1
|
Mousa HAL. Autoinoculation Therapy for the Treatment of Widespread Cutaneous Warts. Dermatol Surg 2024; 50:341-344. [PMID: 38261749 DOI: 10.1097/dss.0000000000004083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND Cutaneous warts are common lesions that are often unresponsive to various therapeutic modalities. OBJECTIVE To assess the role of autoinoculation therapy in the treatment of widespread cutaneous warts. MATERIALS AND METHODS This interventional study included patients with widespread skin warts who did not respond to conventional treatments. Two methods were used to perform the autoinoculation therapy. The first procedure was performed by obtaining a small piece of the wart and inoculating it into a subcutaneous pocket. The second method was developed by the investigator and was performed by inserting a needle into the center of the wart toward the nearby subcutaneous tissue, with multiple forward and backward movements in several directions around the lesion. RESULTS The prospective study included 23 patients. The illness duration ranged from 3 months to 5 years. Autoinoculation interventions revealed full recovery of all warts in 20 cases (87%) within 20 to 90 days (mean: 40.7 days). CONCLUSION Autoinoculation procedures demonstrated effectiveness, less cost, lesser pain, less invasiveness, without leaving skin scars in comparison with other conventional therapies.
Collapse
|
2
|
Jiryis B, Avitan-Hersh E, Mirmovich O, Judith Nevet M, Khamaysi Z. Evaluation of combined treatment with Er:YAG laser and long-pulsed Nd:YAG laser for the treatment of recalcitrant warts: A prospective randomized controlled trial. J Eur Acad Dermatol Venereol 2023; 37:2569-2574. [PMID: 37528476 DOI: 10.1111/jdv.19388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Viral warts are common infectious skin disease induced by human papillomavirus (HPV). Lasers have been used for warts treatment in recent years with variable success rates. OBJECTIVE This study aimed to prospectively evaluate combined treatment with Er:YAG laser and long-pulsed Nd:YAG laser compared to Er:YAG laser for the treatment of recalcitrant warts after one session. MATERIALS AND METHODS This study included 240 lesions from 24 patients. All the lesions were diagnosed clinically as recalcitrant warts after failure of topical treatment and cryotherapy. About 120 lesions underwent a combined therapy of Er:YAG and long-pulsed (LP) Nd:YAG lasers, and the remaining 120 lesions underwent Er:YAG laser therapy only. The clearance rate was evaluated 5 weeks after and classified by three-graded evaluation: complete response, partial response and poor response. RESULTS The clearance rate in the combined Er:YAG + LP Nd:YAG lasers group was, statistically significant, higher than that of the Er:YAG laser group (p = 0.008). The complete response rate was 48% (58 of 120 warts) for the Er:YAG +LP Nd:YAG lasers group and only 29% (35 of 120 warts) for the Er:YAG laser group. CONCLUSION The combination of Er:YAG and long-pulsed Nd:YAG lasers is more effective than Er:YAG laser alone in treating recalcitrant warts after single session.
Collapse
Affiliation(s)
- B Jiryis
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - E Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - O Mirmovich
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - M Judith Nevet
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Z Khamaysi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| |
Collapse
|
3
|
Campolmi P, Quintarelli L, Fusco I, Ronconi L, Zingoni T. Clinical evidence of 595 nm pulse dye laser treatment for viral warts on hands and feet. Skin Res Technol 2023; 29:e13460. [PMID: 37753676 PMCID: PMC10476275 DOI: 10.1111/srt.13460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/26/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Viral warts, induced by infection by different HPV genotypes, are highly frequent in the general population, particularly during infancy and among adolescents. The effectiveness of the 595 nm Pulse dye-laser in treating viral warts on the hands and feet in both adults and children was investigated in this study. MATERIALS AND METHODS A selection of 203 patients with multiple viral warts was made. All patients underwent 4-5 treatment sessions with a 595 nm pulse Dye Laser (PDL). Treatment outcome was assessed by a quartile scale: 1 indicates no or low results (0%-25% of the lesion area cleared), 2 indicates slight clearance (25%-50% of the lesion area cleared), 3 indicates moderate-good clearance (50%-75%), and 4 indicates excellent clearance (75%-100%). Patients were asked for a subjective evaluation of the perceived overall results by means of the following score: unsatisfied (1), not very satisfied (2), satisfied (3), and very satisfied (4). Possible side effects were monitored. Results obtained were judged with a photographic evaluation, immediately and at the control visit (6 months after the last laser session). RESULTS All patients observed global improvements. Most of the lesions were completely removed after laser therapy. A total of 95% of patients achieved excellent clearance and they were very satisfied following the laser treatment. Relevant side effects were absent in all patients. CONCLUSION PDL treatment with the study device using a wavelength of 595 nm has proven to be a tolerable and safe therapy for viral warts management.
Collapse
Affiliation(s)
- Piero Campolmi
- Section of DermatologyDepartment of Surgery and Translational MedicineUniversity of FlorenceFirenzeItaly
| | - Lavinia Quintarelli
- Section of DermatologyDepartment of Health SciencesUniversity of FlorenceFirenzeItaly
| | | | | | | |
Collapse
|
4
|
Al‐Sabak H, Jaafar AA. Treatment of plane warts with long pulse ND - YAG laser 532 nm. Skin Res Technol 2023; 29:e13462. [PMID: 37753672 PMCID: PMC10493339 DOI: 10.1111/srt.13462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Warts are one of the contagious viral diseases that may cause disturbing cosmetic problems. Plane warts represents a common self-limiting viral infection of the skin caused by the Human Papilloma Virus, however, those that do not disappear by themselves can be very difficult to treat with no uniformly effective treatment modality. OBJECTIVE To assess the efficacy of long pulsed 532 nm ND:YAG laser in the treatment of plane warts. PATIENTS AND METHODS In this therapeutic clinical trial study, 34 patients with plane warts were enrolled. Each patient was eligible for up to three treatment sessions administrated at 2 weeks intervals with long pulsed ND:YAG laser at a spot size 3 mm; wavelength 532 nm; pulsed duration 20 ms; and fluence 30 J/cm2 . The patients were assessed before each treatment session and at 3 months after the last treatment session. The response to treatment was graded using four points scale: Scale 1 = poor: <25%, Scale 2 = fair: 25%-50%, Scale 3 = good: 51%-75%, Scale 4 = excellent: >75%. RESULTS Twenty-two patients only with a total of 478 lesions, completed the study; their ages ranged from (6-45) years with a mean ± SD 19.95 ± 13.142 years. Thirteen patients (59.09%) were female and nine (40.90%) were male. The results from this study showing that long pulsed ND:YAG laser 532 nm led to an excellent response in 19 patients (86.36%) in which 15 of 19 patients showed a complete response (78.94%); one patient showed a good response (4.545%), one showed a fair response (4.545%) and one showed a poor response (4.545%) at the end of three-months follow up. The difference was statistically significant; the P value at the three months follow-up was 0.002. The cumulative clearance rate after the first, second, and third treatment sessions was 58.4%, 77.7%, and 89.9% respectively. Recurrence was seen in only one patient (4.545%). Side effects were generally mild and didn't prevent normal activity. CONCLUSION Long pulsed ND:YAG laser 532 nm appears to be an effective method for treatment of plane warts.
Collapse
Affiliation(s)
- Haider Al‐Sabak
- Head of Dermatology and Laser DepartmentCollege of MedicineUniversity of KufaNajafIraq
| | | |
Collapse
|
5
|
Anzai T, Tsunoda A, Saikawa Y, Matsumoto F, Ito S, Ikeda K. Response to the letter from editor on "Cryosurgical ablation for treatment of common warts on the nasal vestibule". Am J Otolaryngol 2021; 42:102936. [PMID: 33551173 DOI: 10.1016/j.amjoto.2021.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 01/15/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Takashi Anzai
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
| | - Atsunobu Tsunoda
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yuichiro Saikawa
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Fumihiko Matsumoto
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Shin Ito
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Katsuhisa Ikeda
- Department of Otorhinolaryngology, Juntendo University Faculty of Medicine Tokyo, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| |
Collapse
|
6
|
Pavan N, Crestani A, Abrate A, De Nunzio C, Esperto F, Giannarini G, Galfano A, Gregori A, Liguori G, Bartoletti R, Porpiglia F, Simonato A, Trombetta C, Tubaro A, Ficarra V, Novara G. Risk of Virus Contamination Through Surgical Smoke During Minimally Invasive Surgery: A Systematic Review of the Literature on a Neglected Issue Revived in the COVID-19 Pandemic Era. Eur Urol Focus 2020; 6:1058-1069. [PMID: 32527624 PMCID: PMC7274598 DOI: 10.1016/j.euf.2020.05.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 05/29/2020] [Indexed: 01/01/2023]
Abstract
CONTEXT The coronavirus disease 2019 (COVID-19) pandemic raised concerns about the safety of laparoscopy due to the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diffusion in surgical smoke. Although no case of SARS-CoV-2 contagion related to surgical smoke has been reported, several international surgical societies recommended caution or even discouraged the use of a laparoscopic approach. OBJECTIVE To evaluate the risk of virus spread due to surgical smoke during surgical procedures. EVIDENCE ACQUISITION We searched PubMed and Scopus for eligible studies, including clinical and preclinical studies assessing the presence of any virus in the surgical smoke from any surgical procedure or experimental model. EVIDENCE SYNTHESIS We identified 24 studies. No study was found investigating SARS-CoV-2 or any other coronavirus. About other viruses, hepatitis B virus was identified in the surgical smoke collected during different laparoscopic surgeries (colorectal resections, gastrectomies, and hepatic wedge resections). Other clinical studies suggested a consistent risk of transmission for human papillomavirus (HPV) in the surgical treatments of HPV-related disease (mainly genital warts, laryngeal papillomas, or cutaneous lesions). Preclinical studies showed conflicting results, but HPV was shown to have a high risk of transmission. CONCLUSIONS Although all the available data come from different viruses, considering that the SARS-CoV-2 virus has been shown in blood and stools, the theoretical risk of virus diffusion through surgical smoke cannot be excluded. Specific clinical studies are needed to understand the effective presence of the virus in the surgical smoke of different surgical procedures and its concentration. Meanwhile, adoption of all the required protective strategies, including preoperative patient nasopharyngeal swab for COVID-19, seems mandatory. PATIENT SUMMARY In this systematic review, we looked at the risk of virus spread from surgical smoke exposure during surgery. Although no study was found investigating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or any other coronavirus, we found that the theoretical risk of virus diffusion through surgical smoke cannot be excluded.
Collapse
Affiliation(s)
- Nicola Pavan
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | | | - Alberto Abrate
- Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Cosimo De Nunzio
- Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy
| | - Francesco Esperto
- Department of Urology, Campus Biomedico University of Rome, Rome, Italy
| | - Gianluca Giannarini
- Urology Unit, Academic Medical Centre Hospital 'Santa Maria della Misericordia', Udine, Italy
| | | | | | - Giovanni Liguori
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Riccardo Bartoletti
- Department of Translational Research and New Technologies, Urologic Unit, University of Pisa, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Alchiede Simonato
- Urology Section, Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy; Urology Unit, Department of Surgery, S. Croce e Carle Hospital, Cuneo, Italy
| | - Carlo Trombetta
- Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
| | - Andrea Tubaro
- Department of Urology, Sant'Andrea Hospital, University La Sapienza, Rome, Italy
| | - Vincenzo Ficarra
- Department of Human and Pediatric Pathology "Gaetano Barresi", Urologic Section, University of Messina, Messina, Italy
| | - Giacomo Novara
- Department Surgery, Oncology and Gastroenterology, Urologic Unit, University of Padova, Padova, Italy.
| |
Collapse
|
7
|
Clebak KT, Mendez-Miller M, Croad J. Cutaneous Cryosurgery for Common Skin Conditions. Am Fam Physician 2020; 101:399-406. [PMID: 32227823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cryosurgery is the application of freezing temperatures to achieve the destruction of tissue. Cutaneous cryosurgery has become a commonly performed outpatient procedure because of the combination of its safety, effectiveness, low cost, ease of use, lack of need for injectable anesthetic, and good cosmetic results. Cryosurgery may be performed in the outpatient setting using dipstick, spray, or cryoprobe techniques to treat a variety of benign, premalignant, and malignant skin lesions with high cure rates. Benign lesions such as common and plantar warts, anogenital condylomas, molluscum contagiosum, and seborrheic keratoses can be treated with cryotherapy. Basal and squamous cell carcinomas with low-risk features may be treated with cryosurgery. Contraindications to cryosurgery include neoplasms with indefinite margins or when pathology is desired, basal cell or squamous cell carcinomas with high-risk features, and prior adverse local reaction or hypersensitivity to cryosurgery. Potential adverse effects include bleeding, blistering, edema, paresthesia, and pain and less commonly include tendon rupture, scarring, alopecia, atrophy, and hypopigmentation.
Collapse
Affiliation(s)
- Karl T Clebak
- Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | | | - Jason Croad
- Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| |
Collapse
|
8
|
Baczako A, Krautheim V, Biedermann T, Volz T. Combination of Surgery and Nd:YAG Laser Therapy for Recalcitrant Viral Warts: A Successful Therapeutic Approach for Immunosuppressed Patients. Acta Derm Venereol 2019; 99:349-350. [PMID: 30460366 DOI: 10.2340/00015555-3092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Andrea Baczako
- Department of Dermatology and Allergology, Klinikum rechts der Isar, Technical University of Munich, 80802 Munich, Germany.
| | | | | | | |
Collapse
|
9
|
Loo SKF, Tang WYM. Warts (non-genital). BMJ Clin Evid 2014; 2014:1710. [PMID: 24921240 PMCID: PMC4054795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Warts are caused by the human papillomavirus (HPV), of which there are over 100 types. HPV probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. METHODS AND OUTCOMES We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS We found 17 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; intralesional candida antigen; contact immunotherapy; cryotherapy; duct tape occlusion; photodynamic treatment; pulsed dye laser; surgical procedures; and topical salicylic acid.
Collapse
|
10
|
Kim SJ, Byun SW, Lee SS. Various tumors in the nasal vestibule. Int J Clin Exp Pathol 2013; 6:2713-2718. [PMID: 24294358 PMCID: PMC3843252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 10/21/2013] [Indexed: 06/02/2023]
Abstract
Various types of diseases can involve the nasal vestibule. Diagnosis and treatment of a nasal vestibular mass is often challenging due to the anatomical features of the nasal vestibule. Here, we present four cases with nasal vestibular masses. Two cases were diagnosed as squamous papillomas. The others were a trichofolliculoma and pseudoepitheliomatous hyperplasia with hyperkeratosis. Our aim was to discuss the characteristics of each disease and the considerations thought to be necessary for diagnosis and treatment of nasal vestibular tumors from these cases and the related literature.
Collapse
Affiliation(s)
- So Jeong Kim
- Department of Otolaryngology-Head and Neck Surgery, Ewha Womans University School of Medicine Seoul, Korea
| | | | | |
Collapse
|
11
|
Zimmerman EE, Crawford P. Cutaneous cryosurgery. Am Fam Physician 2012; 86:1118-1124. [PMID: 23316984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Cutaneous cryosurgery refers to localized application of freezing temperatures to achieve destruction of skin lesions. It can be used to treat a broad range of benign and premalignant skin conditions, and certain malignant skin conditions, with high cure rates. Cellular destruction is accomplished by delivery of the cryogen via dipstick, probe, or spray techniques. It is widely used in primary care because of its safety, effectiveness, low cost, ease of use, good cosmetic results, and lack of need for anesthesia. Cryosurgery is as effective as alternative therapies for most cases of molluscum contagiosum, dermatofibromas, keloids, and plantar or genital warts. It is a more effective cure for common warts than salicylic acid or observation. Cryosurgery is generally the treatment of choice for actinic keratosis. Contraindications to cryosurgery include cryofibrinogenemia, cryoglobulinemia, Raynaud disease, agammaglobulinemia, and multiple myeloma. Complications from cryosurgery include hypopigmentation and alopecia, and can be avoided by limiting freeze times to less than 30 seconds. Referral to a dermatologist should be considered in cases of diagnostic uncertainty or for treatment of skin cancer, which requires larger amounts of tissue destruction, resulting in higher complication rates.
Collapse
|
12
|
Nguyen NV, Burkhart CG. Cryosurgical treatment of warts: dimethyl ether and propane versus liquid nitrogen - case report and review of the literature. J Drugs Dermatol 2011; 10:1174-1176. [PMID: 21968668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
For years, dermatologists have relied on cryotherapy with liquid nitrogen as a safe and effective treatment for warts. More recently, several over-the-counter (OTC) wart-freezing therapies have become available. Manufacturers have substituted liquid nitrogen with dimethyl ether and propane (DMEP), and marketed these new preparations to be safe and effective alternatives to in-office cryotherapy with liquid nitrogen. However, data from in vitro studies and comparative studies in humans refute manufacturers' claims that these products reproduce in-office cryotherapy.
Collapse
|
13
|
Ahmed A, Matthews M, Browning JC. Verruca vulgaris in a plaque of acanthosis nigricans. Dermatol Online J 2011; 17:9. [PMID: 21696689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Warts are common cutaneous tumors, induced by different strains of the human papilloma virus. Many people develop one or more warts in their lifetime, most of which resolve spontaneously. We present a case of multiple warts within a plaque of acanthosis nigricans probably related to autoinoculation.
Collapse
Affiliation(s)
- Atif Ahmed
- San Antonio Uniformed Services Health Education Consortium, Wilford Hall Medical Center and San Antonio Military Medical Center, San Antonio, Texas, USA
| | | | | |
Collapse
|
14
|
Bolotov IN, Minaev SV, Matveevskaia ES, Neshta ES. [The surface anesthesia in outpatient pediatric department]. Khirurgiia (Mosk) 2011:55-56. [PMID: 21378709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The combination of even parts lidocaine and prilocaine in crème substance was used for surface anesthesia in 73 children, aged 1,5-16 years. Such surgical interventions as molluscum contagiosum eradication, laser wart resection and prepuce synechia dissection were performed. The described anesthetic was highly effective in all areas, but the nasolabial triangle. Resection of warts larger then 0,5 sm required either additional infiltrative anesthesia or step-wise resection. Local allergic reaction was registered in one case, no systemic reactions were noticed. Generally, the used method of surface anesthesia proved to be highly appropriate in pediatric practice.
Collapse
|
15
|
Khaled A, Ben Romdhane S, Kharfi M, Zeglaoui F, Fazaa B, Kamoun MR. Assessment of cryotherapy by liquid nitrogen in the treatment of hand and feet warts. Tunis Med 2009; 87:690-692. [PMID: 20187359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Cryotherapy with liquid nitrogen is the most widely used method to treat hand and feet warts. Therapeutic response to this method depends on many factors related to warts and to the patient. The aim of this study is to determine factors influencing therapeutic response of warts to cryotherapy by liquid nitrogen. METHODS It was a prospective transversal study including 100 patients with warts of the hands and/or feet treated by cryotherapy with liquid nitrogen (cotton wool bud) and referred to Dermatology Department of Charles Nicolle Hospital of Tunis. Demographic data, so as characteristics of warts were recorded. Patients received one treatment/week with a maximum of 4 sessions. Patients whose warts were seen to be resolved were classified as cured. Cure-predictive factors were studied with a multi varied study with logistic regression. RESULTS Of the 100 patients (56 females/44 males, Mean age: 22 years), ten were withdrawn. In 89 patients, warts were present on hands, whereas 23 had warts on feet and 12 had warts on both hands and feet. The mean number of warts per patient was 7. The total cure rate was of 64.4% and was more elevated in hands compared to feet (70.8% versus 10.5%). There was no difference between mean ages of cured group and not cured one (22.2 years versus 21 years). The mean duration of warts in cured patients was lower than that of not cured patients. The mean number of warts before treatment was 4.3 in cured patients and 12.3 warts in not cured patients. The mean number of treatments was 2.3 in cured patients and 4 treatments in not cured patients. The difference between these factors into cured and not cured groups was statistically significant in uni-varied study but not significant in multi-varied one. CONCLUSION The effectiveness of liquid nitrogen used by traditional method in the treatment of hand and feet warts seems to depend on multiple factors: wart's duration, number of warts and number of treatments. These factors depend on each other.
Collapse
Affiliation(s)
- Aida Khaled
- Service de Dermatologie, Hôpital Charles Nicolle, Tunis
| | | | | | | | | | | |
Collapse
|
16
|
Abstract
Various treatment methods have been adopted in the management of warts; however, there is still no consensus on first-line treatment. This study was designed to evaluate the efficacy of long-pulsed Nd:YAG laser in the treatment of warts. Over the course of 1 yr, 369 patients with recalcitrant or untreated warts were exposed to a long-pulsed Nd:YAG laser. The following parameters were used: spot size, 5 mm; pulse duration, 20 msec; and fluence, 200 J/cm(2). No concomitant topical treatment was used. In all, 21 patients were lost during follow up; hence, the data for 348 patients were evaluated. The clearance rate was 96% (336 of the 348 treated warts were eradicated). The clearance rate of verruca vulgaris after the first treatment was very high (72.6%), whereas the clearance rate of deep palmopantar warts after the first treatment was low (44.1%). During a median follow-up period of 2.24 months (range, 2-10 months), 11 relapses were seen (recurrence rate, 3.27%). In conclusion, long-pulsed Nd:YAG laser is safe and effective for the removal or reduction of warts and is less dependent on patient compliance than are other treatment options.
Collapse
Affiliation(s)
- Tae Young Han
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Ji Ho Lee
- Gowoonsesang Dermatology Clinic, Seoul, Korea
| | | | - Ji Young Ahn
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Seong Jun Seo
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| | - Chang Kwun Hong
- Department of Dermatology, College of Medicine, Chung-Ang University, Seoul, Korea
| |
Collapse
|
17
|
Avery JK. Where was the doctor? Tenn Med 2009; 102:37. [PMID: 19691199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- J Kelley Avery
- State Volunteer Mutual Insurance Company, Brentwood, TN, USA
| |
Collapse
|
18
|
Abstract
OBJECTIVE The purpose of this presentation is to show the sonographic morphologic characteristics of plantar warts and the scope of sonography in the treatment of these lesions. METHODS We retrospectively reviewed 27 sonographic examinations of the plantar region; 17 corresponded to plantar warts diagnosed by dermatologists in which the diagnoses were medically derived from sonographic examinations after failure of their treatments. The remaining group consisted of 10 healthy individuals. Sonograms were compared with standard histologic findings. RESULTS The sonographic features of normal plantar skin and plantar warts are described, including the shape, echogenicity, pattern of growth, involvement of skin layers, and blood flow in the lesions. CONCLUSIONS Sonography may be considered as reliable support for plantar wart diagnosis and may have a role in the evaluation of plantar wart treatment modalities, allowing monitoring of therapeutic responses, especially in recurrent and difficult cases with persistent symptoms such as pain.
Collapse
Affiliation(s)
- Ximena Wortsman
- Department of Radiology, Clinica Servet, Almirante Pastene 150, Providencia, Santiago, Chile.
| | | | | |
Collapse
|
19
|
Kim J, Lee DH, Cho KJ, Lee SY. Huge verruca vulgaris (wart) of the external auditory canal. Otolaryngol Head Neck Surg 2009; 139:865-6. [PMID: 19041521 DOI: 10.1016/j.otohns.2008.08.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 08/11/2008] [Indexed: 12/25/2022]
Affiliation(s)
- Joohwan Kim
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | | | | |
Collapse
|
20
|
Koç M, Kavala M, Kocatürk E, Mete O, Can B, Zindanci I, Aktas S. Multiple warty dyskeratomas on the scalp. Dermatol Online J 2009; 15:8. [PMID: 19336025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Warty dyskeratoma is usually characterized by solitary papules or nodules which reveal acantholytic dyskeratosis histopathologically. Warty dyskeratoma most commonly presents as a single lesion, but there are a few case reports of patients with multiple lesions. Herein we report a female patient presenting with multiple verrucous papules on the scalp diagnosed clinically and histopathologically as warty dyskeratoma.
Collapse
Affiliation(s)
- Melek Koç
- Department of Dermatology, Goztepe Training and Research Hospital
| | | | | | | | | | | | | |
Collapse
|
21
|
Acar B, Babademez MA, Karabulut H, Karasen RM. An unusual cause of dysphonia: laryngeal verruca vulgaris. B-ENT 2009; 5:183-187. [PMID: 19902857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
PROBLEMS/OBJECTIVES Verruca vulgaris of the larynx (VVL) is an uncommon lesion with clinical and histopathological features that are easily misdiagnosed as verrucous carcinoma, and thus may lead to unnecessary surgery. This case study investigated clinical and pathological features that might distinguish VVL from other keratotic laryngeal lesions. METHODOLOGY A 35-year-old man presented with a 3-month history of progressive hoarseness and superficial, keratotic, vocal cord lesions. The verrucoid configuration of the surface and lack of nuclear atypia enabled treatment by local excision. The biopsied lesion was sectioned and examined by immunohistochemistry, and in situ hybridization. RESULTS The patient was disease-free up to 1 year and 6 months after surgery. The exophytic, keratotic lesions of the larynx had features of cutaneous verruca vulgaris. No human papilloma virus was detected. CONCLUSIONS We described histopathological features of VVL that will facilitate its distinction from laryngeal keratosis, squamous papillomas, verrucous hyperplasia, and verrucous carcinoma.
Collapse
Affiliation(s)
- B Acar
- Kecioren Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey.
| | | | | | | |
Collapse
|
22
|
Burkhart CG, Pchalek I, Adler M, Burkhart CN. An in vitro study comparing temperatures of over-the-counter wart preparations with liquid nitrogen. J Am Acad Dermatol 2007; 57:1019-20. [PMID: 17719128 DOI: 10.1016/j.jaad.2007.06.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2007] [Revised: 06/18/2007] [Accepted: 06/26/2007] [Indexed: 12/01/2022]
Abstract
BACKGROUND Over-the-counter (OTC) wart-freezing therapies have appeared on the market claiming that they reproduce in-office cryotherapy. OBJECTIVE We sought to determine whether these OTC home wart removal products are as cold as liquid nitrogen. METHODS The coldness obtained by 3 representative commercial wart products, and liquid nitrogen, was assessed using a thermometer calibrated from -100 degrees C to 50 degrees C. Temperatures of the commercial wart products used were measured and compared with those obtained with liquid nitrogen. RESULTS None of the OTC coolants were as cold as liquid nitrogen, and they did not lower temperature as quickly as liquid nitrogen. LIMITATIONS This study did not evaluate the clinical efficacy of any of the agents studied. CONCLUSIONS Despite advertising messages, OTC refrigerants do not achieve freezing equivalent to liquid nitrogen.
Collapse
Affiliation(s)
- Craig G Burkhart
- University of Toledo College of Medicine, Toledo, Ohio 43560, USA.
| | | | | | | |
Collapse
|
23
|
Affiliation(s)
- Gian Piero Lozzi
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | | |
Collapse
|
24
|
Xu A, Wang S, Cheng D, Wang P. A rare case of large, unusual, and mutilating verruca vulgaris with cutaneous horns treated with plastic surgery. Cutis 2007; 80:145-148. [PMID: 17944175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Cutaneous horn is a morphologic designation for a protuberant mass of keratin produced by unusual cohesiveness of keratinized material. We report a rare case of large, unusual, and mutilating verruca vulgaris with cutaneous horns in a 39-year-old male peasant. To our knowledge, this is the first case of the underlying phalangeal bones being largely demolished, resulting in serious mutilation. The patient was successfully treated with plastic surgery. Of note in this case is the bone absorption of the terminal phalanges and loss of hand function.
Collapse
Affiliation(s)
- Aie Xu
- Department of Dermatology, The Third Hospital of Hangzhou, China.
| | | | | | | |
Collapse
|
25
|
Ueeck BA, Woo BM, Stewart JCB, Assael LA. Keratinizing odontogenic cyst with verrucous proliferation. J Oral Maxillofac Surg 2007; 65:585-8. [PMID: 17307615 DOI: 10.1016/j.joms.2006.08.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2006] [Accepted: 08/07/2006] [Indexed: 11/22/2022]
Affiliation(s)
- Brett A Ueeck
- Department of Oral and Maxillofacial Surgery, Oregon Health and Science University, Portland, OR 97239, USA.
| | | | | | | |
Collapse
|
26
|
Graells J, Espinola A, Barrio C, Muñoz MD, Román A, Parellada N. [Minor cutaneous ambulatory surgery and cryotherapy. Comparative study between a dermatologist and family physicians]. Actas Dermosifiliogr 2007; 98:171-7. [PMID: 17504701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
INTRODUCTION Lack of diagnostic skill in cutaneous surgery may lead to erroneous and potentially detrimental therapies. This study compares the diagnosis and treatment in cutaneous surgery, including cryotherapy, between a dermatologist and family physicians. METHODS It is an observational, prospective study on a random sample of patients that consulted the dermatologist for candidate lesions. Each lesion was independently evaluated by a dermatologist and a family physician, both of whom assigned the clinical diagnosis and therapeutic advice. Concordance for diagnosis, recommended treatment and indication for cryotherapy was calculated by Cohen's kappa coefficient. RESULTS Six hundred forty-six lesions were evaluated. Global kappa indexes were 0.69 (95 % CI, 0.65-0.73) for diagnostic concordance, 0.62 (95 % CI, 0.56-0.67) for recommended treatment and 0.73 (95 % CI, 0.67-0.78) for indication of cryotherapy. Diagnostic concordance was significantly better for melanocytic nevus, achrocordon and for lesions with multiple and monomorphous presentation, and worse for isolated pigmented lesions. For recommended treatment concordance was better for multiple and monomorphous lesions and worse for skin cancer and seborrheic keratosis. For indication of cryotherapy concordance was worse for skin cancer, melanocytic nevus, acrochordon and seborrheic keratosis. Family physicians made an erroneous indication for cryotherapy in 5.88 % of cases, including 3 non melanoma skin cancers. CONCLUSIONS Concordance between dermatologists and family physicians for minor cutaneous surgery is generally good. Family physicians should be more careful in evaluating solitary pigmented lesions and patients at risk for skin cancer.
Collapse
MESH Headings
- Adult
- Ambulatory Surgical Procedures/statistics & numerical data
- Carcinoma, Basal Cell/diagnosis
- Carcinoma, Basal Cell/surgery
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/surgery
- Clinical Competence
- Cryotherapy/statistics & numerical data
- Dermatology
- Diagnosis, Differential
- Diagnostic Errors
- Family Practice
- Female
- Humans
- Keratosis, Seborrheic/diagnosis
- Keratosis, Seborrheic/surgery
- Keratosis, Seborrheic/therapy
- Male
- Middle Aged
- Nevus, Pigmented/diagnosis
- Nevus, Pigmented/surgery
- Nevus, Pigmented/therapy
- Observer Variation
- Prospective Studies
- Sampling Studies
- Skin Diseases/diagnosis
- Skin Diseases/surgery
- Skin Diseases/therapy
- Skin Neoplasms/diagnosis
- Skin Neoplasms/surgery
- Skin Neoplasms/therapy
- Warts/diagnosis
- Warts/surgery
- Warts/therapy
Collapse
Affiliation(s)
- J Graells
- Servicio de Dermatología, Hospital Comarcal de Sant Boi de Llobregat, Barcelona, España.
| | | | | | | | | | | |
Collapse
|
27
|
Abstract
The term keratosis covers a variety of growths such as warts and pressure-induced callosities. Warts develop in the absence of pressure, and often clear up again after a certain period, usually without treatment. Clavi can develop as a result of wearing poorly fitting shoes, but also deformed toes or other anatomical deformities affecting the foot. The resulting non-anatomical stressing leads to the formation of pressure callosities and even to pressure sores.
Collapse
Affiliation(s)
- L Kurvin
- Chirurgische Klinik, Campus Innenstadt, Ludwig-Maximilians-Universität München.
| | | |
Collapse
|
28
|
Abstract
Viral wart infections constitute one of the most common pediatric skin diseases, and various modalities have been used to manage them. Although pulsed dye laser therapy is known to be a safe and efficacious modality, the reported cure rates for this method have varied, and no studies have reported treatment of pediatric patients alone. This prospective, nonblinded, nonrandomized study was performed to evaluate the efficacy and safety of pulsed dye laser therapy for pediatric warts. We found that this method is safe, relatively effective, and worth considering as an additional therapeutic option for viral warts in children, although not as a first-line therapy.
Collapse
Affiliation(s)
- Hyun Su Park
- Department of Dermatology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
| | | | | | | |
Collapse
|
29
|
Thomas KS, Keogh-Brown MR, Chalmers JR, Fordham RJ, Holland RC, Armstrong SJ, Bachmann MO, Howe AH, Rodgers S, Avery AJ, Harvey I, Williams HC. Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model. Health Technol Assess 2006; 10:iii, ix-87. [PMID: 16849001 DOI: 10.3310/hta10250] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To estimate the costs of commonly used treatments for cutaneous warts, as well as their health benefits and risk. To create an economic decision model to evaluate the cost-effectiveness of these treatments, and, as a result, assess whether a randomised controlled trial (RCT) would be feasible and cost-effective. DATA SOURCES Focus groups, structured interviews and observation of practice. Postal survey sent to 723 patients. A recently updated Cochrane systematic review and published cost and prescribing data. REVIEW METHODS Primary and secondary data collection methods were used to inform the development of an economic decision model. Data from the postal survey provided estimates of the effectiveness of wart treatments in a primary care setting. These estimates were compared with outcomes reported in the Cochrane review of wart treatment, which were largely obtained from RCTs conducted in secondary care. A decision model was developed including a variety of over-the-counter (OTC) and GP-prescribed treatments. The model simulated 10,000 patients and adopted a societal perspective. RESULTS OTC treatments were used by a substantial number of patients (57%) before attending the GP surgery. By far the most commonly used OTC preparation was salicylic acid (SA). The results of the economic model suggested that of the treatments prescribed by a GP, the most cost-effective treatment was SA, with an incremental cost-effectiveness ratio (ICER) of 2.20 pound/% cured. The ICERs for cryotherapy varied widely (from 1.95 to 7.06 pound/% cured) depending on the frequency of applications and the mode of delivery. The most cost-effective mode of delivery was through nurse-led cryotherapy clinics (ICER = 1.95 pound/% cured) and this could be a cost-effective alternative to GP-prescribed SA. Overall, the OTC therapies were the most cost-effective treatment options. ICERs ranged from 0.22 pound/% cured for OTC duct tape and 0.76 pound/% cured for OTC cryotherapy to 1.12 pound/% cured for OTC SA. However, evidence in support of OTC duct tape and OTC cryotherapy is very limited. Side-effects were commonly reported for both SA and cryotherapy, particularly a burning sensation, pain and blistering. CONCLUSIONS Cryotherapy delivered by a doctor is an expensive option for the treatment of warts in primary care. Alternative options such as GP-prescribed SA and nurse-led cryotherapy clinics provide more cost-effective alternatives, but are still expensive compared with self-treatment. Given the minor nature of most cutaneous warts, coupled with the fact that the majority spontaneously resolve in time, it may be concluded that a shift towards self-treatment is warranted. Although both duct tape and OTC cryotherapy appear promising new self-treatment options from both a cost and an effectiveness perspective, more research is required to confirm the efficacy of these two methods of wart treatment. If these treatments are shown to be as cost-effective as or more cost-effective than conventional treatments, then a shift in service delivery away from primary care towards more OTC treatment is likely. A public awareness campaign would be useful to educate patients about the self-limiting nature of warts and the possible alternative OTC treatment options available. Two future RCTs are recommended for consideration: a trial of SA compared with nurse-led cryotherapy in primary care, and a trial of home treatments. Greater understanding of the efficacy of these home treatments will give doctors a wider choice of treatment options, and may help to reduce the overall demand for cryotherapy in primary care.
Collapse
|
30
|
Schein O, Orenstein A, Bar-Meir E. Plantar verrucous carcinoma (epithelloma cuniculatum): rare form of the common wart. Isr Med Assoc J 2006; 8:885. [PMID: 17214114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
|
31
|
Seiler A. [Rapidly growing wart-like nodule. A second nipple?]. MMW Fortschr Med 2006; 148:5. [PMID: 17615759 DOI: 10.1007/bf03364852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
32
|
Coates CM, Boehm AP, Leonheart EE, Vlahovic TC. Malignant transformation of plantar verrucae. Adv Skin Wound Care 2006; 19:384-5. [PMID: 16943705 DOI: 10.1097/00129334-200609000-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Claire M Coates
- Temple University School of Podiatric Medicine, Philadelphia, PA, USA
| | | | | | | |
Collapse
|
33
|
Abstract
Human papillomaviruses (HPVs) are small DNA viruses responsible for a broad range of clinical presentations, characterized histologically by the proliferation of epithelial cells. HPVs are responsible for benign as well as malignant lesions, the most frequent of the latter being cervical carcinoma. A better knowledge of the immunobiology of these lesions allowed the development of prophylactic vaccines (for the most frequent genital types) that are presently under evaluation. The present paper describes different approaches for the treatment of HPV lesions, still mostly based on surgery, and underlines the importance of developing adjuvant therapies.
Collapse
Affiliation(s)
- Robert Snoeck
- Rega Institute for Medical Research, K.U. Leuven, Belgium.
| |
Collapse
|
34
|
Sorensen K, Watson S. Excision of viral wart and free flap repair. Ann Plast Surg 2006; 57:358-9. [PMID: 16929217 DOI: 10.1097/01.sap.0000233081.47215.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
35
|
Neumaier J. [Often they heal spontaneously and the treatments are not always harmless: concerning warts waiting and seeing is a legitimate therapy]. MMW Fortschr Med 2006; 148:12-3. [PMID: 16875371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
|
36
|
Gesslein M. [Wart removed, foot lost]. MMW Fortschr Med 2006; 148:12-3. [PMID: 16711480 DOI: 10.1007/bf03364634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M Gesslein
- Chirurgische Klinik, Waldkrankenhaus St Marien, Erlangen
| |
Collapse
|
37
|
[Warts--self medication or removal by a physician?]. Med Monatsschr Pharm 2006; 29:72. [PMID: 16506592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
|
38
|
Affiliation(s)
- Derya Ozçelik
- Department of Plastic and Reconstructive Surgery, Abant Izzet Baysal University, Düzce, Turkey
| | | | | | | | | |
Collapse
|
39
|
|
40
|
Rass K, Hamsch C. [Differential diagnosis of verrucous skin changes. When wild warts grow rapidly...]. MMW Fortschr Med 2005; 147:59-61. [PMID: 16218230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
This article gives and overview of the various types of verrucous skin changes (viral warts, seborrheic warts).
Collapse
Affiliation(s)
- K Rass
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum des Saarlandes, Homburg.
| | | |
Collapse
|
41
|
Tuccari G, Giuffrè G, Scarf R, Simone A, Todaro P, Barresi G. Immunolocalization of lactoferrin in surgically resected pigmented skin lesions. Eur J Histochem 2005; 49:33-8. [PMID: 15823792 DOI: 10.4081/924] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Lactoferrin (Lf) expression was determined immunohistochemically in 57 formalin-fixed paraffin-embedded bioptic samples obtained from an equal number of patients treated by surgery to remove pigmented skin lesions (nevi = 23; melanoma = 12; vulgaris and seborrhoeic warts = 12; basal cell carcinoma = 10); in addition, 10 specimens of normal skin were studied as control. On 3 mm thick sections, depigmentation and antigen retrieval procedures were performed. The Lf immunoreactivity was revealed by a rabbit anti-human Lf. Quantification of Lf immunoreactivity was performed using an intensity-distribution (ID) score. Melanocytic cells, regardless of their benign or malignant nature, were consistently stained, with no significant differences in the Lf ID-score between melanomas or nevi. A different intensity of Lf immunoreactivity was encountered in superficial portions of warts, exclusively inside squamous epithelial cells arranged in sheets or whorls of keratin. On the contrary, basal cell carcinomas were always unstained, while a slight Lf positivity was found in focal keratinized areas present in two tumours showing baso-squamous differentiation. The Lf immunoreactivity was localized in the cytoplasm and only occasionally in the nucleus. The biological meaning of Lf in these cases of human skin specimens remains unexplained, although it cannot be ruled out that Lf might be involved in the defense system against tumours, or alternatively, may be used by cells requiring iron availability for their turnover. Moreover, the immunohistochemical expression of Lf in melanocytic lesions might be also related to a Lf-melanin interaction. Finally, the involvement of Lf in skin squamous non-neoplastic elements could be related to its role as one of the molecules modulating an unspecific inflammatory or anti-oxidant response.
Collapse
Affiliation(s)
- G Tuccari
- Department of Human Pathology, Azienda Ospedaliera Universitaria Policlinico G. Martino, pad. D, via Consolare Valeria, 98125 Messina Italy.
| | | | | | | | | | | |
Collapse
|
42
|
Abstract
Treatment of warts can involve medical and surgical methods. Infrared coagulation is a surgical method very rarely used in the treatment of warts. We planned an open-labeled prospective study to research the effect of infrared coagulation in the treatment of common warts, comparing it with electrocoagulation, and discussing its applicability as an alternative therapy regimen. Eighteen patients with common warts were included in this study. There were 49 warts of various sizes (1 mm to 1 cm) in these 18 patients. Twenty-seven warts were treated with infrared coagulation, and 22 warts were treated with electrocoagulation. Sixteen patients were treated with both infrared coagulation and electrocoagulation; two patients were treated with only infrared coagulation. The patients were followed-up for six months after treatment. Changes in sizes of warts, healing times, and cure rates were compared by Mann-Whitney U test. The mean healing time was 35.5 +/- 5.7 days with infrared coagulation and 32.9 +/- 4.0 days with electrocoagulation. There was not any significant difference between healing times (p > 0.05). Bacterial infection was seen on seven (31.8%) warts treated with electrocoagulation, but no side effects were seen with infrared coagulation. There was a significant difference between side effect rates in two groups (p < 0.01). Nine (33.3%) of the warts treated with infrared coagulation and seven (31.8%) of the warts treated with electrocoagulation recurred in the six-month follow-up period. The overall cure rates at the end of the follow-up period were 66.7% and 68.2% respectively. There was not any significant difference between the cure rates in the two groups (P > 0.05). We conclude that infrared coagulation is a safe and cheap method and should be kept in mind as an alternative modality for the treatment of common warts.
Collapse
Affiliation(s)
- Suleyman Piskin
- Trakya University, Faculty of Medicine, Department of Dermatology, 22030-Edirne, Turkey
| | | | | |
Collapse
|
43
|
Weyandt GH, Benoit S, Becker JC, Bröcker EB, Hamm H. Kontrollierte schichtweise Abtragung anogenitaler Warzen mittels Argon-Plasma-Koagulation. Controlled layered removal of anogenital warts by argon-plasma coagulation. J Dtsch Dermatol Ges 2005; 3:271-5. [PMID: 16370475 DOI: 10.1111/j.1610-0387.2005.04757.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND According to guidelines of the German STD Association, appropriate treatment of extensive anogenital warts with comparable recurrence rates includes cryotherapy, surgical excision, electrosurgery, CO2- and Nd:YAG-laser vaporisation. All these procedures are associated with varying degrees of risk for bleeding, release of potentially infectious aerosol, deep thermal destruction, slow wound healing, and scarring. METHODS Using argon-plasma coagulation anogenital warts can be removed in layers in a controlled manner. High frequency current flows through the argon plasma to the tissue, allowing well-controlled, superficial tissue destruction. RESULTS From January 2001 to March 2003, 54 patients with extensive genital, anal or anogenital warts were treated. After one treatment, 66% of the pa- tients remained disease-free in the following 4 months. Thirteen patients (24%) showed early recurrence after 4 weeks, five patients (9%) at a later date. In these patients, further treatment, in 9 cases combined with topical imiquimod cream, were necessary for complete remission. CONCLUSION Compared to other therapeutic procedures, argon-plasma coagulation is a better controlled, quick and low-risk option for the treatment of anogenital warts. Depending on the type of involvement and individual risk factors, postoperative treatment with topical imiquimod cream may be useful.
Collapse
Affiliation(s)
- Gerhard H Weyandt
- Klinik und Poliklinik für Haut-und Geschlechtskrankheiten der Universität Wurzburg.
| | | | | | | | | |
Collapse
|
44
|
Dissemond J. [After wet shave. spines on the chin]. MMW Fortschr Med 2005; 147:59. [PMID: 18441567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- J Dissemond
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen
| |
Collapse
|
45
|
Abstract
OBJECTIVE The authors report a case of spontaneous and gustatory facial pain and sweating. METHODS The patient had frequent episodes of pain, sweating, and flushing bilaterally in the hairless skin of the ophthalmic and maxillary distributions of the trigeminal nerve. Gustatory stimuli (e.g., orange juice, pickled onions) reliably evoked episodes, but episodes also frequently came on spontaneously. The problem had begun during adolescence, about the time of topical treatment and then electrocauteries for facial warts. The patient reported benefit from tricyclic antidepressants, guanethidine, and trospium chloride (an anti-cholinergic quaternary amine used in Europe for urinary urgency). There was no pain or excessive sweating in other body areas, nor pain with exercise. RESULTS Administration of edrophonium IV evoked pain and sweating, and ganglion blockade by IV trimethaphan eliminated pain and sweating and markedly attenuated responses to edrophonium. Trospium chloride also prevented edrophonium-induced pain and sweating. Bicycle exercise produced the same increment in forehead humidity as in a spontaneous episode but did not evoke pain. Tyramine infusion did not bring on pain or sweating, whereas iontophoretic acetylcholine administration to one cheek evoked pain and sweating bilaterally. Topical glycopyrrolate cream eliminated spontaneous, gustatory, and edrophonium-induced episodes. CONCLUSIONS The findings indicate that facial pain and sweating can result from occupation of muscarinic cholinergic receptors after acetylcholine release from local nerves. The authors propose that after destruction of cutaneous nerves, aberrant regenerant sprouting innervates sweat glands, producing gustatory sweating as in auriculotemporal syndrome (Frey syndrome), and innervates nociceptors, producing pain.
Collapse
Affiliation(s)
- David S Goldstein
- Clinical Neurocardiology Section, National Institute of Neurologic Disorders and Stroke, Building 10, Room 6N252, 10 Center Drive, MSC 1620, Bethesda, MD 20892-1620, USA.
| | | | | | | |
Collapse
|
46
|
Fox GN. Facial lesion that came "out of nowhere". J Fam Pract 2004; 53:779-781. [PMID: 15469771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Affiliation(s)
- Gary N Fox
- Mercy Health Partners Family Practice Residency Program, 2200 Jefferson Avenue, Toledo, OH 43624, USA.
| |
Collapse
|
47
|
Ergün SS, Su O, Büyükbabaný N. Giant verruca vulgaris. Dermatol Surg 2004; 30:459-62. [PMID: 15008885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Common warts (verrucae vulgares) are hyperkeratotic papulonodules that are most often seen on the hands, arms, and legs, but they can be seen anywhere on the glabrous skin. Common warts represent the most frequent clinical lesions produced by the human papillomavirus (HPV). OBJECTIVE Although they are diagnosed easily, giant, chronic, isolated, solitary, recalcitrant verruca vulgaris involving nail and nail bed on the digits can be misdiagnosed, and the differential diagnosis should be made carefully and verified by biopsies. METHOD A 50-year-old male patient had a giant periungual verruca vulgaris on his left second finger. It was present for 2 years, was unresponsive to any treatment modality, and was treated by surgical excision. RESULTS After 18 months of follow-up, there was no evidence of recurrence, and both aesthetic and functional results were quite satisfactory. CONCLUSION Lesions of long duration generally lose their characteristic histopathologic features, and HPV cannot be detected in these lesions by polymerase chain reaction. Therefore, multiple sections should be examined histopathologically, and extreme care should be taken in order to avoid misdiagnosis.
Collapse
Affiliation(s)
- Selma Sönmez Ergün
- Department of Plastic and Reconstructive Surgery, SSK Vakýf Gureba Hospital, Istanbul, Turkey.
| | | | | |
Collapse
|
48
|
Abstract
BACKGROUND A case of hemorrhagic bullae and blisters on the hand of a patient with hemophilia A after cryosurgery for verruca vulgaris is reported. OBJECTIVE To discuss a hemorrhagic complication in a patient with hemophilia A after cutaneous cryosurgery. METHODS This is an observatory case report. RESULTS Even minimal cryosurgery can induce hemorrhagic bullae in patients with hemophilia A. CONCLUSION The risks and benefits of cryosurgery should be weighed carefully in patients with bleeding disorders such as hemophilia.
Collapse
Affiliation(s)
- John G Hancox
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA
| | | | | |
Collapse
|
49
|
Abstract
AIM Warts are difficult to treat and none of the several modes of treatment suggested for their cure has been proven to be the most effective. We evaluated the efficacy of a modification of the CO (2) laser technique for recalcitrant warts in pediatric patients. PATIENTS AND METHODS During a period of 5 years, 40 consecutive pediatric patients (average age: 12.7 +/- 2.8 years) were treated by CO (2) laser for 54 recalcitrant warts. Previous treatments were caustic and/or surgical procedures (average 2.7 procedures). Local anesthesia or digital block was performed in all patients, with intravenous sedation in two patients. The laser was used at 5 W in super-pulse mode throughout the procedure. The skin was cut with the focused laser beam in a circular fashion, about 5 mm around the wart, until all the layers of the skin down to the subcutaneous tissue were penetrated. The lesion was drawn aside and excised, using the laser beam as a scalpel. No curettage was used. The base of the wart was then vaporized with the laser in a defocused fashion, until a clean surgical field was obtained. Follow-up was weekly up to 1 month, and at 3, 6, and 12 months. RESULTS Warts were located on fingers (24 cases), in the plantar area (10 cases), on hands (9 cases), knees, and legs (4 cases each), arms (2 cases) and elbow (1 case). Twenty-seven patients (67.5 %) had a solitary wart and the other 13 children had multiple warts (up to 6) at one or more locations. Fingers were the most common location of multiple warts (10 cases). All patients underwent the procedure in one session. No case of intractable operative bleeding, local infection, or prolonged exudative drainage was encountered. One patient complained of severe transient postoperative pain. The healing time was 4 to 5 weeks. At 12 months, there was no recurrence of the warts. No significant or disabling scarring was noticed, but hypopigmentation was noted in 11 cases (27.5 %). CONCLUSION This technique provides a high success rate with minimal side effects and is well tolerated by young patients.
Collapse
Affiliation(s)
- F Serour
- Clalit Health Services, Holon, Israel.
| | | |
Collapse
|
50
|
Filippo JS, Brodell RT. The nonresponding "wart". Paring with a scalpel may reveal a different lesion. Postgrad Med 2003; 114:57-8, 61. [PMID: 12926177 DOI: 10.3810/pgm.2003.08.1482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|