RESUMO
RATIONALE: Plantar warts, caused by human papillomavirus (HPV) infection, are a common skin condition on the plantar surface. Despite the availability of various treatments, achieving satisfactory outcomes remains elusive. This study explores a novel therapeutic approach combining traditional Chinese medicine (TCM) soaking therapy with cryotherapy to address this challenge. PATIENTS CONCERNS: This study focuses on 3 patients who presented with multiple and giant plantar warts, each with a disease duration exceeding 2 years. These patients had undergone numerous unsuccessful cryotherapy treatments, leaving them with persistent and troublesome warts. DIAGNOSES: All 3 patients were diagnosed with multiple and giant plantar warts caused by HPV infection. INTERVENTIONS: Following unsuccessful cryotherapies, the patients were administered TCM soaking therapy as an adjunct treatment. OUTCOMES: Remarkably, all 3 patients achieved complete remission of their plantar warts within 2 to 4 months after combining cryotherapy with TCM soaking therapy. LESSONS: Our findings suggest that relying solely on cryotherapy is insufficient for effectively treating plantar warts. The key to successful treatment lies in inhibiting wart proliferation and continuously thinning them, which can be achieved through soaking in TCM. This study demonstrates the potential of combining cryotherapy with TCM soaking as a novel and effective therapeutic approach for treating multiple and giant plantar warts.
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Crioterapia , Medicina Tradicional Chinesa , Verrugas , Humanos , Verrugas/terapia , Crioterapia/métodos , Medicina Tradicional Chinesa/métodos , Masculino , Adulto , Feminino , Terapia Combinada , Infecções por Papillomavirus/terapia , Infecções por Papillomavirus/complicações , Resultado do Tratamento , Dermatoses do Pé/terapia , Adulto JovemRESUMO
Treating plantar warts is still a challenging problem with a long list of diverse treatment options that none of them seems to be definitive. To evaluate the effectiveness of intralesional acyclovir versus intralesional Hepatitis-B vaccine (HBV) in treatment of multiple resistant plantar warts. Forty-eight patients with resistant plantar warts completed the study with no dropouts. They were randomized into 3 groups; group(A) receiving intralesional HBV, group (B) receiving intralesional acyclovir and group (C) receiving intralesional saline as a control group over 5 biweekly sessions or until wart clearance. Clinical outcome was assessed through sequential digital lesion photographing upon each visit. Treatment related adverse reactions were recorded. 43.8%, 37.5% & 18.7% of Groups A, B &C respectively showed a complete response. pain was obvious in 100% and 56.3% of cases receiving intralesional acyclovir and HBV respectively. Up to the 6 month follow up period, none of the complete responders in all groups returned with a recurrence. Both acyclovir and HBV showed comparable efficacy and seem to be promising options for treating plantar warts being safe, affordable, and theoretically safe in immunocompromised cases.
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Aciclovir , Antivirais , Vacinas contra Hepatite B , Injeções Intralesionais , Verrugas , Humanos , Verrugas/tratamento farmacológico , Verrugas/terapia , Aciclovir/administração & dosagem , Aciclovir/efeitos adversos , Masculino , Feminino , Adulto , Antivirais/administração & dosagem , Antivirais/uso terapêutico , Resultado do Tratamento , Adulto Jovem , Vacinas contra Hepatite B/administração & dosagem , Adolescente , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To observe the clinical effect of modified fire-needle technique and herbal bathing-repairing therapy of TCM on multiple verruca plantaris. METHODS: Seventy patients with multiple verruca plantaris were randomly divided into an observation group (35 cases, 1 case was eliminated) and a control group (35 cases, 2 cases dropped out). In the control group, the herbal bathing-repairing therapy of TCM was adopted. In the observation group, besides the treatment as the control group, fire needling and cauterization were delivered on the base of skin lesion or the sites with rich blood vessels under the dermoscope. The intervention was provided once a week, one course of treatment was composed of 3 weeks, and two courses were required in each group. The score of the self-designed symptom scale, the score of dermatology life quality index (DLQI) and the area of typical skin lesion were observed before and after treatment. The clinical effect was evaluated after treatment and the recurrence was assessed 2 months after treatment completion in the two groups. RESULTS: After treatment, the scores of the self-designed symptom scale and DLQI were lower and the area of typical skin lesion was smaller compared with those before treatment in the two groups (P<0.05). The scores of the self-designed symptom score and DLQI in the observation group were reduced (P<0.05), and the area of typical lesion was smaller (P<0.05) in comparison with those in the control group. The total effective rate was 91.2% (31/34) in the observation group, higher than that in the control group (60.6%, 20/33, P<0.05). The recurrence rate was 6.5% (2/31) in the observation group, lower than that in the control group (35.0%, 7/20, P<0.05). CONCLUSION: Modified fire-needle technique combined with herbal bathing-repairing therapy ameliorates clinical symptoms and the quality of life in the patients with multiple verruca plantaris and reduces the recurrence of the disease.
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Terapia por Acupuntura , Verrugas , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Terapia por Acupuntura/instrumentação , Terapia por Acupuntura/métodos , Adulto Jovem , Verrugas/terapia , Verrugas/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Adolescente , Resultado do Tratamento , Terapia Combinada , Idoso , Medicina Tradicional ChinesaRESUMO
Tinea infections are caused by dermatophytes, except for tinea versicolor, which is caused by yeasts in the Malassezia genus. If available, potassium hydroxide preparation should be performed to confirm diagnosis of tinea capitis or onychomycosis. In some cases, fungal culture, UV light examination, or periodic acid-Schiff stain can be helpful. Topical drugs are effective for tinea corporis, tinea cruris, and tinea pedis. Tinea incognito is an atypical presentation that usually requires systemic treatment. Management of tinea capitis always requires oral drugs. Oral drugs are preferred for onychomycosis treatment but should not be prescribed without confirmation of fungal infection. Localized cases of tinea versicolor can be managed with topical drugs, but oral drugs might be needed for severe, widespread, or recurrent cases. Warts are superficial human papillomavirus infections. Common treatments include irritant, destructive (eg, cryotherapy), immune stimulant (eg, intralesional Candida antigen), and debridement and excision methods. Scabies infestation results in intensely itchy papules, nodules, or vesicles. Mites and burrows on the skin are pathognomonic but difficult to identify. Dermoscopy, particularly with UV light, can make identification easier. Topical permethrin and oral ivermectin are two of the most commonly used treatments. All household and close contacts should be treated regardless of the presence or absence of symptoms.
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Escabiose , Humanos , Criança , Adolescente , Escabiose/diagnóstico , Escabiose/tratamento farmacológico , Escabiose/terapia , Verrugas/diagnóstico , Verrugas/terapia , Tinha/diagnóstico , Tinha/terapia , Tinha/tratamento farmacológico , Antifúngicos/uso terapêutico , Onicomicose/diagnóstico , Onicomicose/terapia , Onicomicose/tratamento farmacológico , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/terapia , Infestações por Ácaros/diagnóstico , Infestações por Ácaros/terapia , Infestações por Ácaros/tratamento farmacológico , DermoscopiaRESUMO
Plantar warts are common skin lesions that continue to represent a therapeutic challenge. They are still resistant to therapy and are highly recurrent, despite the diverse number of treatments available. Therapies targeting vasculature, such as pulsed dye laser, have been used successfully in the treatment of plantar warts. Polidocanol, a detergent sclerosant approved for the sclerotherapy of incompetent and dilated saphenous veins, has also been used as an off-label therapy for a wide range of skin conditions with vascular components such as hemangiomas and pyogenic granuloma. The current, open-label, prospective, pilot study aimed to evaluate the safety and efficacy of the intralesional polidocanol 3% in the treatment of plantar warts. Twenty patients (11 females and 9 males), with plantar warts, aged 12-50 years received biweekly sessions of intralesional polidocanol 3% until complete clearance or for a maximum of 6 sessions. Response to treatment was graded as complete (100% clearance), partial (50-99%), and no response (< 50%). At the end of the study, 12 (60%) patients achieved complete clearance of their warts after 1-5 sessions, 5 (25%) patients had only partial response, and 3 (15%) patients did not achieve any clearance of their warts. The procedure was largely tolerable by patients. Pain at the injection site and bruises were reported by 9 (45%) and 2 (10%) patients, respectively. Both side effects resolved spontaneously and completely within a few days. The findings of the current study suggest that intralesional injection of 3% polidocanol in biweekly sessions may be a safe, effective, and tolerable method for the treatment of plantar warts.
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Injeções Intralesionais , Polidocanol , Soluções Esclerosantes , Escleroterapia , Verrugas , Humanos , Polidocanol/administração & dosagem , Projetos Piloto , Feminino , Masculino , Adulto , Escleroterapia/métodos , Escleroterapia/efeitos adversos , Verrugas/terapia , Verrugas/tratamento farmacológico , Adolescente , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Soluções Esclerosantes/administração & dosagem , Soluções Esclerosantes/efeitos adversos , Estudos Prospectivos , CriançaRESUMO
Chemokine receptors are members of the G protein-coupled receptor superfamily. The C-X-C chemokine receptor type 4 (CXCR4), one of the most studied chemokine receptors, is widely expressed in hematopoietic and immune cell populations. It is involved in leukocyte trafficking in lymphoid organs and inflammatory sites through its interaction with its natural ligand CXCL12. CXCR4 assumes a pivotal role in B-cell development, ranging from early progenitors to the differentiation of antibody-secreting cells. This review emphasizes the significance of CXCR4 across the various stages of B-cell development, including central tolerance, and delves into the association between CXCR4 and B cell-mediated disorders, from immunodeficiencies such as WHIM (warts, hypogammaglobulinemia, infections, and myelokathexis) syndrome to autoimmune diseases such as systemic lupus erythematosus. The potential of CXCR4 as a therapeutic target is discussed, especially through the identification of novel molecules capable of modulating specific pockets of the CXCR4 molecule. These insights provide a basis for innovative therapeutic approaches in the field.
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Agamaglobulinemia , Síndromes de Imunodeficiência , Verrugas , Humanos , Síndromes de Imunodeficiência/genética , Síndromes de Imunodeficiência/terapia , Verrugas/terapia , Linfócitos B , Receptores CXCR4Assuntos
Neutropenia , Verrugas , Masculino , Humanos , Criança , Reinfecção , Verrugas/diagnóstico , Verrugas/terapia , Neutropenia/diagnóstico , Neutropenia/etiologiaRESUMO
BACKGROUND: Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge. OBJECTIVE: To summarize the current evidence on the safety and efficacy of laser and energy-based devices for the treatment of cutaneous verrucae. METHODS: A comprehensive systematic review of the literature on laser and energy-based devices for the treatment of cutaneous verrucae was performed. RESULTS: A total of 904 unique studies were identified, of which 109 were included in this review. The most commonly used lasers as a single treatment modality for verrucae included the long-pulsed Nd:Yag (n = 20) and pulsed dye (n = 18) lasers. Other modalities included the CO2 ablative laser (n = 10), photodynamic therapy (n = 11), local hyperthermia (n = 11), microwave therapy (n = 2), and nanopulse stimulation (n = 1). Other studies combined energy-based modalities with additional treatments, such as retinoids, imiquimod, and intralesional bleomycin. Overall, such devices were generally well-tolerated, with only a mild side effect profile. CONCLUSION: Overall, the use of laser and energy-based devices is a safe and well-tolerated option for cutaneous verrucae that is relatively less invasive than surgical interventions. Future studies using more consistent outcome assessment tools will be valuable to help clinicians develop device-specific protocols and treatment regimens to ensure replicable and effective outcomes.
Assuntos
Verrugas , Humanos , Verrugas/terapia , Terapia a Laser/instrumentação , Terapia a Laser/métodos , Fotoquimioterapia/métodos , Fotoquimioterapia/instrumentação , Resultado do Tratamento , Hipertermia Induzida/instrumentação , Hipertermia Induzida/métodos , Lasers de Gás/uso terapêuticoRESUMO
BACKGROUND: Few studies have addressed the relationship of human papillomavirus (HPV) biotypes to patient characteristics and the clinical signs, course, and response to the treatment of plantar warts. OBJECTIVE: Analyze the HPV types associated with plantar warts and their relationship with warts characteristics, patient characteristics and response to treatment. METHODS: A total of 372 patients sampled for hyperkeratosis of a plantar wart were included. Multiplex polymerase chain reaction (PCR) was performed to detect the HPV biotype. RESULTS: The prevalence of HPV was 81.2%, and HPV1 was the most prevalent biotype (36.1%). HPV1 was the most prevalent biotype in patients < 70 years old (90.9% in < 10 years), and biotypes 2, 19 and 27 were the most prevalent in patients > 70 years old (p = 0.012). HPV1 was the most frequent in patients with one (39,9%) or two (47.1%) warts and HPV5 (33.3%) in patients with three warts (p < 0.001). Cure, spontaneous resolution, and recurrence were higher in HPV1 (p < 0.001). HPV14 warts healed the fastest (2 months quartile 1-3 (2.0-2.0)), and HPV5 (10.977 (6.0-20.0)) and HPV27 (7.5 (3.0-10.0)) warts (p = 0.033) took the longest to heal. CONCLUSIONS: HPV biotype is associated with age and the number of warts and appears to influence the natural history of warts and their response to treatment.
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Mupapillomavirus , Infecções por Papillomavirus , Verrugas , Humanos , Idoso , Infecções por Papillomavirus/complicações , Genótipo , Verrugas/diagnóstico , Verrugas/terapia , Papillomavirus Humano , Papillomaviridae/genéticaRESUMO
AIM: WHIM (warts, hypogammaglobulinaemia, infections and myelokathexis) syndrome is a rare combined primary immunodeficiency disease caused by gain-of-function (GOF) mutations in the chemokine receptor CXCR4 and includes severe neutropenia as a common feature. Neutropenia is a known risk factor for periodontitis; however, a detailed periodontal evaluation of a WHIM syndrome cohort is lacking. This study aimed to establish the evidence base for the periodontal status of patients with WHIM syndrome. MATERIALS AND METHODS: Twenty-two adult WHIM syndrome patients and 22 age- and gender-matched healthy volunteers (HVs) were evaluated through a comprehensive medical and periodontal examination. A mouse model of WHIM syndrome was assessed for susceptibility to naturally progressing or inducible periodontitis. RESULTS: Fourteen patients with WHIM syndrome (63.6%) and one HV (4.5%) were diagnosed with Stage III/IV periodontitis. No WHIM patient presented with the early onset, dramatic clinical phenotypes typically associated with genetic forms of neutropenia. Age, but not the specific CXCR4 mutation or absolute neutrophil count, was associated with periodontitis severity in the WHIM cohort. Mice with a Cxcr4 GOF mutation did not exhibit increased alveolar bone loss in spontaneous or ligature-induced periodontitis. CONCLUSIONS: Overall, WHIM syndrome patients presented with an increased severity of periodontitis despite past and ongoing neutrophil mobilization treatments. GOF mutations in CXCR4 may be a risk factor for periodontitis in humans.
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Síndromes de Imunodeficiência , Neutropenia , Doenças Periodontais , Periodontite , Doenças da Imunodeficiência Primária , Verrugas , Adulto , Humanos , Animais , Camundongos , Síndromes de Imunodeficiência/complicações , Síndromes de Imunodeficiência/genética , Síndromes de Imunodeficiência/diagnóstico , Doenças da Imunodeficiência Primária/complicações , Doenças da Imunodeficiência Primária/genética , Verrugas/genética , Verrugas/terapia , Neutropenia/complicações , Neutropenia/genética , Doenças Periodontais/complicações , Doenças Periodontais/genética , Periodontite/complicações , Periodontite/genéticaRESUMO
Cryotherapy with liquid nitrogen has been established as the first-line treatment for pediatric patients with viral warts. Cold-induced urticaria (CU) is a rare skin reaction triggered by cold stimuli. We present the case of a pediatric patient with viral warts who developed CU after receiving cryotherapy.
Assuntos
Urticária ao Frio , Urticária , Verrugas , Humanos , Criança , Crioterapia/efeitos adversos , Verrugas/etiologia , Verrugas/terapia , Nitrogênio , Urticária/etiologia , Urticária/terapia , Resultado do TratamentoRESUMO
Cryotherapy is commonly regarded as the primary treatment method for plantar warts. A new medical device called nitric-zinc complex solution (NZCS) has also emerged as a potential alternative for wart treatment. The main aim of this study was to analyze and compare the effectiveness of cryotherapy using liquid nitrogen and NZCS in treating plantar warts. We conducted a randomized and controlled clinical trial involving patients with plantar warts. A total of 62 patients were enrolled in the study and monitored for 12 weeks or until their warts were completely resolved. The patients received either cryotherapy or NZCS, with a maximum of six treatment applications. The cure rate was 65.5% in the group treated with cryotherapy and 56.6% in the group treated with NZCS. The average number of treatment applications required for curing warts was significantly lower in the cured group (3.28 ± 1.63) than in the group with unresolved warts (5.5 ± 1.27) (p < 0.01). Moreover, the average number of applications was lower in the cryotherapy group (3.6 ± 1.8) than in the NZCS group (4.8 ± 1.8) (p < 0.01). Based on the findings, NZCS could be considered a favorable first-line treatment option for plantar warts.
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Verrugas , Zinco , Humanos , Resultado do Tratamento , Verrugas/terapia , Crioterapia/métodos , PapillomaviridaeRESUMO
Tattoos are a form of decorative body art in which pigment dyes of different colors are inoculated into the skin. It is estimated that 15-25% of general population has one or more tattoos (1), and the reasons for the popularity of this procedure may include greater social acceptance, aesthetic appeal, or perhaps the option of using laser removal techniques to eliminate unwanted tattoos. Even though modern professional tattoos are usually performed in sterile conditions, complications still occur, and with increasing numbers of people getting tattoos, the incidence of tattoo-associated side-effects presenting to dermatologists, which may be as high as 2%, is likely to increase (2). Herein we present a case of a 43-year-old male patient with multiple HPV-associated flat warts (verrucae planae) confined to the black pigment of a tattoo done 15 years ago. A 43-year-old patient presented to our clinic due to eczema on the trunk. However, during skin examination, we observed asymptomatic verrucous papules confined to the black ink of a tattoo done 15 years ago on the lateral side of his right lower leg (Figure 1a). Clinical examination showed multiple, discrete, skin-colored, verrucous papules disseminated exclusively within the lines of the black-colored tattoo. Full skin examination did not reveal any similar lesions anywhere else on the body. Dermoscopically, papules showed a discretely papillomatous surface and sharp borders (Figure 1b). The patient had another black tattoo on his trunk, in which no similar lesions were found. All his tattoos had been done more than 15 years ago in a professional tattoo salon and with no previous history of cutaneous lesions within tattoos. The patient had no other medical conditions and was not taking any medications. Additionally, no history of warts or other HPV-related lesions of the skin or mucosal membranes could be established. A biopsy of an individual papule was taken and sent for a histopathological analysis, which subsequently showed hyperkeratotic, orthokeratotic, and parakeratotic acanthotic epidermis with hypergranulosis and rare cells with perinuclear halo indicative of koilocytes (Figure 3b). Immunohistochemical analysis showed negative reaction for p16 and p53, while Ki67 was positive only in rare basal and suprabasal cells. These findings were indicative of low-risk HPV, and the diagnosis of HPV-induced verruca plana was ultimately established. The patient was then successfully treated with cautious curettage of the lesions, leaving no scars. Due to the growing popularity of tattoos, especially among younger populations, it is necessary to emphasize the possibility of various tattoo-related side-effects that can still occur due to improper preparation of the tattoo location, contamination of ink products, improperly sterilized instruments, or due to insufficient personal hygiene following tattooing (3). In the past, tattoo-associated infections were significantly more frequent, with the highest prevalence of Staphylococcus and Streptococcus infections causing impetigo, folliculitis, cellulitis, erysipelas, or sepsis (2), but recent improvement and efforts in using sterile techniques in tattooing has led to a significant drop in the number of tattoo-related infections. In this short report, we present a case of a different and a relatively rare type of tattoo-associated infection - flat warts i.e., verrucae planae. Flat warts are usually caused by HPV-3, -6B, -10, -28, and -49. Typical predilection sites are the face, dorsal sides of the hands or feet, arms, and legs, and they usually appear as skin-colored, pink, or brown, flat-topped discrete papules. It is believed that HPV can be inoculated through contaminated ink, instruments, the artist's saliva, or that it may be a pre-existing unnoticed wart in the tattooed area (4-6). The latency period between tattooing and HPV infection can range from several months to 10 years, with a mean period of 5 years (3). This may suggest that the immune system can control the infection for some time, and that some form of immune suppression may result in the development of a clinical disease. In our case, the latency period could not be established due to the patient's unawareness of the lesions, and no potential trigger could be identified. The occurrence of lesions on only one of the patient's tattoos as well as their confinement to the black pigmented ink may indicate a correlation to this specific pigment. Ramey et al. (6) conducted a study in which they assessed the localization of warts in differently colored tattoos. The results showed that black ink tattoos had a seven times higher risk of developing warts when compared with colored ink. At first it was thought that this was due to HPV inoculation via contaminated instruments, ink, or autoinoculation of the patient's own warts, but some evidence indicates that it is unlikely for HPV to survive in ink and that if the warts were inoculated they would occur equally in all ink colors. A different theory by Ruocco et al. (7) explains this phenomenon through an "immunocompromised district" mechanism, in which polycyclic aromatic hydrocarbons found in black ink produce reactive oxygen species (ROS) that can damage cellular structures and consequently increase the risk of a variety of infections, including HPV. Moreover, black ink contains almost pure nanoparticles, which are associated with greater ROS production than the larger particles found in colored ink (7,8). There are several treatment options for verrucae planae, such as liquid nitrogen cryotherapy, topical 5% fluorouracil, topical 5% imiquimod, 0.025-0.050% tretinoin, 10% salicylic acid, or 10-30% glycolic acid. These treatments have differing success rates. Destructive modalities, such as surgical excision, curetting, or laser ablation may significantly damage the tattoo and cause scarring, and are thus not regularly performed. It's necessary to emphasize that despite today's sterile methods of tattooing, complications may still occur and medical professionals, namely dermatologists, should be aware of them. A person who wishes to get a tattoo should be advised to visit a licensed tattoo artist at a licensed tattoo parlour only. Patients with pre-existing dermatoses characterized by an isomorphic phenomenon, such as psoriasis or lichen planus, are particularly prone to developing a tattoo-associated adverse reaction, and those with severe dermatoses should be advised to avoid tattooing. Additionally, people with a previous history of warts should be aware of the possibility of warts occurrence, even years or decades after tattooing. Even though most of tattoo-related side effects are merely inconveniences, there is a potential for serious complications and patients should be advised as such.
Assuntos
Infecções por Papillomavirus , Tatuagem , Verrugas , Masculino , Humanos , Adulto , Tatuagem/efeitos adversos , Infecções por Papillomavirus/etiologia , Espécies Reativas de Oxigênio , Verrugas/diagnóstico , Verrugas/etiologia , Verrugas/terapia , Cicatriz/etiologiaAssuntos
Verrugas , Humanos , Verrugas/terapia , Resultado do Tratamento , Crioterapia/efeitos adversosRESUMO
BACKGROUND: Plantar warts (verrucae plantaris) are a common source of pain for patients and are often refractory to treatment. Previous work has shown a high clearance rate of verrucae using a surface-based microwave device (Swift®). AIMS: To assess the efficacy, defined as the complete visible clearance of warts, in patients with verrucae plantaris receiving microwave treatment. PATIENTS: We undertook a retrospective review and identified records of 85 patients who underwent a course of microwave treatment at a single US-based podiatry centre. Efficacy was analyzed on the basis on intention-to-treat. RESULTS: In patients who received ≥1 session there was a complete clearance rate of 60.0% (51/85) (intention-to-treat; 59 patients completed treatment, 26 lost to follow-up) and 86.4% (51/59) per treatment completion; no significant differences in clearance rates of children and adults were observed (61.0% [25/41] vs. 59.1% [26/44]). There were 31 patients who received three sessions of microwave therapy with a clearance rate of 71.0% (22/31) as per intention-to-treat (27 patients completed treatment, 4 lost to follow-up). An average of 2.3 sessions (SD: 1.1; range: 1-6) was required for the complete clearance of plantar warts. Complete clearance was also observed in some patients with recalcitrant warts following additional treatment sessions (42.9% [3/7]). A significant reduction in wart related pain was reported for all patients undergoing treatment. Some patients continued to report a reduced amount of pain post-therapy compared with pretherapy. CONCLUSIONS: Microwave treatment of verrucae plantaris appears to be a safe and effective procedure.
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Doenças do Pé , Verrugas , Adulto , Criança , Humanos , Doenças do Pé/terapia , Micro-Ondas/efeitos adversos , Dor , Resultado do Tratamento , Estados Unidos , Verrugas/terapiaRESUMO
BACKGROUND: Genital warts caused by human papillomavirus (HPV) are one of the most common sexually transmitted infections. Long latency, lesions' multiplicity, high recurrence rate, and the tendency to malignant transformation are essential challenges during management. Traditional treatment modalities are known to be lesion-directed while intralesional immunotherapy was introduced to act beyond individual lesions and to confront the previous challenges through injection of known antigens, such as measles, mumps and rubella (MMR) vaccine, to stimulate the immune system against HPV. Needling-induced autoinoculation is also considred as an immunotherapeutic procedure that does not include the injection of antigens. We evaluated the efficacy of needling-induced autoinoculation in the management of genital warts. METHODS: Fifty patients with multiple recurrent (≥4) genital warts were divided into two equal groups. One group was subjected to needling-induced autoinoculation and the other was subjected to intralesional MMR injection every 2 weeks for a maximum of three sessions. Follow-up was done for 8 weeks after the last session. RESULTS: Both needling and MMR showed statistically significant therapeutic outcome. Needling showed significant improvement with regard to the number (P = 0.000) and size (P = 0.003) of lesions. In parallel, MMR showed significant improvement with regard to the number (P = 0.001) and size (P = 0.021) of lesions. There was no statistically significant difference between both treatments outcomes in regard to number (P = 0.860) and size (P = 0.929) of lesions. CONCLUSIONS: Both needling and MMR are effective immunotherapeutic modalities in management of genital warts. Needling-induced autoinoculation, being more safe and inexpensive, may be considered as a competing choice.
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Condiloma Acuminado , Infecções por Papillomavirus , Vacinas , Verrugas , Humanos , Verrugas/terapia , Condiloma Acuminado/terapia , Imunoterapia/métodos , Injeções Intralesionais , Resultado do TratamentoRESUMO
Verruca vulgaris is always stubborn to treat. We applied a new combined therapy of local recombinant human interferon alpha 1b (rhIFNα1b) injection plus acupuncture on verruca vulgaris recently to evaluate the efficacy and safety of the combined therapy. The retrospective study was conducted in The First Hospital of China Medical University from 2018 to 2020. Patients with verruca vulgaris were included. Combined therapy with local rhIFNα1b injection plus acupuncture was set as treatment group, rhIFNα1b injection and carbon dioxide (CO2) laser were set as control groups. A total of 2415 patients were included in the study. The cure rates were 81.85%, 85.93%, and 100% in combined group, rhIFNα1b group, and CO2 laser group, separately. All lesions cured in combined group were located on hands or feet, while majority of lesions cured in other groups were located on other sites. For patients with medium/big single lesion or 6-9 lesions, less treatment times were needed in combined group than rhIFNα1b group. For patients with small single, two to five or more than ten lesions, the treatment times of combined group and rhIFNα1b group were comparable. All patients complained of pain in varying degrees when local injection or laser irradiation. Compared with CO2 laser group, more fever, less swelling or scar was reported in combined group. In conclusion, combined therapy of local rhIFNα1b plus acupuncture was beneficial for verruca vulgaris with limited adverse effects. The therapy was more acceptable by younger female patients with verruca vulgaris.