1
|
Friedland R, Renert-Yuval Y, Solomon-Cohen E, Reiss-Huss S, Ben Amitai D. Verrulyse Methionine ® as Monotherapy in Children and Adolescents With Common Warts. J Cutan Med Surg 2024; 28:248-252. [PMID: 38314702 DOI: 10.1177/12034754241230691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Common cutaneous non-genital viral warts are a common skin infection with significant morbidity in the pediatric population. Although various therapeutics are available, many of them necessitate recurrent patient visits and may be associated with significant irritation and pain. Verrulyse Methionine® (VM), a nutritional supplement, was previously suggested as a non-invasive treatment option for the disease. OBJECTIVE To assess the response to oral VM supplement as a monotherapy in a cohort of children and adolescents with multiple, non-genital viral warts after failing previous treatments. METHODS We reviewed medical records of pediatric patients (<18 y/o) with viral warts treated with VM between 2010 and 2021. RESULTS Among 25 patients with multiple verrucae vulgaris lesions who failed previous treatments, 14 (56%) had complete or almost-complete response to VM within 4 months, after an average of 18 months of active disease prior to VM treatment initiation. None of the 4 patients with verruca plana had response to VM treatment. Favourable cosmetic results were found in responders, and no adverse events were recorded. CONCLUSION Response rates in our cohort are comparable to those reported in the literature for destructive local therapeutics for viral warts. Thus, our data suggest that VM may be considered for children with multiple verrucae vulgaris, providing a painless and non-invasive therapeutic option for this common disease.
Collapse
Affiliation(s)
- Rivka Friedland
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Renert-Yuval
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Efrat Solomon-Cohen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
| | - Shiran Reiss-Huss
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dan Ben Amitai
- Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
2
|
Couselo-Rodríguez C, Batalla A, Martínez-Fernández S, Dávila-Pousa C, Soto-García D, Vilanova-Trillo L, Flórez Á. Off-label Prescription in Paediatric Dermatology: A Retrospective Observational Study in a Tertiary Hospital. Acta Derm Venereol 2023; 103:adv11937. [PMID: 38078687 PMCID: PMC10726374 DOI: 10.2340/actadv.v102.11937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/10/2023] [Indexed: 12/18/2023] Open
Abstract
Off-label prescription in paediatric patients is common, where some studies indicate that dermatological conditions are more prone to off-label treatment. This is the first study to analyse the prevalence of off-label prescription in paediatric dermatology consultation. This retrospective observational study was performed using the medical records of paediatric patients who were evaluated in a paediatric dermatological consultation in Pontevedra University Hospital, Pontevedra, Spain. Of the 468 patients reviewed, 186 prescriptions were issued and 51.10% were off-label prescription drugs. The dermatological conditions for which off-label prescription was most common were atopic dermatitis (29.0%), followed by warts (12.9%) and infantile haemangiomas (11.8%). With respect to drugs, topical tacrolimus (23.7%) was the most frequently prescribed off-label drug. The main reason for prescribing an off-label drug was for a disease not included on the label (62.4%), followed by issuing it at a lower age than authorized (55.9%). There was a significant association between a higher percentage of off-label prescription and younger age (p < 0.001), and the treatment of vitiligo, infantile haemangiomas and warts (p < 0.001). Likewise, the off-label prescription was significantly more common in the case of topical terbinafine, timolol, desloratadine and topical salicylic acid (p < 0.001). To conclude, off-label prescription is predominant in paediatric dermatology, as observed in 51.1% of our patients.
Collapse
Affiliation(s)
- Carmen Couselo-Rodríguez
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-Uvigo, Spain.
| | - Ana Batalla
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-Uvigo, Spain
| | - Sandra Martínez-Fernández
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-Uvigo, Spain
| | | | - Diego Soto-García
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-Uvigo, Spain
| | - Lucía Vilanova-Trillo
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-Uvigo, Spain
| | - Ángeles Flórez
- Department of Dermatology, University Hospital of Pontevedra, Pontevedra, Spain; DIPO Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Sergas-Uvigo, Spain
| |
Collapse
|
3
|
Singh Y. The Application of Machine Learning in Predicting Outcome of Cryotherapy and Immunotherapy for Wart Removal. Ann Dermatol 2021; 33:345-350. [PMID: 34341636 PMCID: PMC8273329 DOI: 10.5021/ad.2021.33.4.345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 09/03/2020] [Accepted: 12/17/2020] [Indexed: 11/14/2022] Open
Abstract
Background Warts can be extremely painful conditions that may be associated with localised bleeding and discharge. They are commonly treated by cryotherapy or immunotherapy. However, each of these therapies have discomforting side effects and are no official dermatological guideline that exist that may be used to determine which of these methods would work on an individual patient. Objective This study aimed at developing a machine learning algorithm that improved the prediction of the outcome of wart removing using cryotherapy and immunotherapy. Methods Support vector machines, core vector machines, random forest, k-nearest neighbours, multilayer perceptron and binary logistic regression was applied on datasets in to create a model that predicted the outcome of an immunotherapy and cryotherapy treatments based on sex, age, time that has passed since last treatment, number of warts, type, area, diameter and result of treatment. Results The average accuracy of the immunotherapy prediction was 88.6%±8.0% while the same measure for cryotherapy prediction was 94.6%±4.0%. The most efficient immunotherapy and cryotherapy model had an accuracy of 100%, predicating the correct treatment outcome when applied to all test cases. Conclusion This study successfully created a machine learning model that improved the prediction ability of the outcome of immunotherapy and cryotherapy for wart removal. This model created a more in-depth guideline for understanding is immunotherapy would work and took a new approach to cryotherapy.
Collapse
Affiliation(s)
- Yashik Singh
- Department of Telehealth, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
4
|
Abarca Lachén E, Hernando Martínez P, Gilaberte Calzada Y. The Most Useful Pharmaceutical Formulations (Individualized Medications) in Pediatric Dermatology: A Review. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.01.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
5
|
Abarca Lachén E, Hernando Martínez P, Gilaberte Calzada Y. The Most Useful Pharmaceutical Formulations (Individualized Medications) in Pediatric Dermatology: A Review. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:302-313. [PMID: 33220314 DOI: 10.1016/j.ad.2020.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/30/2020] [Accepted: 11/09/2020] [Indexed: 01/19/2023] Open
Abstract
The administration of appropriate doses of active ingredients and excipients is crucial for achieving desired treatment outcomes in pediatric dermatology. A number of factors need to be considered, including the characteristics of the lesion, the patient, and the drug. An additional challenge in pediatric settings is the limited number of commercially available formulations suitable for use in children. Drug compounding, which is the preparation of medications tailored to the needs of individual patients, is a good alternative for pediatric populations for a number of reasons. Using a customized compound, the clinician can prescribe formulations that contain the optimal dose of the active ingredients within acceptable limits and the most suitable vehicle and formulation components. Compounding can also be used to combine several active ingredients in a single medication and even adapt the vehicle to the characteristics of the lesion and the needs of the patient. The pharmaceutical formulations described in this review are based on extensive clinical experience and can be customized to meet individual needs.
Collapse
Affiliation(s)
- E Abarca Lachén
- Facultad de Ciencias de la Salud, Universidad San Jorge, Villanueva de Gállego, Zaragoza, España; Sociedad Española del Medicamento Individualizado (LASEMI), España.
| | - P Hernando Martínez
- Facultad de Ciencias de la Salud, Universidad San Jorge, Villanueva de Gállego, Zaragoza, España; Sociedad Española del Medicamento Individualizado (LASEMI), España
| | - Y Gilaberte Calzada
- Servicio de Dermatología, Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España
| |
Collapse
|
6
|
Nguyen AL, Quint KD, Bouwes Bavinck JN, Erceg A, de Kort WJA, Körver JEM. Real-life treatment of cutaneous warts with cantharidin podophyllin salicylic acid solution. Dermatol Ther 2019; 32:e13143. [PMID: 31664756 PMCID: PMC6916542 DOI: 10.1111/dth.13143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 10/18/2019] [Accepted: 10/26/2019] [Indexed: 11/30/2022]
Abstract
Patients often request treatment of their burdensome cutaneous warts. However, a safe and effective treatment for cutaneous warts is lacking. This study evaluates treatment outcome, side effects, and patient satisfaction after topical application of cantharidin 1% podophyllin 2% salicylic acid 30% (CPS1) solution in a large series of children and adults with cutaneous warts. Fifty‐two children and 83 adults with warts, treated with CPS1 solution between October 2012 and October 2014, were included. Complete clearance of warts occurred in 86.5% of children and 62.7% of adults treated with CPS1 solution (p < .01). Resolution of warts was partial in 3.9 and 24.1% and absent in 9.6 and 13.2% of children and adults respectively. Side effects were present in 41.2% of children and 46.3% of adults (p = .7). Most common side effects were blistering, pain, and burning sensation. No serious adverse events occurred. On a 10‐point scale, median patient satisfaction score was 9.0 (interquartile range 7.8–10.0) and 8.0 (interquartile range 5.1–9.7) for children and adults respectively (p < .01). CPS1 solution is a safe and promising treatment modality with a high clearance and high patient satisfaction rate for the management of cutaneous warts, particularly in children.
Collapse
Affiliation(s)
- Anh Ly Nguyen
- Department of Dermatology, Amphia Hospital, Breda, The Netherlands.,Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Koen D Quint
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Dermatology, Roosevelt Clinics, Leiden, The Netherlands
| | | | - Angelina Erceg
- Department of Dermatology, Amphia Hospital, Breda, The Netherlands
| | - Wim J A de Kort
- Department of Dermatology, Amphia Hospital, Breda, The Netherlands
| | - John E M Körver
- Department of Dermatology, Amphia Hospital, Breda, The Netherlands
| |
Collapse
|
7
|
Meloni G, Milani M. Efficacy and Tolerability of Topical Green Tea Extract (Polyphenon E) Application in a "Therapy-Resistant" Plantar Wart. Case Rep Dermatol 2018; 10:127-132. [PMID: 29928201 PMCID: PMC6006655 DOI: 10.1159/000489160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 04/10/2018] [Indexed: 01/28/2023] Open
Abstract
Plantar warts account for 30% of all cutaneous warts. These lesions could be very painful, especially if the lesion is located over pressure sites such as the metatarsal head. Plantar wart treatment remains a challenging therapeutic problem. A 67-year-old immunocompetent nonsmoking man presented with a large mosaic plantar wart on his right foot. The lesion had been present for 5 years. Several cryotherapy sessions (a total of 6 procedures) had been performed with no success. The lesion was therefore treated with a 5-fluorouracil (5-FU) regimen and then with a topical combination of 5-FU and salicylic acid, but also these approaches failed. At the initial visit, a large (16 cm2) mosaic wart lesion was present. Treatment with topical Polyphenon E, 10%, twice daily was prescribed and started. After 3 months of treatment, the lesion completely disappeared. Interestingly, no curettage or mechanical pickling of the hyperkeratotic parts of the lesion were performed before the start of the treatment. Local tolerability was evaluated as very good by the patient.
Collapse
Affiliation(s)
| | - Massimo Milani
- Medical Department, Cantabria Lab, Difa Cooper, Caronno Pertusella, Italy
| |
Collapse
|
8
|
Vacuna triple vírica como tratamiento de verruga subungueal recalcitrante. ACTAS DERMO-SIFILIOGRAFICAS 2017; 108:966-968. [DOI: 10.1016/j.ad.2017.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 02/21/2017] [Accepted: 02/24/2017] [Indexed: 11/22/2022] Open
|
9
|
Morales-Raya C, Maroñas-Jiménez L, Aragón-Miguel R, Postigo-Llorente C. Mumps, Measles, and Rubella Vaccine for the Treatment of a Recalcitrant Subungual Wart. ACTAS DERMO-SIFILIOGRAFICAS 2017. [DOI: 10.1016/j.adengl.2017.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
10
|
Valerio E, Parata F, Cutrone M. Handy paediatric dermatology. Arch Dis Child Educ Pract Ed 2017; 102:78. [PMID: 28148538 DOI: 10.1136/archdischild-2016-312358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/06/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Enrico Valerio
- Pediatric Intensive Care Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Francesca Parata
- Pediatrics Department, Ospedale Dell'Angelo, Mestre (Venice), Italy
| | - Mario Cutrone
- Pediatric Dermatology Unit, Ospedale Dell'Angelo, Mestre (Venice), Italy
| |
Collapse
|