The efficacy of silver nitrate cauterization for pyogenic granuloma of the hand

Quitkin, H. Matthew; Rosenwasser, Melvin P.; Strauch, Robert J.

doi:10.1053/jhsu.2003.50092

Cited by 41 publications

(42 citation statements)

References 15 publications

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“…The use of silver nitrate has also been used to chemically cauterize epithelial tissues in the treatment of pyogenic and umbilical granulomas, epistaxis, corns and warts. [85][86][87][88][89] This treatment for warts is currently more widely used in the United Kingdom where non-prescription 95% silver nitrate caustic applicator pencils are available. 90 In the United States, however, the Food and Drug Administration has warned consumers that "all over-the-counter (OTC) drug products containing colloidal silver ingredients or silver salts for internal or external use are not generally recognized as safe and effective and are misbranded."…”

Section: Destructive Therapymentioning

confidence: 99%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

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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Section: Destructive Therapymentioning

confidence: 99%

An Armamentarium of Wart Treatments

Lipke¹

2006

Clinical Medicine & Research

282

295

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“…Silver nitrate cauterization in the offi ce setting can treat simple cases of pyogenic granuloma [5,7]. In this case the response to silver nitrate alone was not enough to eradicate the lesion.…”

Section: Discussionmentioning

confidence: 88%

Pyogenic granuloma successfully treated with electric cautarization — case study

Alomar¹

2012

J Basic Clin Pharma

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TREATMENTTh e treatment was done in three stages;Topical application of salicylic acid (twice daily) in order to burn the af-1.fected area. Th e treatment was continued for one month. Figure 4 shows the results of that particular treatment. Th e results were not successful and bleeding continued. Burning the area with silver nitrate rods; once every other day for two 2.weeks. Figure 5 shows the results of that particular treatment. Th e results were partially successful. Th e bleeding continued but the quantity decreased. Th e problem with this treatment was the burning sensation and the severe excruciating pain accompanied with the application of silver nitrate. Th e pain continued for hours after the application. Cauterization; the area was locally anaesthetized and cauterized electri-3.cally. A course of antibiotics (amoxycilline with clavulinic acid) was given after the procedure in order to prevent any complications. Th e procedure took 15 minutes. After one week of the procedure, bleeding stopped, but a fl uid discharge continued (fi gure6). Th ree weeks later the discharge stopped completely and the injury started to heal (fi gure 7). Another 2 weeks later the healing was complete and bleeding had stopped (fi gure 8). DISCUSSIONPyogenic granuloma is a benign vascular erosion of the skin and mucosal areas with unidentifi ed etiology [1]. It is also referred to as lobular capillary hemangioma. It consists of a group of blood vessels arranged in a lobular form. It might occur at any age but it is more common in children and young people with an increased prevalence among females. It was originally considered the tumor of pregnancy [2]. Pyogenic granuloma presentation includes sudden growth of a vascular tissue over several weeks or months [2]. Increasing levels of pregnancy hormones might be the reason for its prevalence [3]. It has been suggested that estrogen hormone plays a major role in the development of granuloma gravidarum [11]. In the past it was thought to be a result of a bacterial infection where antibiotics had failed to heal the lesion. In another case study it was shown that antibiotics also failed to induce any improvement [6].Treatment of pyogenic granuloma includes cryosurgery, curettage, electrodesiccation, chemical cauterization, and laser surgery [4]. Silver nitrate cauterization in the offi ce setting can treat simple cases of pyogenic granuloma [5,7]. In this case the response to silver nitrate alone was not enough to eradicate the lesion. Even though it helped in reducing the lesion and increasing the healing process when electrical cauterization procedure implemented. In a case study of an 82 year old man with pyogenic granuloma, cauterization with imiquimod 5% cream showed successful healing with no recurrence after 8 months of follow up [8]. Another study also supports the use of imiquimod 5% cream especially in children with promising results and no recurrence [9]. Laser therapy can also be used to cauterize the lesion with good therapeutic outcomes [10]. Laser therapy requires a s...

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“…Treatment options include surgical excision, silver nitrate, cauterization, pulsed-dye laser, and curettage. 18,19 Recurrence of the lesion can occur with all treatment options and is increased if any tissue is left behind. 20 Silver nitrate has been reported to achieve complete resolution of PGs in 85% of patients, with 1 to 3 treatments.…”

Section: Pyogenic Granulomamentioning

confidence: 99%

“…20 Silver nitrate has been reported to achieve complete resolution of PGs in 85% of patients, with 1 to 3 treatments. 18 Weekly topical phenol has also been reported as a therapy for periungual PG, with decreased size occurring within 1 week of topical application and complete resolution by 14 weeks. 21 Our preference is to use silver nitrate for small lesions in the office and surgically excise large lesions or those with atypical features worrisome for another type of tumor.…”

Section: Pyogenic Granulomamentioning

confidence: 99%