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Balestrieri M, Chiantore MV, Garbuglia AR, Carnovale-Scalzo C, Falcucci S, Di Bonito P. Remission of HPV-Related Diseases by Antivirals for Herpesvirus: Clinical Cases and a Literature Review. Viruses 2024; 16:756. [PMID: 38793636 PMCID: PMC11125809 DOI: 10.3390/v16050756] [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: 04/11/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Epidemiological studies have shown that HPV-related diseases are the most prevalent sexually transmitted infections. In this context, this report will present various clinical cases demonstrating the effectiveness of Acyclovir (ACV) or its prodrug Valaciclovir (VCV), both acyclic guanosine analogs commonly used for the treatment of HHV-1 and HHV-2, for the treatment of HPV-related diseases. The report shows the remission of five cases of penile condyloma and a case of remission in a woman affected by cervical and vaginal condylomas and a vulvar giant condyloma acuminate of Buschke and Lowenstein. The literature review shows that ACV is effective in treating skin warts when administered orally, topically, and intralesionally, suggesting its therapeutic potential in other diseases associated with HPV. ACV was also used successfully as an adjuvant therapy for juvenile and adult forms of laryngeal papillomatosis, also known as recurrent respiratory papillomatosis, prolonging the patient's symptom-free periods. Although the prevention of HPV infections is certainly achieved with the HPV vaccine, ACV and VCV have shown to be effective even against genotypes not included in the current vaccine and can be helpful for those problematic clinical cases involving unvaccinated individuals, immunocompromised patients, people who live with HIV, or non-responders to the vaccine. We and others concluded that randomized clinical trials are necessary to determine the efficacy of ACV and VCV for HPV-related diseases.
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Affiliation(s)
- Maria Balestrieri
- Gynaecology and Diagnostic Colposcopy Clinic, Via Enea, 23, 00181 Rome, Italy;
| | - Maria Vincenza Chiantore
- Department of Infectious Diseases, Viral Hepatitis and Oncovirus and Retrovirus Diseases (EVOR) Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.V.C.); (S.F.)
| | - Anna Rosa Garbuglia
- Laboratory of Virology, National Institute for Infectious Diseases (INMI) Lazzaro Spallanzani, IRCCS, Via Portuense, 292, 00149 Rome, Italy;
| | - Caterina Carnovale-Scalzo
- Histopathology Laboratory, Ospedale San Carlo di Nancy, GVM Care and Research, Via Aurelia, 275, 00165 Rome, Italy;
| | - Susanna Falcucci
- Department of Infectious Diseases, Viral Hepatitis and Oncovirus and Retrovirus Diseases (EVOR) Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.V.C.); (S.F.)
| | - Paola Di Bonito
- Department of Infectious Diseases, Viral Hepatitis and Oncovirus and Retrovirus Diseases (EVOR) Unit, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy; (M.V.C.); (S.F.)
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García-Oreja S, Álvaro-Afonso FJ, Sevillano-Fernández D, García-Morales EA, López-Moral M, Lázaro-Martínez JL. Does HPV biotype influence the characteristics and evolution of plantar warts? J Evid Based Med 2024; 17:10-12. [PMID: 38305569 DOI: 10.1111/jebm.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 12/18/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024]
Abstract
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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Affiliation(s)
- Sara García-Oreja
- Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Francisco Javier Álvaro-Afonso
- Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Esther Alicia García-Morales
- Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - Mateo López-Moral
- Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
| | - José Luis Lázaro-Martínez
- Clínica Universitaria de Podología, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, Spain
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Chen HY, Ruan AX, Su XH, Ji C. Painless and non-invasive treatment of plantar warts utilizing traditional Chinese medicine soaking: A case report. Explore (NY) 2024; 20:261-263. [PMID: 37673761 DOI: 10.1016/j.explore.2023.08.015] [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: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Warts result from an infection with the human papilloma virus (HPV). Plantar warts, also known as Verruca plantaris, can be notably painful for the patient and possess contagious qualities, thus necessitating assertive treatment. Despite several available approaches for addressing plantar warts, efficacy remains elusive. CASE PRESENTATION One 22-year-old firefighter suffered from numerous plantar warts. After 26 days of traditional Chinese medicine soaking, the rashes completely disappeared. The treatment was without complications or discomfort, and a three-month follow-up showed no recurrence. CONCLUSION Our case investigation highlighted the efficacy of herbal soaking as a safe, painless, and non-invasive therapeutic option, positioning it as a potential avenue for managing multiple plantar warts.
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Affiliation(s)
- Hua-Yu Chen
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350000, China; Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350000, China
| | - Ai-Xing Ruan
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350000, China; Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350000, China
| | - Xin-Hong Su
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350000, China; Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350000, China
| | - Chao Ji
- Department of Dermatology, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350000, China; Fujian Dermatology and Venereology Research Institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350000, China.
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Alou L, Becerro-de-Bengoa-Vallejo R, Losa-Iglesias ME, Moreno J, Sánchez-Gómez R, González N, Sevillano D. Strengthening the relationship between intractable plantar keratosis and human papillomavirus. J Med Virol 2024; 96:e29431. [PMID: 38293752 DOI: 10.1002/jmv.29431] [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: 12/21/2023] [Revised: 01/11/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024]
Abstract
The aim of the study was to determine the presence of human papillomavirus (HPV) in patients with intractable plantar keratosis (IPK) by comparing the histopathological findings of biopsies. A prospective, observational, and concordance study was carried out. Three different specimens were taken from each IPK. A first punch was sent for histopathological examination, and a second punch and a superficial skin scraping were both sent for HPV polymerase chain reaction (PCR) and type determination. A total of 51 patients were included. From the histopathological examination, it was determined that 35 (68.6%) samples were diagnosed as warts and 16 (31.3%) as keratosis. However, the presence of HPV was confirmed by PCR in 49 (96.1%) and in 42 (82.4%) samples obtained by punch and superficial scraping, respectively. In the 49 PCR-positive samples, the most common HPV types were HPV1, HPV2, HPV27, HPV57, and HPV65, accounting for 81.6% of the samples. In conclusion, this study demonstrates that HPV infection and IPK lesions are very closely related. Although we cannot confirm that HPV is the cause of the development of IPK, the high prevalence of HPV observed in these lesions calls for a change to the procedures for managing IPK.
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Affiliation(s)
- Luis Alou
- Medicine Department, Microbiology Area, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | | | - Marta E Losa-Iglesias
- Department of Nursing and Stomatology, Faculty of Health Sciences, King Juan Carlos University, Madrid, Spain
| | | | - Rubén Sánchez-Gómez
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, Spain
| | - Natalia González
- Medicine Department, Microbiology Area, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - David Sevillano
- Medicine Department, Microbiology Area, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Aldana-Caballero A, Mingorance-Alvarez E, Mayordomo R, Marcos-Tejedor F. Clinical implementation of a multiplex PCR detection method for HPV causing plantar warts and genotype distribution in different geographical areas of Spain. Heliyon 2024; 10:e23550. [PMID: 38187313 PMCID: PMC10767125 DOI: 10.1016/j.heliyon.2023.e23550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/02/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Human papillomavirus is the ethological agent of various tumors, including plantar warts as one of the most frequent clinical presentations. Diagnosis of these warts continues to be mainly clinical, and a significant incidence of misdiagnosis leads to inadequate treatment. The aim of this study is to implement and validate a multiplex PCR detection method in the clinical setting to detect HPV in samples and to study genotype distribution in Spain to improve future molecular diagnostics. Viral DNA was extracted from 128 samples of clinically suspected plantar warts from various locations in Spain. A multiplex PCR was run alongside internal controls, and amplicons were processed for sequencing and HPV genotyping. The method was validated by assessing both inter- and intra-run repeatability. The PCR detection method returned 81.2 % (n = 104) positive results in the samples tested. Inter- and intra-run repeatability tests showed excellent intra-run agreement (κ = 1.00, p < 0.001) and good inter-run agreement (κ = 0.737, p < 0.001). The most frequent HPV type was HPV1, followed by HPV27, showing a statistical difference between the distribution of HPV genotypes in different areas of Spain. Clinical implementation of a DNA PCR detection method for plantar warts can avoid 18.8 % of unnecessary treatments in doubtful cases, and the method is reliable and validated for the purpose. HPV types show an asymmetric geographical distribution that should be considered for diagnosis and treatment.
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Affiliation(s)
- A Aldana-Caballero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, Universidad de Castilla-La Mancha, Talavera de la Reina, Spain
| | - E Mingorance-Alvarez
- Department of Anatomy, Cellular Biology and Zoology, Universidad de Extremadura, DEDAP Research Group, Plasencia, Spain
| | - R Mayordomo
- Department of Anatomy, Cellular Biology and Zoology, Universidad de Extremadura, DEDAP Research Group, Plasencia, Spain
| | - F Marcos-Tejedor
- Department of Medical Sciences, Universidad de Castilla La Mancha, DEDAP Research Group Collaborator, Talavera de La Reina, Spain
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Koç HA, Metin A. Spectrophotometric intracutaneous analysis findings and characteristics in plantar verrues. Photodiagnosis Photodyn Ther 2023; 44:103835. [PMID: 37806609 DOI: 10.1016/j.pdpdt.2023.103835] [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: 08/12/2023] [Revised: 09/22/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Spectrophotometric intracutaneous analysis (SIAscopy) is a non-invasive computerized method that provides insights beyond dermoscopic examination. This study aimed to show the various findings of the plantar verrucae with the SIAscopy evaluation, which displays the chromophores of the skin, melanin, hemoglobin, and collagen. METHODS Plantar verrucae lesions scanned using SIAscopy, and their color, total melanin, dermal melanin, collagen, and blood views were recorded on a computer. These SIAgraphs were examined individually and compared to dermoscopic literature findings. RESULTS The results of color view were in conformity with dermoscopic findings reported in the literature. Among the findings detected for the first time by a SIAscopic examination, a white halo around the vessel in view of total melanin, effacement in the keratinized areas, and whitening in the vascular areas were noted. There was a mottled collagen condensation, which was believed to be induced by dermal papillomatosis in the lesions in the view of collagen, and consequently, as a result of remittent light reflections due to the collagen structure in this area. There was a clarification in the vascular structures that were noticed in the color view in the blood view. It was noted that vascular structures that have not yet been thrombosed under the thickened epidermis could not be detected in color view. CONCLUSION Our study reveals that SIAscopy, a rapid, non-invasive, and easy-to-use examination method similar to dermoscopy, can also diagnose other skin diseases, particularly pathogenetic processes that induce epidermal and papillary dermis changes, apart from pigmented lesions.
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Affiliation(s)
| | - Ahmet Metin
- Pamukkale University School of Medicine, Denizli, Turkey
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7
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Redzic N, Pereira AR, Menon S, Bogers J, Coppens A, Kehoe K, Vanden Broeck D. Characterization of type-specific HPV prevalence in a population of persistent cutaneous warts in Flanders, Belgium. Sci Rep 2023; 13:17492. [PMID: 37840107 PMCID: PMC10577142 DOI: 10.1038/s41598-023-44154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023] Open
Abstract
Cutaneous warts are benign skin lesions caused by the human papillomavirus (HPV). Even though they are considered benign, they can have a considerable impact on the quality of life and cause serious illness in certain immunocompromised populations. Studies have shown that the efficacy of wart treatment is dependent on the causative HPV type. Therefore, in this article, we aim to determine the HPV genotype-specific prevalence in cutaneous warts of a Flemish population as part of the Omnivirol-Salycilic acid randomized controlled trial. Swab samples of cutaneous warts (n = 269) were collected during enrollment. The DNA extraction was performed on the automated NucliSENS® easyMAG® system (bioMérieux). The samples were analyzed with two separate in-house PCR assays capable of detecting the most prevalent cutaneous HPV types (i.e. wart-associated HPV qPCR) as well as the most relevant mucosal types (i.e. RIATOL qPCR assay). In total, the type-specific prevalence of 30 distinct HPV genotypes was determined. The beta-globin gene was used as a cellularity control and for viral load quantification. Data concerning wart persistence, previous treatment, wart type, and other relevant wart and patient characteristics was collected through a baseline questionnaire. The study population consisted mostly of persistent warts considering that 98% (n = 263) of the sampled skin lesions were older than six months and 92% (n = 247) had undergone previous treatment. The most prominent wart type was the mosaic verruca plantaris (42%, n = 113). The most prevalent HPV types were cutaneous HPV types 27 (73%, n = 195), 57 (63%, n = 169), and 2 (42%, n = 113). Only 2% (n = 6) of the lesions was HPV negative. The highest median viral loads were observed with HPV27 and 57 (i.e. 6.29E+04 and 7.47E+01 viral copies per cell respectively). The multivariate analysis found significant associations between wart persistence and certain wart types, the number of warts, and HPV genotypes. Based on these findings, persistent warts are more likely to: (1) be verruca vulgaris, verruca plantaris simple or mosaic, (2) to manifest as multiple warts, (3) and to be negative for HPV type 2 or 4. These characteristics can be useful in the clinical setting for future risk stratification when considering treatment triage and management. Trial registration: NCT05862441, 17/05/2023 (retrospectively registered).
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Affiliation(s)
- Nina Redzic
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium.
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium.
| | - A Rita Pereira
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
| | - Sonia Menon
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Johannes Bogers
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- National Reference Centre for HPV, Brussels, Belgium
- Department of Obstetrics and Gynecology, Women's Clinic, Ghent University Hospital, Ghent, Belgium
| | - Astrid Coppens
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
| | - Kaat Kehoe
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
- National Reference Centre for HPV, Brussels, Belgium
| | - Davy Vanden Broeck
- Laboratory of Molecular Diagnostics, AML - Sonic Healthcare Benelux, Antwerp, Belgium
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
- National Reference Centre for HPV, Brussels, Belgium
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Ana M OR, Silvia GL, Alba GS, Sara ZG, Esther CL. Treatment efficacy of 0.9% saline and mepivacaine infiltration with Dermojet® in eliminating plantar warts. J Cosmet Dermatol 2023. [PMID: 36798042 DOI: 10.1111/jocd.15680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/23/2023] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Plantar warts are benign, epidermal neoformations, viral, and easily transmitted. Although 30% of these warts disappear spontaneously, the American Association of Dermatology recommends treatment if they cause pain or bleeding. OBJECTIVES The aim of this study was to determine the efficacy of Dermojet® infiltration using a solution composed of equal parts of 0.9% saline and 2% mepivacaine in the treatment of plantar warts, and to identify the type of necrosis achieved at 7-10 days after the infiltration (M1 sample) and at 15-17 days (M2 sample). METHOD In this analytical prospective observational study, 102 histories were reviewed by the same researcher. The patients were treated with this technique at four private podiatry clinics. RESULTS A total of 61.8% of the patients were male. The patients' mean age was 26.6 ± 14.10 years. A total percentage of 78.4% of the patients achieved complete elimination of the lesion by the second evaluation and after a single infiltration. Bivariate analysis revealed a significant inverse relationship between treatment efficacy and a history of previous disease (p < 0.001) and the period of evolution of the lesion (p < 0.001; 95% CI [0.78-7.91]). Multivariate linear regression analysis revealed an association with the number of evaluation sessions (p < 0.001) and with previous illnesses (p = 0.014). A total percentage of 82.35% presented partial necrosis in the M1 sample and 76.92% had complete necrosis in the M2 sample. CONCLUSIONS In 78.4% of the patients considered, the plantar warts treated disappeared after a single infiltration. The variables associated with treatment efficacy were the number of follow-up visits and the existence of associated diseases.
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Affiliation(s)
- Oltra-Romero Ana M
- Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, University Miguel Hernández, Sant Joan d'Alacant, Spain
| | - Garcia-Lázaro Silvia
- Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, University Miguel Hernández, Sant Joan d'Alacant, Spain
| | - Gracia-Sánchez Alba
- Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, University Miguel Hernández, Sant Joan d'Alacant, Spain
| | - Zúnica-García Sara
- Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, University Miguel Hernández, Sant Joan d'Alacant, Spain
| | - Chicharro-Luna Esther
- Department of Behavioural Sciences and Health, Nursing Area, Faculty of Medicine, University Miguel Hernández, Sant Joan d'Alacant, Spain
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Amantea C, Foschi N, Gavi F, Borrelli I, Rossi MF, Spuntarelli V, Russo P, Gualano MR, Santoro PE, Moscato U. HPV Vaccination Adherence in Working-Age Men: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2023; 11:vaccines11020443. [PMID: 36851321 PMCID: PMC9958554 DOI: 10.3390/vaccines11020443] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV) infection is the most common sexually transmitted viral infection in the world. HPV vaccination adherence rates in men are generally lower than in women. The aim of this systematic review and meta-analysis was to assess adherence to HPV vaccination in young working-age males (18-30 years old). METHODS A systematic review was performed using three databases: PubMed, Scopus, and Web of Science, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS After duplicate removal, the initial search resulted in 478 eligible papers. With the exclusion of 425 papers after screening the abstracts, full texts of 53 articles were reviewed. Subsequently, 45 were excluded. Among the eight studies included, four (50%) examined the vaccination adherence in young adults through data registered in nationwide insurance or private companies' databases, three (37.5%) in young adults in different settings through data collected from surveys and questionnaires, and one (12.5%) an HPV vaccination campaign in a family medicine residency practice. CONCLUSION Adherence to HPV vaccination in men of working age (18-30 years) does not appear to be adequate (pooled prevalence 11%). In order to achieve a higher level of compliance, it is important to place an emphasis on vaccination campaigns in schools as well as in the workplace, after consultation with and approval from local, regional, and federal public health agencies.
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Affiliation(s)
- Carlotta Amantea
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Nazario Foschi
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Filippo Gavi
- Postgraduate School of Urology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Correspondence:
| | - Ivan Borrelli
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Maria Francesca Rossi
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Valerio Spuntarelli
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Pierluigi Russo
- Postgraduate School of Urology, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Maria Rosaria Gualano
- School of Medicine, Saint Camillus International University of Health Sciences, UniCamillus, 00131 Rome, Italy
| | - Paolo Emilio Santoro
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
| | - Umberto Moscato
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Health Science and Public Health, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy
- Department of Women, Children and Public Health Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Francesco Vito 1, 00168 Rome, Italy
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10
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Wu X, Hu Y, Lu Y, Ke X, Liu K, Zhou X, Hu Y. A Retrospective Study of Clinical Efficacy of Cantharidin Cream for Verruca Plantaris. Infect Drug Resist 2022; 15:4059-4063. [PMID: 35924013 PMCID: PMC9342431 DOI: 10.2147/idr.s375384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022] Open
Abstract
Verruca plantaris (plantar wart) is a type of benign feet hyperplasia that is caused by a human papillomavirus (HPV) infection. In this study, we aimed to assess the clinical efficacy underlying cantharidin cream in the treatment of Verruca plantaris compared to CO2 laser and liquid nitrogen cryotherapy. One hundred and fifty patients affected with Verruca plantaris were enrolled in this retrospective clinical study. The treatment efficacy rate in the three groups was assessed 4 and 12 weeks after treatment. After 4 weeks of treatment, 46 cases in the externally applied cantharidin cream therapy group were cured with an apparent efficiency of 92.0% (46/50). Contrarily, 42 cases in the CO2 laser group were cured with 84.0% (42/50) efficiency, while 40 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 80.0% (40/50). Although the clinical cure rate of Verruca plantaris in the Cantharidin group was greater than in the CO2 laser group and in the liquid nitrogen cryotherapy group, there were no statistical differences found among the three groups (P = 0.225). After 12 weeks of treatment, 43 cases in the external cantharidin cream therapy group were cured with an apparent efficiency of 86.0% (43/50). Similarly, 39 cases in the CO2 laser group were cured with an apparent efficiency of 78.0% (39/50), while 36 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 72.0% (36/50). The statistical differences among the three groups were not found (P =0.230), but the resolution rate of warts in Cantharidin group was the highest among the three groups. The results from this study demonstrated that external cantharidin cream therapy could be served as an alternative treatment for Verruca plantaris.
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Affiliation(s)
- Xuelin Wu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
| | - Yanqing Hu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
| | - Yan Lu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
| | - Xiuling Ke
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
| | - Kangxing Liu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
| | - Xianyi Zhou
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
| | - Yongxuan Hu
- Department of Dermatology and Venereology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, People’s Republic of China
- Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Guangzhou, People’s Republic of China
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11
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Ferrari J. Verrucae pedis in children with juvenile idiopathic arthritis and other paediatric rheumatic diseases: a cross-sectional study. J Foot Ankle Res 2022; 15:29. [PMID: 35449072 PMCID: PMC9026681 DOI: 10.1186/s13047-022-00526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Verrucae pedis (verrucae / VPs) are a common viral infection of the skin seen in children. There are limited studies of the prevalence, duration and impact of verrucae pedis in children who are immunosuppressed. The studies available suggest that, in these children, the warts are more widespread and are more long-standing. The primary aim of this study was to determine the prevalence of verrucae pedis in children attending rheumatology clinics who may have some degree of immunosuppression due to their prescribed medication and compare this to the reported prevalence in the healthy population. METHOD Children attending out-patient rheumatology appointments were recruited. The young people were aged between four and 17 years old. A visual inspection of both feet was used to identify potential verrucae. Diagnosis of a verruca pedis was confirmed on observation of the typical clinical features. The location, duration of presence, previous treatments, presence of verrucae in other family members and psychological impact was recorded. RESULTS A total of 71 children were included. Of the group, 55 children had no verrucae present, 16 children had one or more verrucae. The prevalence of verrucae was 22.5%. Medication impacting on the immune system was prescribed in 80% of the group. There appeared to be no greater chance of having verrucae if taking immunosuppressive medication than compared to having no medication (OR = 1.1, 95%CI 0.26 to 4.48, p = 0.46). Children with verrucae tended to be between 9 and 12 years old. In total, 37.5% of the young people with verrucae had lesions reportedly present for 24 months or more. Two-thirds of the participants were not concerned about verrucae being present and most participants with a verruca were not aware of what a verruca was, but despite this the majority of participants (81%) had sought treatment for the verrucae. CONCLUSION Children with Juvenile Idiopathic Arthritis and other rheumatic conditions have no greater prevalence of verrucae compared to the general population. The verrucae present were of a similar clinical type and did not seem to be more widespread or have atypical features, which has been reported in other immunocompromised populations. The percentage of lesions remaining beyond 24 months was found to be slightly greater than has been reported in other healthy populations. The children in this study seemed to be less emotionally concerned about their verrucae, despite this most families had sought treatment for the verrucae.
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Affiliation(s)
- Jill Ferrari
- University of East London, Stratford, London, UK.
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12
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Nofal A, Adel L, Fawzy M, Elkholy BM. Intralesional immunotherapy for multiple recalcitrant plantar warts: Candida antigen is superior to intralesional purified protein derivative. Dermatol Ther 2022; 35:e15440. [PMID: 35285995 DOI: 10.1111/dth.15440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/03/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Treatment of recalcitrant plantar warts represent a highly challenging issue for both patients and physicians. Candida antigen and purified protein derivative (PPD) have shown promising efficacy in the treatment of warts, however no previous studies have compared both antigens for recalcitrant plantar warts. AIM To assess the efficacy and safety of intralesional Candida antigen versus intralesional PPD in the management of recalcitrant plantar warts. PATIENTS AND METHODS The study included 120 adult patients with multiple recalcitrant plantar warts. They were randomly assigned to one of three groups; Candida antigen, PPD, or normal saline. Injections into the largest wart were repeated every two weeks until clearance or for a maximum of 5 sessions. RESULTS Complete wart clearance was reported in 33 patients (82.5%) of the Candida antigen group, in 22 patients (55.6%) of the PPD group, and in one patient (5%) of the control saline group. A statistically significant difference was found between the studied groups in favor of Candida antigen. Adverse effects were mild and insignificant in the 3 groups. CONCLUSIONS Intralesional antigen immunotherapy by Candida antigen or PPD is a promising, safe, and cost-effective therapeutic option for multiple recalcitrant plantar warts, with statistically significant superiority of Candida antigen. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ahmad Nofal
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Member of Interactive Dermatology Research group, Egypt
| | - Lamiaa Adel
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Manal Fawzy
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Basma M Elkholy
- Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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13
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Applying particle swarm optimization-based decision tree classifier for wart treatment selection. COMPLEX INTELL SYST 2022. [DOI: 10.1007/s40747-021-00348-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractWart is a disease caused by human papillomavirus with common and plantar warts as general forms. Commonly used methods to treat warts are immunotherapy and cryotherapy. The selection of proper treatment is vital to cure warts. This paper establishes a classification and regression tree (CART) model based on particle swarm optimisation to help patients choose between immunotherapy and cryotherapy. The proposed model can accurately predict the response of patients to the two methods. Using an improved particle swarm algorithm (PSO) to optimise the parameters of the model instead of the traditional pruning algorithm, a more concise and more accurate model is obtained. Two experiments are conducted to verify the feasibility of the proposed model. On the hand, five benchmarks are used to verify the performance of the improved PSO algorithm. On the other hand, the experiment on two wart datasets is conducted. Results show that the proposed model is effective. The proposed method classifies better than k-nearest neighbour, C4.5 and logistic regression. It also performs better than the conventional optimisation method for the CART algorithm. Moreover, the decision tree model established in this study is interpretable and understandable. Therefore, the proposed model can help patients and doctors reduce the medical cost and improve the quality of healing operation.
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14
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Assessment of Visual Diagnosis by Podiatrists for HPV and Onychomycosis: The Need for Complementary Tests. J Fungi (Basel) 2022; 8:jof8020135. [PMID: 35205889 PMCID: PMC8878088 DOI: 10.3390/jof8020135] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/25/2022] [Accepted: 01/27/2022] [Indexed: 01/27/2023] Open
Abstract
Onychomycosis and human papillomavirus (HPV) plantar warts are common in clinical practice. Clinical diagnosis is based on searching for pathognomonic signs and symptoms. However, due to misdiagnosis, podiatrists may unnecessarily prescribe antifungal treatments or burn lesions with chemical agents. The objective of this study was to assess podiatrists’ visual diagnosis of these infections and their willingness to use complementary tests. A 12-item questionnaire was developed to assess visual diagnostic ability. The diagnoses of all lesions were verified before the questionnaire was sent out. The respondents were 415 podiatrists with a range of years of experience. While 86.3% of podiatrists considered complementary tests for onychomycosis necessary, only 21.4% used them regularly. As many as 60.2% would leave a distal subungual onychomycosis untreated based on visual diagnosis. In the case of HPV, only 14.5% of respondents considered complementary tests necessary, although 76.6% would treat a non-HPV lesion with regular chemical agents. Years of experience did not affect the percentage of misdiagnoses. Complementary tests are needed in clinical practice to avoid unnecessary treatments. Podiatrists easily identify clear signs and symptoms but have difficulty making differential diagnoses. Research should focus on ensuring complementary tests are available to health professionals.
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15
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Sequential Use of CO 2 Laser Prior to Nd:YAG and Dye Laser in the Management of Non-Facial Warts: A Retrospective Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010115. [PMID: 35056422 PMCID: PMC8780825 DOI: 10.3390/medicina58010115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 12/26/2022]
Abstract
Background and Objectives: Warts are benign lesions of viral etiology characterized by a hyperkeratotic appearance tending to spread across the skin surface. Various treatments have been proposed to manage this condition, such as acids, imiquimod, photodynamic therapy, cryotherapy, and various lasers. Materials and Methods: In this paper, we describe a combination protocol using CO2 laser prior to Nd:YAG laser for lesions interesting the palmoplantar areas or dye laser for lesions on other skin surfaces in the management of non-facial warts resistant to traditional therapies. In total, 34 patients with 103 warts suffering from wart infection resistant to traditional therapies treated from 1 January 2019 to 1 June 2020 were retrospectively enrolled at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). Two dermatologists measured clinical results, classifying lesions with complete resolution, partial resolution, or non-responding. Patients at four months follow-up were asked to evaluate their degree of satisfaction with a visual analog scale (VAS). Results: Almost all patients reported the complete resolution of lesions, with no patient reporting scarring. Five patients reported hypopigmentation in the treated areas. The mean satisfaction level was high. Only three patients experienced a relapse of the condition. Conclusions: Using a vascular laser following a CO2 superficial ablation of warts may help reduce the risk of scarring and decrease the incidence of relapses for lesions resistant to traditional therapies. Therefore, more extensive studies will be necessary to confirm the obtained results.
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16
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A Nonhealing Wound on the Right Heel. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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García-Oreja S, Álvaro-Afonso FJ, Sevillano-Fernández D, Tardáguila-García A, López-Moral M, Lázaro-Martínez JL. A non-invasive method for diagnosing plantar warts caused by human papillomavirus (HPV). J Med Virol 2021; 94:2897-2901. [PMID: 34890486 DOI: 10.1002/jmv.27514] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/03/2021] [Accepted: 12/07/2021] [Indexed: 11/11/2022]
Abstract
The methods that are used for the diagnostic confirmation of human papillomavirus (HPV) include excisional biopsy and histopathological studies or polymerase chain reaction (PCR). They are invasive, laborious, and subject to ethical restrictions due to the benign nature of these warts. This study aims to analyse the accuracy of noninvasive swab samples to diagnose plantar warts. Fifty plantar warts were included in the study. Skin swabs and hyperkeratosis skin scales were collected from each wart. Multiplex PCR was performed to detect and type the HPVs. The prevalence of HPV in this study was 90% when the sample was obtained using the wart scraping method and 94% when it was obtained using swabs and the new method. In 45 of the 45 positive samples (sensitivity: 100%), the result between the wart scab and wart swab were almost identical. The genotyping result was identical in all 46 patients who had a positive result using both methods. The swab method appears to be a simple and accurate technique to diagnose plantar warts due to HPV. It is a noninvasive technique that could be performed even by inexperienced professionals and in patients with pain or a fear of needles.
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Affiliation(s)
- Sara García-Oreja
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), University Podiatric Clinic, Complutense University of Madrid, Madrid, Spain
| | - Francisco Javier Álvaro-Afonso
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), University Podiatric Clinic, Complutense University of Madrid, Madrid, Spain
| | | | - Aroa Tardáguila-García
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), University Podiatric Clinic, Complutense University of Madrid, Madrid, Spain
| | - Mateo López-Moral
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), University Podiatric Clinic, Complutense University of Madrid, Madrid, Spain
| | - José Luís Lázaro-Martínez
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), University Podiatric Clinic, Complutense University of Madrid, Madrid, Spain
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18
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Aldana-Caballero A, Marcos-Tejedor F, Mayordomo R. Diagnostic techniques in HPV infections and the need to implement them in plantar lesions: A systematic review. Expert Rev Mol Diagn 2021; 21:1341-1348. [PMID: 34752720 DOI: 10.1080/14737159.2021.2004889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Human papillomavirus has been reported as the etiological cause of most cervical cancers and other potentially malignant lesions. It also affects other areas, producing benign tumors on the skin. Plantar warts are a common problem found in clinical practice and share signs and symptoms with other dermatological conditions. Diagnosis of HPV infection remains a hot topic in research. METHOD The present work systematically reviews the literature on the diagnostic techniques available in the clinical setting for any type of lesion produced by the virus and compares the techniques identified to those found in use for foot lesions. RESULTS Results showed a variety of diagnostic methods, including molecular techniques, which exhibit more sensitivity than other methods but are less frequently applied to plantar lesions, where visual inspection is the most frequent method but can lead to errors. CONCLUSION The techniques identified need to be applied to plantar lesions to improve differential diagnosis in clinical practice. EXPERT OPINION Research will continue to grow and a proper diagnostic technique for plantar lesions will be available in the near future.
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Affiliation(s)
- Alberto Aldana-Caballero
- Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Health Sciences, University of Castilla-La Mancha, Talavera de la Reina, Toledo, Spain
| | - Felix Marcos-Tejedor
- Department of Medical Sciences, Universidad de Castilla La Mancha, Dedap Research Group Collaborator, Talavera de La Reina, Spain
| | - Raquel Mayordomo
- Department of Anatomy, Cellular Biology and Zoology, Universidad de Extremadura, DEDAP Research Group, Plasencia, Spain
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19
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Bhatti A, Chowdhary S, Ferrise T, Govardhanam N, Parish A, Tropper Y, Vlahovic TC. Plantar Verruca and Dermoscopy: An Update. Clin Podiatr Med Surg 2021; 38:513-520. [PMID: 34538428 DOI: 10.1016/j.cpm.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Traditionally, plantar warts or verrucae are often diagnosed by visual appearance and the lateral squeeze test. At times, these methods are not able to elucidate the difference between a plantar wart and a callus. The use of the dermatoscope can not only distinguish the difference between a wart and a callus, which ultimately helps to customize treatment plans to increase efficacy, but also be used to follow the therapeutic effects of treatment. The dermatoscope is a tool that can be used in the diagnosis of plantar verrucae and in assessment of the success of therapy.
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Affiliation(s)
- Adam Bhatti
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA
| | - Saakshi Chowdhary
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA
| | - Thomas Ferrise
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA
| | - Naga Govardhanam
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA
| | - Alexandra Parish
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA
| | - Yaakov Tropper
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA
| | - Tracey C Vlahovic
- Temple University School of Podiatric Medicine, 148 North 8th Street, Philadelphia, PA 19107, USA.
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20
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Redzic N, Benoy I, Vanden Broeck D, Bogers JP. Development and validation of a wart-associated human papilloma virus genotyping assay for detection of HPV in cutaneous warts. J Med Virol 2021; 93:3841-3848. [PMID: 33090508 DOI: 10.1002/jmv.26623] [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: 06/25/2020] [Revised: 10/16/2020] [Accepted: 10/20/2020] [Indexed: 11/09/2022]
Abstract
Cutaneous warts are infectious disorders caused by human papillomavirus (HPV). A recent study revealed that the HPV genotype influences the natural course and response to treatment for plantar warts, suggesting that HPV genotyping could potentially be used to optimize wart treatment schemes. For this purpose, a wart-associated HPV genotyping assay was developed. The assay was subjected to an intensive validation process including, i.a., empiric determination of the annealing temperature, primer-probe optimization, evaluation of the analytical specificity and sensitivity, viral load quantification, and qualitative as well as quantitative analysis of intra-run repeatability and inter-run reproducibility. The newly developed assay was employed in a small-scale HPV genotyping study of wart biopsies (n = 50). The assay exhibited an analytical type-specific sensitivity and specificity of 100% (95% confidence interval [CI]: 83.9%-100%). The limit of quantification of the tested sequences corresponded to less than 17 viral copies/µl, while the limit of detection was less than 5 copies/µl. Very good to excellent agreements were gained between intra- and inter-run measurements (κ = 0.85-1.00) and coefficients of variation of the quantitative agreements were less then 3%. 22.5% (95% CI: 11%-39%) of the analyzed biopsies were negative for the tested HPV types, while 35% (95% CI: 21%-52%) contained multiple infections. The wart-associated HPV quantitative polymerase chain reaction assay was proven to be highly sensitive and specific. Multiple HPV infections were detected in 35% of lesions, contradicting the current literature claiming that in immunocompetent patients only 4%-16% of warts exhibit multiple HPV infections. This assay is qualified to be implemented in development of future genotype specific wart treatment strategies.
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Affiliation(s)
- Nina Redzic
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- Laboratory of Molecular Pathology, AML, Antwerp, Belgium
| | - Ina Benoy
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- Laboratory of Molecular Pathology, AML, Antwerp, Belgium
- National Reference Center for HPV, Brussels, Belgium
| | - Davy Vanden Broeck
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- Laboratory of Molecular Pathology, AML, Antwerp, Belgium
- National Reference Center for HPV, Brussels, Belgium
- Department of Obstetrics and Gynaecology, International Center for Reproductive health, Ghent University, Ghent, Belgium
| | - Johannes P Bogers
- AMBIOR, Laboratory for Cell Biology and Histology, University of Antwerp, Antwerp, Belgium
- Laboratory of Molecular Pathology, AML, Antwerp, Belgium
- National Reference Center for HPV, Brussels, Belgium
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21
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Basavarajappa SJ, Subramaniyan R, Dabas R, Lal SV, Janney MS. A Comparative Study of Topical 5% 5-Fluorouracil with Needling versus 30% Trichloroacetic Acid with Needling in the Treatment of Plantar Warts. Indian Dermatol Online J 2021; 12:412-416. [PMID: 34211907 PMCID: PMC8202494 DOI: 10.4103/idoj.idoj_507_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/01/2020] [Accepted: 12/14/2020] [Indexed: 11/12/2022] Open
Abstract
Background: Warts are benign proliferations of keratinocytes caused by Human Papilloma Virus (HPV). Plantar warts are caused by HPV types 1, 2, 4, 27 and 57. It is challenging to treat them due to frequent recurrences. Aim: To compare the efficacy and safety of topical 5% 5-Fluorouracil (5-FU) with needling versus 30% Trichloroacetic acid (TCA) with needling in the treatment of plantar warts. Materials and Methods: Sixty consecutive patients of plantar warts were randomly allocated into two groups of 30 each and treated with either 30% TCA with needling or 5% 5-FU with needling once in four weeks, until complete clearance of warts or for a maximum of three sessions. Baseline clinical photographs were taken and subjective response at the end of treatment was recorded. Objective assessment at 4, 8, and 12 weeks was carried out and outcome was evaluated by reduction in number and size of warts. Adverse effects of each group were noted and compared. Follow-up of patients was done at 6 months for clinical assessment of results and to study recurrence. Results: Out of 30 patients in 30% TCA group, 28 patients (93.33%) had complete response and 02 patients (6.66%) had partial response at the end of 12 weeks. In 5-FU group, 26 patients (86.66%) showed complete response, 02 patients (6.66%) had partial response, and 02 patients (6.66%) had no response to treatment. The mean reduction in size and number of warts was better in the TCA group and was significant at 4th week of follow up while at the end of 8th week and 12th week, the response was identical. There was no recurrence of warts in the complete responders at the end of 6 months. The main adverse effect seen in both groups was pain at the needling site. Conclusion: Needling with both topical 5% 5-FU and 30% TCA are highly effective in clearing plantar warts. However, 30% TCA has the advantage of early action and complete clearance of plantar warts with fewer adverse effects.
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Affiliation(s)
| | | | - Rajeshwari Dabas
- Department of Dermatology, Command Hospital, Udhampur, J & K, Kollam, Kerala, India
| | - Sandeep V Lal
- Department of Dermatology, Victoria (Women and Child) Hospital, Kollam, Kerala, India
| | - Manasa S Janney
- Department of Dermatology, Military Hospital, Dimapur, Nagaland, India
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22
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Rageh RM, Hewedy ESS, Hegab DS. Intralesional injection of Candida albicans antigen versus measles, mumps, and rubella vaccine for treatment of plantar warts. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2021. [DOI: 10.15570/actaapa.2021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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23
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Nofal A, Alakad R, Fouda I, Fawzy MM. Intralesional Antigen Immunotherapy in the Treatment of Periungual Warts. J Cutan Med Surg 2021; 25:286-292. [PMID: 33504211 DOI: 10.1177/1203475420988859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Intralesional immunotherapy using different types of antigens is considered an effective and safe treatment option for different types of warts. However, there are few studies that illustrate the use of these antigens in the treatment of periungual warts as a distinct type of warts. OBJECTIVE To evaluate the efficacy and safety of three antigens: measles, mumps, rubella (MMR) vaccine, Candida antigen, and purified protein derivative (PPD) in the treatment of periungual warts. METHODS The study included 150 patients who were randomly assigned to 3 groups with 50 patients in each. Each agent was injected intralesionally at a dose of 0.1 mL into the largest wart at 2-week intervals until complete clearance or for a maximum of 5 sessions. RESULTS Complete clearance of warts was observed in 70%, 80%, and 74% in PPD, Candida antigen, and MMR vaccine groups, respectively. There was no statistically significant difference regarding the therapeutic response between the 3 studied groups. Adverse effects were transient and insignificant in the 3 groups. No recurrence of the lesions was reported in any of the studied groups. CONCLUSIONS Intralesional antigen immunotherapy seems to be an effective therapeutic option for the treatment of periungual warts.
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Affiliation(s)
- Ahmad Nofal
- 68799 Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Interactive Dermatology Research Group, Cairo, Egypt
| | - Rania Alakad
- 68799 Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt.,Interactive Dermatology Research Group, Cairo, Egypt
| | - Ibrahim Fouda
- Interactive Dermatology Research Group, Cairo, Egypt.,486471 Dermatology and Venereology Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Mohamed M Fawzy
- Interactive Dermatology Research Group, Cairo, Egypt.,68782 Dermatology, Venereology and Andrology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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24
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Magalhães GM, Vieira ÉC, Garcia LC, De Carvalho-Leite MDLR, Guedes ACM, Araújo MG. Update on human papilloma virus - part I: epidemiology, pathogenesis, and clinical spectrum. An Bras Dermatol 2021; 96:1-16. [PMID: 33341319 PMCID: PMC7838122 DOI: 10.1016/j.abd.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023] Open
Abstract
Infection with human papilloma virus (HPV) is related to a great number of cutaneous and mucosal manifestations. The spectrum of HPV ranges from inapparent infections, through various clinical benign presentations including cutaneous and mucosal disease, to malignant and premalignant conditions. New HPV types are currently described in the literature; many of them are characterized as high-risk types due to their oncogenic potential. Knowledge regarding their epidemiology and pathogenesis is important to understand not only infection and disease processes, but also to formulate the clinical and laboratory basis for diagnosis, therapeutics, and prophylactic measures. This non-systematic review aims to discuss and to update those aspects, with an emphasis on relevant topics for dermatologists. HPV infection and related diseases in the Brazilian scenario are highlighted, including common dermatologic conditions seen at clinics as well as the condition of a public health problem as a sexually transmitted infection. The oncogenicity of the virus and the variety of clinical outcomes - especially in the immunocompromised individuals - are addressed.
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Affiliation(s)
- Geraldo Magela Magalhães
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Érica Cristina Vieira
- Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas Campos Garcia
- Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Antônio Carlos Martins Guedes
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Marcelo Grossi Araújo
- Department of Internal Medicine, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Dermatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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25
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García-Oreja S, Álvaro-Afonso FJ, García-Álvarez Y, García-Morales E, Sanz-Corbalán I, Lázaro Martínez JL. Topical treatment for plantar warts: A systematic review. Dermatol Ther 2020; 34:e14621. [PMID: 33263934 DOI: 10.1111/dth.14621] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/08/2020] [Accepted: 11/23/2020] [Indexed: 01/08/2023]
Abstract
There are a wide variety of treatments for plantar warts, but none has been shown to be effective in all patients. We aimed to perform a systematic review of the efficacy of different topical treatments on plantar warts. Systematic electronic searches (Pubmed, Cochrane Library, Embase, and Web of Science) were conducted in April 2020. Meta-analyses, systematic reviews, and retrospective or prospective clinical trials of the effects of topical and nonsurgical treatments of plantar warts were included. Two authors performed the study selection and data extraction. Any discrepancies between the two reviewers were discussed with a third reviewer. Forty-four studies were included. The average cure rates of the most frequent treatments were variable across the studies: cryotherapy (45.61%), salicylic acid (13.6%), cantharidin-podophyllin-salicylic acid formulation (97.82%), laser (79.36%), topical antivirals (72.45%), intralesional bleomycin (83.37%), and intralesional immunotherapy (68.14%). Twenty-two studies (50%) had a level of evidence 1b and grade of recommendation A, five studies (11.4%) had a level of evidence 2b and grade of recommendation B, two studies (4.5%) had a level of evidence 3b and grade of recommendation B, and 15 studies (34,1%) with a level of evidence 4 and grade of recommendation C. First-choice treatments for common warts, such as cryotherapy and salicylic acid, have low-cure rates for plantar warts. Other treatments, such as CPA formulation, immunotherapy, and intralesional bleomycin, which have compassionate use, have higher cure rates. This review should stimulate future high-quality research to evaluate these specialized treatments.
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Affiliation(s)
- Sara García-Oreja
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, University Podiatric Clinic, Madrid, Spain
| | - Francisco Javier Álvaro-Afonso
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, University Podiatric Clinic, Madrid, Spain
| | - Yolanda García-Álvarez
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, University Podiatric Clinic, Madrid, Spain
| | - Esther García-Morales
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, University Podiatric Clinic, Madrid, Spain
| | - Irene Sanz-Corbalán
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, University Podiatric Clinic, Madrid, Spain
| | - Jose Luis Lázaro Martínez
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, University Podiatric Clinic, Madrid, Spain
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26
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Huang K, Li M, Xiao Y, Wu L, Li Y, Yang Y, Shi G, Yu N, Liu D, Su J, Wang X, Zhao S, Chen X. The application of medical scale in the treatment of plantar warts: analysis and prospect. J DERMATOL TREAT 2020; 33:637-642. [PMID: 32522070 DOI: 10.1080/09546634.2020.1781757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Plantar warts are common cutaneous diseases on the sole caused by the human papillomavirus, with a high annual incidence rate of 14%. It often causes pain, which impairs quality of life of patients. Numerous therapeutic options for plantar warts exist with variable success. However, all of them, including first-line treatment, have different adverse reactions or high recurrence rates. There is no one effective method for all patients. The choice of treatment method puzzles doctors. With the help of medical scales, we can analyze the patients' condition, so as to guide the choice of treatment methods, which is of great significance for the individualized treatment of patients with plantar warts. This review takes cryotherapy, intralesional injection of bleomycin and photodynamic therapy as examples to discuss the application of medical scales in the treatment of plantar warts, summarizes the scales that can be used to evaluate the status of plantar wart, adverse reactions, prognosis and patient's financial situation, and discusses their clinical and scientific value. We hope to use scales to consider the severity of plantar warts and economic level, help different patients to choose different treatment options, and make suggestions on the evaluation of the adverse reactions and treatment effect.
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Affiliation(s)
- Kai Huang
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Mingjia Li
- Xiangya School of Medicine, Central South University, Hunan, China
| | - Yi Xiao
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Lisha Wu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Yixin Li
- Xiangya School of Medicine, Central South University, Hunan, China
| | - Yang Yang
- Xiangya School of Medicine, Central South University, Hunan, China
| | - Guanzhong Shi
- Xiangya School of Medicine, Central South University, Hunan, China
| | - Nianzhou Yu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Dihui Liu
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Juan Su
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Xianggui Wang
- Department of Ophthalmology, Xiangya Hospital of Central South University, Hunan, China
| | - Shuang Zhao
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
| | - Xiang Chen
- Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Hunan, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Hunan, China
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27
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Boroujeni NH, Handjani F, Saki N. CO 2 laser treatment for plantar warts in children: A case series. Dermatol Ther 2020; 33:e13414. [PMID: 32291877 DOI: 10.1111/dth.13414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/12/2020] [Indexed: 11/28/2022]
Abstract
Several types of human papillomaviruses induce warts. Warts are one of the most common infections in childhood with a reported prevalence of up to 20%. Warts are divided clinically into genital and nongenital forms. Plantar warts are common nongenital warts. In this series, five pediatric cases treated with CO2 laser for their plantar warts are presented. One patient was a known case of Hodgkin's lymphoma. Three of our patients had history of unsuccessful treatments with other modalities, while the other had received no previous treatment. CO2 laser with continuous mode (focused and defocused) was used. In our cases, only one session was enough for clearance of the warts. All the patients were visited 1 week and 3 months after treatment to assess the efficacy and any possible recurrences. Follow-up showed that all the patients remained in remission up to 3 months posttreatment with no adverse events.
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Affiliation(s)
- Nahid Hemmatian Boroujeni
- School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.,Department of Dermatology, Jwan Clinic, Bukan, Iran
| | - Farhad Handjani
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Saki
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran
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28
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Dardet JP, Blasingame NP, Okpare D, Leffler L, Barbosa P. Plantar Verrucae in Human Immunodeficiency Virus Infection: 25 Years of Research of a Viral Coinfection. Clin Podiatr Med Surg 2020; 37:317-325. [PMID: 32146987 DOI: 10.1016/j.cpm.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A higher incidence of plantar verrucae, commonly known as plantar warts, has been shown in patients infected with the human immunodeficiency virus. Several strains of human papillomavirus are associated with clinical manifestations of plantar verrucae. In this literature review, we examine the incidence and clinical manifestations of plantar verrucae in dual coinfection with human immunodeficiency virus and human papillomavirus. We discuss changes in the clinical scenario brought about by the introduction of human immunodeficiency virus antiretroviral therapy. As a clinical condition with notable presence in podiatric medicine, we also confer these findings to increase clinical awareness with treatment modalities.
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Affiliation(s)
- Jean Paul Dardet
- Universidad del Sagrado Corazón, PO Box 12383, San Juan, PR 00914-8505, USA
| | | | - Daniel Okpare
- New York College of Podiatric Medicine, 53 East 124th Street, New York, NY 10035, USA
| | - Luke Leffler
- New York College of Podiatric Medicine, 53 East 124th Street, New York, NY 10035, USA
| | - Peter Barbosa
- Natural Sciences Department, Universidad del Sagrado Corazón, PO Box 12383, San Juan, PR 00914-8505, USA.
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29
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Huang K, Xie Y, Li M, Liu D, Su J, Li F, Deng B, Li J, Shi W, Zhang J, Chen X, Zhao S, Wu L. A Comparative Study: Superficial Shaving Combined With Photodynamic Therapy Versus Cryotherapy in the Treatment of Recalcitrant Plantar Warts. Lasers Surg Med 2020; 52:747-752. [PMID: 31922272 DOI: 10.1002/lsm.23212] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Kai Huang
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Yang Xie
- Department of Dermatology The 3rd Affiliated Hospital of Sun Yat‐Sen University 600 Tianhe Road Guangzhou Guangdong 510630 China
| | - Mingjia Li
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Xiangya School of Medicine Central South University 172 Tongzipo Road Changsha Hunan 410013 China
| | - Dihui Liu
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Juan Su
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Fangfang Li
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Bo Deng
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Jie Li
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Wei Shi
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Jianglin Zhang
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Xiang Chen
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Shuang Zhao
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
| | - Lisha Wu
- Hunan Engineering Research Center of Skin Health and Disease 87 Xiangya Road Changsha Hunan 410008 China
- Hunan Key Laboratory of Skin Cancer and Psoriasis 87 Xiangya Road Changsha Hunan 410008 China
- Department of Dermatology, Xiangya Hospital Central South University 87 Xiangya Road Changsha Hunan 410008 China
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30
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Ghiasi MM, Zendehboudi S. Decision tree-based methodology to select a proper approach for wart treatment. Comput Biol Med 2019; 108:400-409. [DOI: 10.1016/j.compbiomed.2019.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/01/2019] [Accepted: 04/01/2019] [Indexed: 01/04/2023]
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31
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Singh S, Neema S. Comparison of electrosurgery by electrodessication versus cryotherapy by liquid nitrogen spray technique in the treatment of plantar warts. Med J Armed Forces India 2019; 76:156-160. [PMID: 32476712 DOI: 10.1016/j.mjafi.2018.11.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 11/20/2018] [Indexed: 12/31/2022] Open
Abstract
Background Warts or verrucae are benign proliferations of the skin and mucosa resulting from infection with papilloma viruses. Warts form a small subset of patients attending skin out-patient department (OPD), out of which the plantar warts are one of the common presentation. The present study is an attempt to compare two modalities of treatment that is electrosurgery and cryotherapy in patients with plantar warts. There are no studies available where comparison of complications between two modalities has been done in plantar warts thus making it one of unique studies of its kind. Methods A prospective, comparative study was conducted over a period of 6 years. After exclusion criteria, one hundred forty-seven male patients having plantar warts were included in the study. Selection of patients suffering from warts subjected to treatment was done by simple random selection. After treatment, 39 patients were lost to follow-up, and finally 48 patients treated by electrosurgery and 60 by cryotherapy were compared and analysed statistically for response to treatment and incidence of complications. Results The overall clearance rate was 75% in electrosurgery versus 73.3% in cryotherapy patients. The pain, delayed wound healing and scarring were observed significantly in more patients treated with electrosurgery than cryotherapy. In our study, recurrence at 24 weeks was observed in 21.9% of the electrosurgery patients which was slightly higher than cryotherapy, where it was 16.6%. Conclusion This study highlighted that cryotherapy is quick, safe and comparatively painless procedure with less complications with success almost similar to electrosurgery making it more suitable for plantar warts.
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Affiliation(s)
- Sehdev Singh
- Senior Adviser (Dermatology), Command Hospital (Eastern Command), Kolkata, India
| | - Shekhar Neema
- Classified Specialist (Dermatology), Command Hospital (Eastern Command), Kolkata, India
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32
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Comparison of long-pulsed Nd: YAG laser with cryotherapy in treatment of acral warts. Lasers Med Sci 2018; 34:397-403. [DOI: 10.1007/s10103-018-2613-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022]
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33
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Boroujeni NH, Handjani F. Cryotherapy versus CO 2 laser in the treatment of plantar warts: a randomized controlled trial. Dermatol Pract Concept 2018; 8:168-173. [PMID: 30116657 PMCID: PMC6092077 DOI: 10.5826/dpc.0803a03] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 04/10/2018] [Indexed: 12/05/2022] Open
Abstract
Background Warts are one of the most common infections in humans. Plantar warts are a subtype of non-genital warts, and several procedures and topical treatments have been used in its treatment. Cryotherapy is one of the most popular modalities, but it is time-consuming and remission rates vary in different studies. CO2 laser was the first laser used for treating warts. To date, no clinical trial has been done to compare CO2 laser with cryotherapy in the treatment of plantar warts. Patients and Methods This randomized controlled trial was performed in order to compare the efficacy and number of sessions needed to treat plantar warts in 60 patients who had received no previous treatment in the previous 3 months. They were randomly allocated to the cryotherapy or CO2 laser group. The number of sessions needed for response and the recurrence rate after a 3-month follow-up was compared in the 2 groups. Results Sixty patients with plantar warts were randomly allocated to either the CO2 laser or cryotherapy groups. Median age was 25 (range=18–53) and 27 (range= 18–75) years in the cryotherapy group and CO2 laser groups, respectively. Both groups were matched for age and sex (56% male and 44% female in the cryotherapy group and 34% male and 66% female in the CO2 laser group). The median number of sessions needed for complete resolution of the warts in the CO2 laser and cryotherapy groups were 1 (range=1–2) and 3 (range=1–12), respectively. The difference in the number of sessions was statistically significant between the 2 groups (P-value≤0.001). Recurrence rates after a 3-month follow-up was not statistically significant (P-value= 0.069). Conclusion The number of sessions needed to treat plantar warts was less using CO2 laser than cryotherapy; therefore, this modality can be a good addition to the already existing anti-wart armamentarium.
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Affiliation(s)
| | - Farhad Handjani
- Department of Dermatology, Shiraz University of Medical Sciences, Shiraz, Iran.,Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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34
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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.
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Affiliation(s)
| | - Massimo Milani
- Medical Department, Cantabria Lab, Difa Cooper, Caronno Pertusella, Italy
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