Surgical Treatment of Recalcitrant Warts

BackgroundCryotherapy has been accepted as the mainstay in treating periunugal and palmoplantar warts. The major drawback of cryotherapy is the requirement of several unbearably painful treatment sessions.ObjectiveThis study aims to assess the efficacy of immunotherapy in viral wart treatment, as an adjunctive method to cryotherapy.MethodsRetrospective chart review was performed on 124 patients visiting the hospital from January to December 2009 for the treatment of periungual and plantar warts. We analyzed the number of cryotherapy sessions necessary for treating warts and assessed the clinical benefits from the addition of other treatment modalities, by adjusting the various confounding factors.ResultsOf the 124 investigated patients, immunotherapy with diphenylcyclopropenone (DPCP) was performed in 14 patients (11%), together with cryotherapy. After adjusting the factors related to the therapeutic difficulties of wart, the average number of cryotherapy sessions for the immunotherapy-combined group was significantly lower (3.58±1.25) than that for the cryotherapy only group (5.10±0.44) (p=0.026). However, there were no differences in the number of treatment sessions of cryotherapy when topical 5-FU/salicylic acid agents were added to the treatment.ConclusionImmunotherapy may be a successful adjuvant to cryotherapy in reducing the number of agonizing cryotherapy sessions.

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“…Some pain sensitive patients may even give up the therapy before the end, therefore pain limits the success of cryotherapy4.…”

Section: Introductionmentioning

confidence: 99%

Does Immunotherapy of Viral Warts Provide Beneficial Effects When It Is Combined with Conventional Therapy?

2011

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“…Also, as bleeding can be severe for surgical removals, it is recommended to complete the surgery with sufficient hemostasis. While there are not any established guidelines for wound management, Mahrle and Alexander [6] recommended light gauze dressing because occlusive dressing can worsen maceration and make the area susceptible to HPV infection. In addition, daily short bathing of the wound was also recommended to reduce secretion and prevent crust formation.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Subungual Viral Warts

Han

Kim

2020

J Wound Manag Res

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Warts, cutaneous manifestations of human papillomavirus infection, are difficult to cure. Warts have a high recurrence rate and there is no known single completely effective treatment. In this case, a 14-year-old boy presented with a subungual wart of the thumb that did not respond to salicylic acid. Excision was performed due to discomfort caused by pain and deformation of the nail plate. After the first operation, the patient had to receive two revision operations due to recurrence. Epithelialization was completed 2 weeks after the second revision surgery, after which there was no recurrence. According to literature review, many immunocompetent patients can expect spontaneous recovery without any treatment. If treatment is necessary, salicylic acid and cryotherapy have the strongest evidence of efficacy and are recommended as first-line treatments. Various other treatments are used alone or in combination. During surgical removal, special attention should be given for complete removal of the wart to prevent recurrence.

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“…Wart treatments include liquid nitrogen, electrocautery and desiccation, CO 2 laser, topical anti‐wart solution, and intralesional Bleomycin 34,35 . Intralesional interferon has recently become commercially available and is effective but quite expensive.…”

Section: Verruca Vulgarismentioning

confidence: 99%