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1.
Medicine (Baltimore) ; 99(15): e19744, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282734

RESUMO

RATIONALE: Tattooing is a procedure where ink is inserted typically in the intraepidermal space of the skin. Multiple incidences of viral infections following tattooing which lead to warts have been reported in recent years. The aim of this report was to show a relatively rare adverse effect after tattooing - verruca plana. PATIENT CONCERNS: A 27-year-old female presented to our department with complains of multiple verrucous papules over her 2-year-old tattoo without itch. DIAGNOSES: Pathological investigation confirmed the diagnosis as verruca plana. INTERVENTIONS: The patient was treated with 3 cycles of liquid nitrogen cryotherapy and 5% imiquimod cream for 5 months. OUTCOMES: A significant improvement in her lesions was observed after the combined treatment. LESSONS: Clinically, verruca plana post-tattooing is relatively less reported. We need to combine clinical manifestations with pathological results to arrive at a definitive diagnosis. Besides, there are a large numbers of post-tattoo complications and various routes of virus inoculation. Therefore, it is important for medical professionals to caution people before considering to have a tattoo.


Assuntos
Tatuagem/efeitos adversos , Viroses/complicações , Verrugas/patologia , Verrugas/terapia , Adjuvantes Imunológicos/administração & dosagem , Adjuvantes Imunológicos/uso terapêutico , Administração Tópica , Adulto , Terapia Combinada , Crioterapia/métodos , Feminino , Humanos , Imiquimode/administração & dosagem , Imiquimode/uso terapêutico , Resultado do Tratamento , Viroses/patologia , Verrugas/etiologia
2.
J Dermatolog Treat ; 31(1): 56-60, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31137994

RESUMO

Background: Lasers have been used for verruca treatment in recent years with successful results in some types. In addition, peeling processes have been used to enhance penetration in some studies.Objectives: This study aimed to evaluate combined treatment with LP Nd:YAG laser and KoH for the treatment of recalcitrant wart.Methods: This study included 132 lesions from 38 patients. Long-pulsed (LP) Nd:YAG laser was applied to 66 lesions with daily 10% KOH application at night, and the remaining 66 lesions underwent LP Nd:YAG laser therapy only.Results: Both groups showed statistically significant regressions in the size of the lesions at the end of the fifth session compared with those present at the onset of therapy (p < .05). Also, complete clearance of the lesions was noticed after 2.2 sessions in the combined therapy group, and after 3.1 sessions in the LP Nd:YAG laser group (p < .05).Conclusions: Although the difference in clearance rate between the combined therapy group and the LP Nd:YAG laser group could not be detected after the fifth session, adding KOH to LP Nd:YAG laser can decrease the number of treatment sessions to a large extent.


Assuntos
Hidróxidos/uso terapêutico , Lasers de Estado Sólido , Compostos de Potássio/uso terapêutico , Verrugas/terapia , Adolescente , Adulto , Criança , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neodímio/química , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
3.
J Dermatolog Treat ; 31(3): 235-240, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096794

RESUMO

Background: The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo).Methods: Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks.Results: Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group .Conclusions: Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion .


Assuntos
Antibióticos Antineoplásicos/uso terapêutico , Bleomicina/uso terapêutico , Doenças do Pé/terapia , Verrugas/terapia , Adolescente , Adulto , Crioterapia , Feminino , Doenças do Pé/tratamento farmacológico , Doenças do Pé/patologia , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Agulhas , Verrugas/tratamento farmacológico , Verrugas/patologia , Adulto Jovem
4.
J Am Acad Dermatol ; 82(1): 94-100, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31369771

RESUMO

BACKGROUND: Despite the availability of different therapeutic modalities, treatment of recalcitrant common warts is still challenging. Cervarix (GlaxoSmithKline, Brentford, UK), a recombinant bivalent human papillomavirus (HPV) vaccine, has shown promising efficacy in the treatment of warts. OBJECTIVES: To evaluate the beneficial effects and tolerability of intramuscular versus intralesional bivalent HPV vaccine in the treatment of recalcitrant common warts. METHODS: The study included 44 adult patients with multiple recalcitrant common warts; 22 patients received intramuscular injection of bivalent HPV vaccine at 0, 1, and 6 months or until complete clearance of warts, and the other 22 patients received intralesional injection of 0.1 to 0.3 mL of bivalent HPV vaccine into the largest wart at 2-week intervals until complete clearance or for a maximum of 6 sessions. RESULTS: Complete clearance of warts was observed in 18 patients (81.8%) of the intralesional group and 14 patients (63.3%) of the intramuscular group; however, the difference was not statistically significant. Adverse effects were transient and insignificant, and no recurrence was reported in either group. LIMITATIONS: Small study sample and different dosing schedules. CONCLUSIONS: Bivalent HPV vaccine, particularly by intralesional injection, seems to be a potential therapeutic option for the treatment of multiple recalcitrant common warts.


Assuntos
Vacinas contra Papillomavirus/administração & dosagem , Dermatopatias/diagnóstico , Dermatopatias/terapia , Verrugas/diagnóstico , Verrugas/terapia , Adulto , Feminino , Seguimentos , Humanos , Injeções Intralesionais , Injeções Intramusculares , Masculino , Recidiva , Medição de Risco , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
7.
Int J Dermatol ; 58(12): 1477-1482, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31591706

RESUMO

BACKGROUND: Despite the numerous studies on the use of purified protein derivative (PPD), a protein extracted from Mycobacterium tuberculosis, in verruca vulgaris, there is no standardized regimen, and efficacy of single versus multiple injections has not been compared. METHODS: This is a randomized, open-label, superiority trial. Sixty-six patients with at least three warts in two different anatomic sites were randomized into two groups: a single injection (n = 29) and multiple injection (n = 29) groups. Patients were treated every 2 weeks until a maximum of six sessions. RESULTS: Multiple injections (79.3%) showed superior clearance rates compared to a single injection of PPD (58.6%) (P-value = 0.0236). Multiple injections also exhibited faster clearance at each time point (P = 0.048). Pain was statistically more significant in the multiple injection group (P = 0.0005). There was no statistically significant difference in incidence of adverse events (P = 0.1795). Amongst all cleared patients in both groups, there were no recurrences after 6 months. CONCLUSION: Multiple injections of warts with PPD cleared more patients with multiple common warts than the use of single injections at the end of 12 weeks and were faster in clearing patients at every time point. Single injection was better tolerated than multiple injections. Both treatments exhibited similar safety profiles and recurrence rates.


Assuntos
Imunoterapia/métodos , Tuberculina/administração & dosagem , Verrugas/terapia , Adulto , Esquema de Medicação , Feminino , Humanos , Injeções Intralesionais , Masculino , Recidiva , Resultado do Tratamento , Tuberculina/efeitos adversos
8.
Pediatr Dermatol ; 36(5): 750-752, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31282037

RESUMO

Cryotherapy using liquid nitrogen is an effective and commonly used treatment for palmoplantar warts. However, pain can be a limiting factor in the effective use of cryotherapy. In this study, we found that a single application of anesthetic cream following cryotherapy treatment of warts reduced posttreatment pain and led to improved tolerability of the procedure.


Assuntos
Anestésicos Locais/uso terapêutico , Crioterapia/efeitos adversos , Combinação Lidocaína e Prilocaína/uso terapêutico , Dor/etiologia , Dor/prevenção & controle , Verrugas/terapia , Adolescente , Criança , Feminino , Humanos , Masculino , Pomadas , Resultado do Tratamento , Adulto Jovem
9.
Photodiagnosis Photodyn Ther ; 27: 340-344, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31252143

RESUMO

BACKGROUND: Periungual warts are a viral infectious disease that occurs in a particular location. It is difficult to eliminate completely, and recurrence is common. Photodynamic therapy (PDT) as an option that has been widely recommended to treat viral warts. However, there are always a few patients with poor efficacy after PDT treatment. We have considered that the reason is the limitation of PDT penetrating deep into tissue. Thus, we combined superficial shaving with PDT to treat recalcitrant periungual warts. METHODS: Twenty-three patients had a total of 61 periungual wart lesions. All patients had recalcitrant periungual warts that had failed to respond to various treatments that had poor curative effects. After local injection of anesthesia, the lesions were shaved in situ, and PDT was performed immediately. A total of three sessions of PDT were applied for each patient after only one superficial shaving. The overall clinical response rate, recurrence rates, cosmetic outcomes, adverse events, patient satisfaction and quality of life were assessed. The potential risk factors have also been recorded. RESULTS: We achieved a 96% success rate (defined as more than 50% on clearance) in our 23 patients using combination superficial shaving with PDT after treatment for 3 months. At the 12-month follow-up, 21 patients (91%) had excellent cosmetic outcomes. All patients had satisfactory therapeutic effects and significant improvement in the quality of life. Pain during the illumination process was the main adverse event, but all patients were able to tolerate it. We also found that frequent or continuous hand activity, such as playing Mah-jong, may be a potential risk factor for periungual warts. CONCLUSION: Our results offer promise for combining superficial shaving with PDT as an effective and safe therapy for patients with periungual warts, especially for those periungual warts that are recurrent, have multiple lesions, and thickness corneum stratum of lesions. For nails that are not suitable for routine surgery, combined superficial shaving with PDT is recommended.


Assuntos
Fotoquimioterapia/métodos , Verrugas/tratamento farmacológico , Adolescente , Adulto , Ácido Aminolevulínico , Criança , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Unha , Fármacos Fotossensibilizantes , Verrugas/terapia , Adulto Jovem
11.
Indian J Dermatol Venereol Leprol ; 85(4): 355-366, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31172979

RESUMO

Background: Present day therapeutic modalities for viral warts are mostly ablative in nature, limited by high recurrence rates and are unsuitable for numerous lesions. Immunotherapy has the potential to overcome these limitations. Aims: This study aimed at comparing efficacy and safety of and quality of life changes with intradermal purified protein derivative (PPD) of tuberculin antigen and Mycobacterium w (Mw) vaccine in immunotherapy of warts. Methods: Patients with multiple (≥5) warts were randomized (1:1) into two groups (PPDand, Mw vaccine groups). Fortnightly, 0.1 ml of either medicine was injected intradermally over the deltoidregion till complete resolution or a maximum of six doses. Patients were followed-up for another 3 months for recurrence. Results: Sixty-four participants received either PPD or Mw vaccine. The number of warts were comparable at baseline (P = 0.089, Mann-Whitney test), and reduced significantly with treatment in both groups (P < 0.001, Friedman's ANOVA), as seen from the fourth follow-up onwards with Mw and fifth follow-up onwards with PPD (P < 0.05, Post hoc Dunn's test). Intergroup comparison showed significantly more (P < 0.05, Mann-Whitney test) reduction with Mw than PPD at the sixth and seventh follow-up. The size of warts also reduced significantly (P < 0.001) in both groups from the third follow-up onwards. Complete remission was more (P = 0.539, Fischer's exact test) in the Mw group (68.8%) than the PPD group (50%); and was significantly higher (P = 0.049, Mann-Whitney test) in patients having shorter duration of warts. Adverse events were significantly more (P < 0.001) with Mw including ulceration (50%), discharge (15.6%), pain-swelling-induration and scar at the injection site (97% each), whereas some of those receiving PPD noted erythema and scaling at the injection site (18.8%), and post-inflammatory hyperpigmentation (12.5%). No recurrence was seen till the end of the study. Limitation: Unicentric trial. Conclusion: Intradermal injection of Mw vaccine was more effective but had a higher incidence of adverse effects compared to PPD of tuberculin antigen in patients with warts.


Assuntos
Vacinas Bacterianas/uso terapêutico , Reação no Local da Injeção/etiologia , Tuberculina/uso terapêutico , Verrugas/terapia , Adolescente , Adulto , Vacinas Bacterianas/efeitos adversos , Método Duplo-Cego , Eritema/induzido quimicamente , Feminino , Seguimentos , Humanos , Hiperpigmentação/induzido quimicamente , Injeções Intradérmicas , Masculino , Dor/induzido quimicamente , Recidiva , Indução de Remissão , Úlcera Cutânea/induzido quimicamente , Tuberculina/efeitos adversos , Adulto Jovem
12.
Dermatol Ther ; 32(5): e12997, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31225688

RESUMO

Intralesional immunotherapy is one of the therapeutic tools of warts. Intralesional Candida antigen was reported as successful treatment of warts. Topical and intralesional vitamin D have been used recently for wart treatment. We aim to evaluate the efficacy and safety of intralesional injection of vitamin D3 in treatment of multiple recalcitrant plantar warts in comparison with intralesional Candida antigen. Sixty patients were divided into three groups: Group I received intralesional vitamin D3, Group II intralesional Candida antigen, and Group III intralesional saline (control group). Injection was done every 3 weeks until clearance of warts or a maximum of three treatments. There was a statistically significant more reduction of warts numbers after treatment in Group I than in the other groups (p < .05). Group I showed better clinical response than Group II (p = .021). In both Groups I and II, clinical response was less favorable in patients with longer disease duration (p = .026). There was also limitation as it is a small study population. Intralesional vitamin D3 injection in multiple recalcitrant plantar warts is a simple, safe, cost effective treatment modality with minimal side effects, and superior results compared with intralesional injection of Candida antigen.


Assuntos
Antígenos de Fungos/administração & dosagem , Candida albicans/imunologia , Colecalciferol/administração & dosagem , Dermatoses do Pé/terapia , Imunoterapia/métodos , Verrugas/terapia , Adulto , Estudos de Casos e Controles , Dermoscopia , Feminino , Seguimentos , Dermatoses do Pé/diagnóstico , Humanos , Injeções Intralesionais , Masculino , Fatores de Tempo , Resultado do Tratamento , Vitaminas/administração & dosagem , Verrugas/diagnóstico , Adulto Jovem
13.
J Med Syst ; 43(7): 220, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31175462

RESUMO

Wart disease (WD) is a skin illness on the human body which is caused by the human papillomavirus (HPV). This study mainly concentrates on common and plantar warts. There are various treatment methods for this disease, including the popular immunotherapy and cryotherapy methods. Manual evaluation of the WD treatment response is challenging. Furthermore, traditional machine learning methods are not robust enough in WD classification as they cannot deal effectively with small number of attributes. This study proposes a new evolutionary-based computer-aided diagnosis (CAD) system using machine learning to classify the WD treatment response. The main architecture of our CAD system is based on the combination of improved adaptive particle swarm optimization (IAPSO) algorithm and artificial immune recognition system (AIRS). The cross-validation protocol was applied to test our machine learning-based classification system, including five different partition protocols (K2, K3, K4, K5 and K10). Our database consisted of 180 records taken from immunotherapy and cryotherapy databases. The best results were obtained using the K10 protocol that provided the precision, recall, F-measure and accuracy values of 0.8908, 0.8943, 0.8916 and 90%, respectively. Our IAPSO system showed the reliability of 98.68%. It was implemented in Java, while integrated development environment (IDE) was implemented using NetBeans. Our encouraging results suggest that the proposed IAPSO-AIRS system can be employed for the WD management in clinical environment.


Assuntos
Diagnóstico por Computador , Aprendizado de Máquina , Verrugas/terapia , Adolescente , Adulto , Idoso , Crioterapia , Mineração de Dados , Feminino , Humanos , Imunoterapia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Resultado do Tratamento , Adulto Jovem
14.
J Dtsch Dermatol Ges ; 17(6): 613-634, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31241843

RESUMO

Extragenital cutaneous warts are benign epidermal tumors caused by human papillomaviruses (HPVs) and a frequent reason for patients to consult a dermatologist. Depending on wart type and site involved, the clinical presentation is highly varied. Given that warts represent a self-limiting condition, a wait-and-see approach may be justified. However, treatment is always indicated if the lesions become painful or give rise to psychological discomfort. Factors to be considered in this context include subjective disease burden, patient age, site affected, as well as the number and duration of lesions. Destructive treatment methods involve chemical or physical removal of diseased tissue. Nondestructive methods consist of antimitotic and antiviral agents aimed at inhibiting viral proliferation in keratinocytes. Some of the various immunotherapies available not only have localized but also systemic effects and are thus able to induce remission of warts located at any distance from the injection site. Especially patients with warts at multiple sites benefit from this form of treatment. Intralesional immunotherapy using the mumps-measles-rubella (MMR) vaccine is a particularly promising option for the treatment of recalcitrant warts in adult patients. For children, on the other hand, HPV vaccination is a novel and promising approach, even though it has not been approved for the treatment of cutaneous warts. At present, there is no universally effective treatment available. Moreover, many frequently employed therapies are currently not supported by conclusive clinical trials.


Assuntos
Dermatopatias Virais/terapia , Verrugas/terapia , Acetatos/uso terapêutico , Adulto , Antivirais/uso terapêutico , Crioterapia/métodos , Curetagem/métodos , Feminino , Fluoruracila/uso terapêutico , Formiatos/uso terapêutico , Humanos , Terapia a Laser/métodos , Masculino , Fototerapia/métodos , Ácido Salicílico/uso terapêutico , Dermatopatias Virais/patologia , Dermatopatias Virais/transmissão , Verrugas/patologia , Verrugas/transmissão , Conduta Expectante
15.
Int J Dermatol ; 58(12): 1435-1438, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31081127

RESUMO

BACKGROUND: Cutaneous viral warts are benign epidermal proliferations caused by human papillomaviruses (HPVs). Despite treatment, a significant proportion of warts fail to resolve, becoming recalcitrant. Vitamin A (retinol) may disrupt the interplay of HPV replication and epithelial cell differentiation, allowing normal tissue to replace warts. Circulating retinol-binding protein (RBP) concentrations highly correlate with retinol levels. AIM: We aimed at evaluation of serum RBP level in patients with recalcitrant cutaneous warts in order to assess its correlation with disease pathogenesis. METHODS: Serum RBP level was measured by an ELISA technique in 50 patients with recalcitrant cutaneous warts and 30 apparently healthy controls. RESULTS: Serum RBP level was significantly lower in patients with recalcitrant warts than the control group (P < 0.001). However, it did not differ regarding different clinical parameters in studied patients (P > 0.05 each). RBP is a reliable biomarker for significant early detection and discrimination between patients and healthy controls (P < 0.001) at a cutoff value ≤1034.6 µg/ml, with sensitivity and specificity (100% each). CONCLUSION: Our results revealed that low serum RBP as a relatively cheap biomarker with high specificity and sensitivity is a reliable indicator of vitamin A (retinol) deficiency that may play a role in the pathogenesis of recalcitrant cutaneous warts among our studied patients.


Assuntos
Proteínas Plasmáticas de Ligação ao Retinol/análise , Deficiência de Vitamina A/diagnóstico , Verrugas/diagnóstico , Adolescente , Adulto , Biomarcadores/sangue , Feminino , Voluntários Saudáveis , Humanos , Masculino , Papillomaviridae/isolamento & purificação , Recidiva , Sensibilidade e Especificidade , Falha de Tratamento , Vitamina A/sangue , Deficiência de Vitamina A/sangue , Verrugas/sangue , Verrugas/terapia , Verrugas/virologia , Adulto Jovem
18.
Photodiagnosis Photodyn Ther ; 27: 276-279, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30965148

RESUMO

BACKGROUND: Cutaneous warts are an extremely common problem, whose eradication can be challenging. Topical PDT involves applying a porphyrin precursor, 5-aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) to the affected area. ALA-PDT has been well documented to be successful in the treatment of recalcitrant warts. PDT has a limited role in the treatment of thicker lesions because the photosensitizer does not penetrate keratotic lesions well, though this is vehicle dependent. OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of curettage + microneedling + ALA-PDT for the treatment of resistant acral warts. We hypothesized that microneedling may increase the efficacy of PDT, providing a channel to deliver the ALA to deeper areas of warts. METHODS: Our study was carried out between November 2017 and July 2018. Eligible participants had one or more resistant plantar or palmar warts. Thirteen patients were recruited. They underwent a thorough curettage, followed by the application of 5-ALA 10% cream on the wart, and by microneedling. Later, the pricked skin was covered for three hours by an occlusive polyurethane dressing, and finally irradiated with a red-light source. Patients performed one session every three weeks for a total of three cycles. RESULTS: After 3 treatments of curettage + microneedling + ALA-PDT, 11 patients (84.6%) showed complete remission (defined as complete disappearance of their warts). One patient (7.7%) showed partial remission (defined as greater than 50% decrease in the wart area) after 3 sessions; this patient needed other 2 sessions to achieve complete remission. The mean follow-up period after healing was 4.3 months. Adverse effects were recorded. CONCLUSION: We have demonstrated, for the first time to our knowledge, that the combination of curettage + microneedling + topical ALA-PDT may offer an effective and safe alternative for the treatment of acral resistant warts, even when PDT alone has already been insufficient.


Assuntos
Ácido Aminolevulínico/análogos & derivados , Curetagem/métodos , Agulhas , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Verrugas/terapia , Adolescente , Adulto , Ácido Aminolevulínico/administração & dosagem , Ácido Aminolevulínico/efeitos adversos , Ácido Aminolevulínico/uso terapêutico , Terapia Combinada , Curetagem/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotoquimioterapia/efeitos adversos , Fármacos Fotossensibilizantes/administração & dosagem , Fármacos Fotossensibilizantes/efeitos adversos , Verrugas/tratamento farmacológico , Adulto Jovem
19.
Skinmed ; 17(1): 68-71, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30888954

RESUMO

A 47-year-old white woman presented to our clinic complaining of recalcitrant warts on her trunk and extremities. She had an extensive past medical history including immunodeficiency of unknown origin, pulmonary hypertension, rheumatoid arthritis, and systemic lupus erythematosus, for which she was being treated with chronic immunosuppressive therapy with methylprednisolone and belimumab. The patient had previously failed treatments at an outside facility with liquid nitrogen, trichloroacetic acid, topical cidofovir, imiquimod, topical 5-fluorouracil, intralesional candida antigen, pulsed-dye laser (Vbeam Perfecta), surgical excision, and photodynamic therapy. (SKINmed. 2019;17:68-71).


Assuntos
Hipertermia Induzida/métodos , Verrugas/terapia , Terapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento , Verrugas/patologia
20.
Cutis ; 103(1): 26;27;28;29;30;E2;E3;E4, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30758340

RESUMO

Warts are superficial viral infections of the skin that are extremely common in children. The infection usually lasts more than 1 year and can be moderately contagious in specific settings; for instance, warts are particularly common and spread more easily in the setting of atopic dermatitis, a chronic, itchy pediatric skin condition caused by barrier and immune defects. Therapies for pediatric warts are characterized according to 6 major categories: destructive; immune stimulating; immune modulating, including normalization of epithelial growth; vascular destructive; irritant; and nitric oxide releasing. The standard of care is the use of destructive therapies, with immune-stimulating and vascular destructive therapies reserved for more prolonged, extensive, or treatment-resistant infections. In this article, a successful paradigm for management of pediatric warts is provided, with enhanced outcomes based on further insight into the disease course and patient selection.


Assuntos
Infecções por Papillomavirus/terapia , Verrugas/terapia , Criança , Humanos , Infecções por Papillomavirus/virologia , Verrugas/virologia
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