Autoimplantation therapy for multiple warts.

BACKGROUND: In the treatment of multiple warts, there is no single treatment that is 100% effective and different modalities of treatment need to be combined. AIM: To evaluate the efficacy of homologous autoimplantation therapy in the treatment of multiple warts. METHODS: A total of 60 patients of multiple verruca vulgaris and palmo-plantar warts were enrolled. Homologous autoimplantation was done after harvesting full-depth wart tissue. Patients were followed upto a period of 6 months. Resolution of warts within a period of 3 months after procedure was considered successful. RESULTS: All the 60 patients were available for follow-up. A total of 28 patients of verruca vulgaris (70%) and 16 patients of palmo-plantar warts (80%) showed resolution of warts within 3 months, accounting for a total clearance rate of 73.3%. Majority of the responders (91%) showed resolution of warts within 2 months. CONCLUSION: This study demonstrates that homologous autoimplantation could be an effective, simple modality of treatment for multiple warts.

A comparative evaluation of skin and nerve histopathology in single skin lesion leprosy.

BACKGROUND: In spite of leprosy being a disease of nerves, ROM therapy for single skin lesion leprosy was based on clinical trials without much evidence-based studies of nerve pathology. The present study was undertaken to compare the histology of skin and nerve in single skin lesion leprosy, and to assess the scientific rationale and justification of single dose ROM therapy. METHODS: Twenty-seven untreated patients with single skin lesion without significantly thickened peripheral nerves were selected. Skin and nearby pure cutaneous nerve biopsies were studied under both H&E and Fite's stain. RESULTS: All the skin biopsies were negative for AFB and clinico-pathological correlation was positive in 51.85% of skin biopsy specimens. Histopathological diagnosis of leprosy was evident in 55.5% of clinically normal looking nerves, with AFB positivity in 29.6% of nerve biopsy specimens. Correlation between clinical diagnosis and nerve histopathology was poor (26%). CONCLUSIONS: Single skin lesion without thickened peripheral nerves as criteria for single dose ROM therapy is not logical, since the histological diagnosis of leprosy in normal looking nerves with presence of AFB is revealed in this study. Pure cutaneous nerve biopsy is a simple outpatient procedure, without complications. This study emphasizes the need to consider nerve pathology as an important tool for further therapeutic recommendations, than just clinical trials and skin pathology alone. Though single dose ROM therapy has been withdrawn recently, the principle holds good for any future therapeutic recommendations.

Oral condylomata acuminata.

A case of oral condylomata acuminata in a boy aged 14 years is reported for its uncommon presentation, which warrants a high index of suspicion for diagnosis.