Pulsed dye laser versus Nd:YAG laser in the treatment of plantar warts: a comparative study

Abstract

Plantar warts are common viral infection that are usually challenging in treatment. Conventional treatment methods are usually invasive, have low efficacy, and need long recovery periods. In this study, we compared pulsed dye laser (PDL) and neodymium yttrium aluminum garnet (Nd:YAG) lasers in the treatment of recalcitrant plantar warts. The study included 46 patients with multiple plantar warts. In each patient, lesions were divided into two groups: one treated with Nd:YAG (spot size, 7 mm; energy, 100 J/cm(2); and pulse duration, 20 ms) and the other with PDL (spot size, 7 mm; energy, 8 J/cm(2); and pulse duration, 0.5 ms). Laser sessions were applied every 2 weeks with maximum of six sessions. The study included 63% males and 37% females with a mean age of 29.6 ± 7.34 years. The cure rate was 73.9% with PDL with no significant difference (p = 0.87) from Nd:YAG (78.3%). The number of sessions required was more in PDL (mean, 5.05 ± 0.2) compared with Nd:YAG (mean, 4.65 ± 0.5) but without significant difference. Complications were significantly higher with Nd:YAG (43.5%) compared with PDL (8.7%). Hematoma was the most common complication recorded by Nd:YAG (28.3 %), and it was significantly higher (p = 0.002) than PDL (2.2%). Relapse was recorded in 8.7% with Nd:YAG compared with 13% in PDL with no significant difference (p = 0.74). Our results suggested that PDL and Nd:YAG lasers are effective in the treatment of resistant plantar warts. PDL is safer and less painful but needs more sessions, while Nd:YAG is more painful and shows more complications.

Intralesional zinc sulfate 2% vs intralesional vitamin D in plantar warts: A clinicodermoscopic study

“…Different treatment strategies are available for warts, for example, cryotherapy, electrocoagulation, topical salicylic acid, topical 5‐fluorouracil, laser surgery, and so forth . Response to any of these treatment options is highly variable, patient dependent and recurrence is common.…”

A comparative study between intralesional PPD and vitamin D3 in treatment of viral warts

“…All of these treatments are essentially painful, time consuming, expensive and recurrence is common. [1][2][3][4][5][6] Therefore immunotherapy seems to be a promising modality in such cases. The role of immunity is documented by the appearance and persistence of warts in immunosuppressed individuals.…”

Combination of Surgery and Nd:YAG Laser Therapy for Recalcitrant Viral Warts: A Successful Therapeutic Approach for Immunosuppressed Patients

“…Which of the mechanisms are predominant and to what extent they are relevant in immunocompetent or immunosuppressed individuals is unknown at this point. Nd:YAG laser was proven more effective than pulsed-dye laser though more painful and afflicted by more side-effects, such as inflammation, infection and scarring (4). Combined therapeutic approaches have been published previously, such as application of salicylic acid and pulsed-dye laser treatment (5) or paring and intense pulsed light (IPL) (6).…”