Effectiveness of the 585nm flashlamp-pulsed tunable dye laser (PTDL) for treatment of plantar verrucae

Jain, Ajay; Storwick, Gregory S.

doi:10.1002/(sici)1096-9101(1997)21:5<500::aid-lsm13>3.0.co;2-c

Cited by 45 publications

(40 citation statements)

References 14 publications

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“…As well as treating the wart in its own right [12,14,15], the formation by the laser of a subepidermal blister serves to``prepare'' the wart and enables the bleomycin to be injected freely and easily. In this way it reduces the likelihood of local complications and provides an alternative technique for the use of bleomycin in warts.…”

Section: Discussionmentioning

confidence: 99%

Pulsed dye laser and intralesional bleomycin for treatment of resistant viol hand warts

Pollock

Sheehan-Dare

2002

Lasers Surg Med

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The initial treatment of the wart with pulsed dye laser serves to "prepare" the wart for the bleomycin injection, which can then be given very easily. This ensures the drug is deposited into the base of the wart where it is most needed and minimises the risk of infiltration of normal skin or the operative environment. This method of combining pulsed dye laser and intralesional bleomycin appears to be a safe, rapid, well tolerated, and successful treatment for resistant hand warts. It has proven to be effective in warts in immunosuppressed patients and at difficult sites (e.g., subungual warts). These findings need confirmation from a larger controlled study.

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Section: Discussionmentioning

confidence: 99%

Pulsed dye laser and intralesional bleomycin for treatment of resistant viol hand warts

Pollock

Sheehan-Dare

2002

Lasers Surg Med

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“…20,138,139 Pulse dye laser has been reported to result in complete remission in 48% to 95% of cases. 102,137,[140][141][142][143][144][145][146][147] One study found no statistically significant difference among cure rates between pulsed dye laser (66%) compared to conventional cryotherapy or cantharidin therapy (70%). 147 It appears that warts in nonacral locations respond better than those on the hands, and plantar warts respond the least to this treatment.…”

Section: Neodymium:yag (Nd:yag) Lasermentioning

confidence: 99%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

277

295

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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...

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“…Furthermore, we assessed the treatment efficacy on recalcitrant warts in this study, which have an expected lower cure rate than simple warts. Several uncontrolled studies have found PDL able to clear 48-93% of simple and/or recalcitrant warts at various locations, and two studies have reported of low cure rates at 0% and 6.5% of warts [5][6][7][8][9][10][11][12][13]15,17,18]. Cure rates observed in these non-randomized, non-controlled studies do not account for the spontaneous resolution of warts and the high risk of bias makes interpretation and validity of these outcomes uncertain.…”

Section: Discussionmentioning

confidence: 99%

“…Newer, non-destructive interventions such as the pulsed dye laser (PDL) and intense pulsed light (IPL) have been suggested for treatment of recalcitrant warts [5][6][7][8][9][10][11][12][13][14][15]. The mechanism of action is assumed to be selective destruction of superficially papillary capillaries of the wart as well as thermal injury of the heat-sensitive HPV [5].…”

Section: Introductionmentioning

confidence: 99%

Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: A randomized clinical trial with blinded outcome evaluation

Togsverd‐Bo¹,

Gluud²,

Winkel³

et al. 2010

Lasers Surg Med

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Background and Objectives: Treatment of recalcitrant viral warts remains a therapeutic challenge. Intense pulsed light (IPL) has been suggested effective to clear wart tissue. The objective was in a randomized controlled trial to assess the efficacy of paring followed by IPL versus paring alone for recalcitrant hand and foot warts. Materials and Methods: Eighty-nine patients with recalcitrant hand and foot warts were included and randomized (1:1) to three treatments at 3-week intervals with either paring of warts followed by IPL or paring of warts alone. IPL was given with the Ellipse Flex IPL system (Danish Dermatologic Development A/S, Hørsholm, Denmark, 400-950 nm, 5.5 millisecond pulse duration in double pulses with a 2 millisecond interval, 26.0-32.5 J/ cm 2 repetitive passes). The primary outcome was complete and partial clearance of warts evaluated by blinded photo assessment at 6 weeks after final treatment. Secondary outcomes were treatment related pain and adverse reactions. Results: We found no significant difference in clearance of warts between the two intervention groups (OR 1.64, 95% confidence interval 0.62-4.38). Paring followed by IPL resulted in complete or partial clearance of wart tissue in nine (22%) and five patients (12.2%) versus five (13.5%) and four patients (10.8%) from paring alone. Mostly plantar warts were treated (92.1%). The pain intensity after paring and IPL was moderate and significantly higher than the pain intensity after paring alone (P<0.0005). No adverse reactions were observed from the two interventions. Conclusion: Paring followed by IPL did not differ significantly from paring alone in clearance of recalcitrant hand and foot warts but caused significantly more pain.

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Effectiveness of the 585nm flashlamp-pulsed tunable dye laser (PTDL) for treatment of plantar verrucae

Cited by 45 publications

References 14 publications

Pulsed dye laser and intralesional bleomycin for treatment of resistant viol hand warts

Pulsed dye laser and intralesional bleomycin for treatment of resistant viol hand warts

An Armamentarium of Wart Treatments

Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: A randomized clinical trial with blinded outcome evaluation

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