Hyfrecation for recalcitrant nongenital warts

Abstract

Background:Verruca vulgaris is a common skin condition in general practice, which often resolves without treatment. For lesions needing treatment, they often persist despite repeated treatment and become recalcitrant warts. Hyfrecation is a form of electrosurgery which has been used in treating common and recalcitrant warts.Objectives:This article describes the history and mechanisms of hyfrecation and also reviews available evidence on the effectiveness of hyfrecation for recalcitrant nongenital warts.Discussion:Hyfrecation provides controlled tissue destruction with carbonized desiccated wounds which are ideal for eradicating recalcitrant warts. A systematic literature search revealed very minimal, if any, good-quality clinical studies that compare the efficacy of hyfrecation against other treatments (i.e., liquid nitrogen) in treating recalcitrant nongenital warts. Other studies reported the benefits of hyfrecation for genital warts. The author illustrates with a case scenario, the benefits of hyfrecation in treating nongenital warts, and thereby, advocates its wider use in general practice.

2019 IUSTI‐Europe guideline for the management of anogenital warts

“…As with electrocautery, any eschar can be removed with a curette. 76,77 Clearance rates of 94-100% and recurrence rates of 22% have been reported. 59,78 Laser surgery (1A)-Laser surgery uses a concentrated beam of infrared, or near infrared, light energy to heat and cauterize the affected area, and allows very high power densities to be delivered to small tissue volumes.…”

Safety and effectiveness of cantharidin-podophylotoxin-salicylic acid in the treatment of recalcitrant plantar warts

“…Viral warts are cutaneous and mucous membranous lesions caused by human papillomavirus , and are a common dermatological disease affecting approximately 7–24% of the general population . Studies have shown a significant portion of common warts (40–60%) resolve spontaneously within 2 years ; however, the remaining 40–60% require medical or surgical intervention .…”

Warts and all: Human papillomavirus in primary immunodeficiencies

“…Other rates of spontaneous clearance have also been reported: 23% at 2 months 5, 6 and 66% by 2 years 6 . There is no exact definition for recalcitrant cutaneous warts but an accepted rule is failure to respond after five treatments over a period of 6 months 7 . Mucosal HPV is much more common, with up to 79% of sexually active women acquiring genital HPV during their lifetime, ranging from no phenotype, to koilocytosis, to genital warts, to high grade intraepithelial neoplasms.…”