photodynamic therapy [ 18 ], and various types of lasers [ 17 ]. In a Cochrane review done in 2003 by Gibbs et al [ 19 ], cryotherapy was reported to be the most commonly used therapy for warts.…”