Cryotherapy versus topical nitric-zinc complex solution for the treatment of plantar warts: A randomized controlled trial.

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.

A novel topical agent in the treatment of seborrheic keratoses: A proof of concept study by clinical and dermoscopic evaluation.

In this proof of concept study, 50 lesions from 15 patients with multiple seborrheic keratoses (SKs) were treated with a novel aqueous solution containing nitric acid, zinc and copper salts, and organic acids (acetic, lactic, and oxalic acid). Treatment consisted in the application of an amount of the solution sufficient to obtain a whitening/yellowish reaction. Application of the nitric-zinc solution was performed every other week until clinical and dermoscopic clearance or crust formation, for a maximum of 4 applications. Efficacy evaluation was performed at 8 weeks (T1) and 6 months (T2). All subjects, who reported no or minimal discomfort during and after the application of the solution, completed the study. At T1, a complete clinical and dermoscopic resolution was observed in 37 lesions after an average of 3 applications/lesion (range 2-4). A partial response, with minimal persistent residual spots, was detected in the remaining 13 lesions. All patients with complete clearance showed no relapses at a 6-month follow-up (T2). The positive preliminary results indicate that this novel solution may represent a promising alternative option for SKs especially in patients not keen or eligible to undergo invasive tissue-destructive procedures.

Treatment of Plantar Warts with a Nitric-Zinc Complex Solution: A Review of 72 Cases.

BACKGROUND: There are multiple conservative treatment options for plantar warts, but none have proven to be universally effective. Nitric acid is often used empirically by podiatrists in the treatment of plantar warts. A novel medical device or topical solution of nitric-zinc complex solution (NZCS) could potentially offer an effective and safe alternative for the targeted treatment of plantar warts. OBJECTIVE: To observe the rate of complete healing of NZCS in a series of plantar wart cases and to establish the minimum number of product applications and time needed for healing. This will help standardize and protocolize its use. METHODS: A descriptive study was conducted involving 72 patients who exhibited symptoms of plantar warts. These patients underwent chemical treatment using a nitric-zinc complex. RESULTS: The cure rate with NZCS was 59.2%. The average number of NZCS applications was 5.9 ± 3.0 and the mean duration of treatment was 9.4 ± 7.1 weeks. A recurrence rate of 6.7% was observed. CONCLUSIONS: The topical solution of the nitric-zinc complex is an effective treatment for plantar warts, which can be considered a first-line treatment option in the general population.

A novel Nitrizinc Complex® solution for topical treatment of seborrhoeic keratosis: an interventional clinical study.

Seborrheic keratosis (SK) is a benign, common disease affecting mostly the middle aged and elderly population. SK lesions are characterized by pigmented skin growth, a warty surface, and sharp margins. Current therapies (curettage or cryotherapy) are invasive and painful. A non-invasive treatment is evaluated in this clinical study. Objectives: To assess the efficacy, safety, and tolerability of Nitrizinc Complex® topical solution (NZCS) for treatment of SK, after one to two topical applications. Thirty-two SK patients with a total of 59 lesions were treated with NZCS. Outcomes were determined by the dermatologist at clinical visits at one, three, six, and 12 months post-procedure and by subjective evaluation of patients through questionnaires. Six months after treatment, complete elimination was observed in 80% of the lesions (72% of the patients), while 93.3% of the lesions showed at least 50% reduction. Treatment ended with 100% cosmetic benefit as no scars or dyschromia were observed in the treated areas. Subjective treatment and cosmetic satisfaction were evaluated and corresponded to 8.66/10 and 8.07/10, respectively. The product was preferred over all other options previously used by all patients. Treatment was highly tolerable as discomfort, such as pain and itching/burning sensations, was minimal. No relapse cases have been observed at 12 months after treatment. This study demonstrates that NZCS is an efficient, easy-to-apply, safe and well tolerated treatment for SK lesions, and may therefore be considered as a potential topical non-invasive alternative for SK treatment.

Efficacy Assessment of a Topically Applied Nitric-Zinc Complex Solution for the Treatment of External Ano-genital Warts in 100 Patients.

INTRODUCTION: External ano-genital warts (AGWs) due to human papilloma virus infection are the most common sexually transmitted ano-genital lesions of viral origin worldwide. Treatments include topical chemicals/drugs, excisional surgery, cryosurgery, electrosurgery and laser surgery. Nitric-zinc complex (NZC) is a new topically applied solution containing nitric acid, zinc, copper and organic acids that induces a caustic effect on condyloma. The objective of this study was to investigate the efficacy and tolerability of NZC in the treatment of AGWs. METHODS: Patients attending for AGWs between September 2016 and February 2018 were retrospectively studied. They received at least one NZC application for a maximum of four treatments (V0, V1, V2, V3) with average intervals of 25 days between sessions. Recurrences were evaluated at 3 and 6 months after clearance. RESULTS: One hundred patients (70 males, 30 females) with a mean age of 36.39 years were studied. The total number of AGWs diagnosed at the baseline visit (V0) in all patients was 418 with a mean of 4.18 AGWs per patient. A wart cure rate of 92% was observed in ≤ 4 treatment sessions (383 lesions cured at visit 4, V4, out of 418 lesions at baseline), with a cure rate of 49% with only one NZC application. Complete clearance was observed in 25, 52, 72 and 84% of patients at V1, V2, V3 and V4, respectively. Relapses were observed in 29% of patients at 3 months and in 5% at 6 months. Of note, patients with ≤ 5 AGWs at V0 showed better clearance results than patients with > 5 lesions (p < 0.05). The treatment was well tolerated by most patients. CONCLUSION: NZC has been demonstrated to be effective for AGWs after 1-4 treatment sessions, obtaining a good response from the first application. The better response in patients with fewer warts suggests that the earlier diagnosis is made and treatment started, the better the expected results. FUNDING: ISDIN.