Efficacy of pulsed dye laser treatment for common warts is not influenced by the causative HPV type: a prospective study

Abstract

Verruca vulgaris (VV) is a prevalent skin condition caused by various subtypes of human papilloma virus (HPV). The most common causes of non-genital lesions are HPV types 2 and 4, and to a lesser extent types 1, 3, 26, 29, and 57. Although numerous therapeutic modalities exist, none is universally effective or without adverse events (AE). Pulsed dye laser (PDL) is a favorable option due to its observed efficacy and relatively low AE rate. However, it is not known which verrucae are most likely to respond to PDL, or whether the causative viral subtype influences this response. The objective of this prospective blinded study was to assess whether the HPV subtype was predictive of response to PDL. For that matter, 26 verrucae from 26 immunocompetent patients were biopsied prior to treatment by PDL. HPV coding sequences were isolated and genotyped using PCR analysis. Patients were treated by PDL (595 nm wavelength, 5 mm spot size, 1.5 ms pulse duration, 12 J/cm fluence) once a month for up to 6 months, and clinical response was assessed. Binary logistic regression analysis and linear logistic regression analysis were used in order to evaluate statistical significance. Different types of HPV were identified in 22 of 26 tissue samples. Response to treatment did not correlate with HPV type, age, or gender. As no association between HPV type and response to PDL therapy could be established, it is therefore equally effective for all HPV types and remains a favorable treatment option for all VV.

Topical and systemic retinoids for the treatment of cutaneous viral warts: A systematic review andmeta‐analysis

“…Whereas topical retinoids are administered in milder cases, systemic retinoids are usually reserved for more widespread and/or recalcitrant CVW, as in the case of immunosuppressed patients. These patients tend to have multiple, hypertrophic, treatment resistant CVW, and according to our experience, best respond to the combination of systemic retinoids and laser treatment 9 …”

“…These patients tend to have multiple, hypertrophic, treatment resistant CVW, and according to our experience, best respond to the combination of systemic retinoids and laser treatment. 9 Among the types of systemic retinoids used, oral etretinate 1 mg/ kg/day was the most effective, with a CR rate of 75% and no cases of relapse during a follow-up period of nearly 2 years. However, it was evaluated in only one prospective cohort study, so the results should be viewed with caution.…”

“…Available treatments are aimed at either breakdown or removal of visible warts or induction of cytotoxicity against infected cells 1 . They include destructive agents (keratolytics, cryotherapy, curettage and cautery, laser, photodynamic therapy), antimitotic agents (podophyllin, bleomycin, retinoids), immune stimulants (topical sensitizers, cimetidine), and topical virucidal agents [formaldehyde (formalin), glutaraldehyde (Glutaral)] 3,6‐14 . The safety and efficacy of this armamentarium are not well established, as double‐blind, randomized controlled clinical trials are scarce 3,15 …”

Laser therapy in cutaneous and genital warts: A review article

“…On the other hand, in other studies there was no correlation between location of lesions and response rates 6,16,17 . Two studies reported no significant correlation between type of HPV and clearance rate 10,11 …”

Lesiones por virus del papiloma humano en pacientes urológicos

“…El período de recuperación es rápido. 27 Los regímenes recomendados por la CDC para condilomas en el meato urinario son crioterapia o cirugía, y para lesiones intra-anales se recomienda crioterapia, cirugía o solución de ácido tricloroacético o bicloroacético al 80-90%. 3 Existe una tendencia creciente de utilizar terapia combinada para tratar las verrugas por VPH, denominada "terapia secuencial proactiva" (PST, por sus siglas en inglés), que promete ser un método efectivo para reducir la tasa de recurrencia de las lesiones y evitar la transmisión sexual.…”