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Bălăceanu-Gurău B, Apostol E, Caraivan M, Ion A, Tatar R, Mihai MM, Popa LG, Gurău CD, Orzan OA. Cutaneous Adverse Reactions Associated with Tattoos and Permanent Makeup Pigments. J Clin Med 2024; 13:503. [PMID: 38256637 PMCID: PMC10816451 DOI: 10.3390/jcm13020503] [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: 12/11/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Tattooing is the procedure of implanting permanent pigment granules and additives into the dermal layer of the skin, serving various purposes such as decoration, medical identification, or accidental markings. There has been a significant rise in the popularity of decorative tattooing as a form of body art among both teenagers and young adults. Thus, the incidence of tattoos is increasing, with expanding applications such as permanent makeup, scar camouflage, nipple-areola, lips, and eyebrows tattooing, and utilization in oncological radiotherapy such as colon marking. However, there have been reported a broad range of adverse reactions linked to tattooing, encompassing allergic reactions, superficial and deep cutaneous infections, autoimmune disorders induced by the Koebner phenomenon, cutaneous tumors, and others. These reactions exhibit different onset times for symptoms, ranging from immediate manifestations after tattoo application to symptoms emerging several years later. Given the limited information on a tattoo's side effects, this review aims to elucidate the clinical spectrum of cutaneous complications of tattoos in different patients. The analysis will investigate both allergic and nonallergic clinical presentations of tattoo-related side effects, microscopic findings from skin biopsies, and therapeutic outcomes. This exploration is essential to improve our understanding of tattoo-related cutaneous complications and associated differential diagnoses and highlight the significance of patient awareness regarding potential risks before getting a tattoo.
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Affiliation(s)
- Beatrice Bălăceanu-Gurău
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Eliza Apostol
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | | | - Ana Ion
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, 010621 Bucharest, Romania
| | - Mara Mădălina Mihai
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Liliana Gabriela Popa
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Cristian-Dorin Gurău
- Orthopedics and Traumatology Clinic, Clinical Emergency Hospital, 014451 Bucharest, Romania;
| | - Olguța Anca Orzan
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (B.B.-G.); (E.A.); (A.I.); (M.M.M.); (L.G.P.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
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Park S, Kim H, Kim JY, Lee EJ, Bae YJ, Oh SH, Kim J. Dual-wavelength long-pulsed 755-nm alexandrite/1,064-nm Nd:YAG laser versus Nd:YAG alone for treatment of palmoplantar verruca. J COSMET LASER THER 2023; 25:86-91. [PMID: 37839083 DOI: 10.1080/14764172.2023.2268309] [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: 12/26/2022] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
We compared the effectiveness and safety of the long-pulsed neodymium-doped yttrium-aluminum-garnet (Nd:YAG) laser alone and combined with a 755-nm alexandrite laser for treating palmoplantar warts. We divided patients into two groups to receive up to four monthly treatments with Nd:YAG alone (single-wavelength) or combined with the alexandrite laser (dual-wavelength). We assessed treatment responses (according to clearance rate), vascular/hyperkeratosis grades, and patient satisfaction and pain ratings. The differences in treatment response (p = .348), patient satisfaction (p = .560), and pain ratings (p = .728) between the groups were not significant. The single- and dual-wavelength treatment options were equally effective in treating recalcitrant palmoplantar warts.
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Affiliation(s)
- Sujin Park
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Kim
- Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
| | - Ji Young Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Jeong Bae
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jihee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
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Campolmi P, Quintarelli L, Fusco I, Ronconi L, Zingoni T. Clinical evidence of 595 nm pulse dye laser treatment for viral warts on hands and feet. Skin Res Technol 2023; 29:e13460. [PMID: 37753676 PMCID: PMC10476275 DOI: 10.1111/srt.13460] [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: 08/01/2023] [Accepted: 08/26/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Viral warts, induced by infection by different HPV genotypes, are highly frequent in the general population, particularly during infancy and among adolescents. The effectiveness of the 595 nm Pulse dye-laser in treating viral warts on the hands and feet in both adults and children was investigated in this study. MATERIALS AND METHODS A selection of 203 patients with multiple viral warts was made. All patients underwent 4-5 treatment sessions with a 595 nm pulse Dye Laser (PDL). Treatment outcome was assessed by a quartile scale: 1 indicates no or low results (0%-25% of the lesion area cleared), 2 indicates slight clearance (25%-50% of the lesion area cleared), 3 indicates moderate-good clearance (50%-75%), and 4 indicates excellent clearance (75%-100%). Patients were asked for a subjective evaluation of the perceived overall results by means of the following score: unsatisfied (1), not very satisfied (2), satisfied (3), and very satisfied (4). Possible side effects were monitored. Results obtained were judged with a photographic evaluation, immediately and at the control visit (6 months after the last laser session). RESULTS All patients observed global improvements. Most of the lesions were completely removed after laser therapy. A total of 95% of patients achieved excellent clearance and they were very satisfied following the laser treatment. Relevant side effects were absent in all patients. CONCLUSION PDL treatment with the study device using a wavelength of 595 nm has proven to be a tolerable and safe therapy for viral warts management.
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Affiliation(s)
- Piero Campolmi
- Section of DermatologyDepartment of Surgery and Translational MedicineUniversity of FlorenceFirenzeItaly
| | - Lavinia Quintarelli
- Section of DermatologyDepartment of Health SciencesUniversity of FlorenceFirenzeItaly
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Paasch U, Zidane M, Baron JM, Bund T, Cappius HJ, Drosner M, Feise K, Fischer T, Gauglitz G, Gerber PA, Grunewald S, Herberger K, Jung A, Karsai S, Kautz G, Philipp C, Schädel D, Seitz AT, Nast A. S2k guideline: Laser therapy of the skin. J Dtsch Dermatol Ges 2022; 20:1248-1267. [PMID: 36098675 DOI: 10.1111/ddg.14879] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This guideline aims to improve the efficiency and safety of lasers and optical radiation sources with similar effects (especially IPL). Laser therapy of skin lesions with an increased amount of melanocytes should be performed with caution. Laser treatment of pigmented melanocytic nevi is not recommended. The guideline contains recommendations regarding the treatment of lentigines and café-au-lait spots, non-pigmented dermal nevi, Becker nevus, nevus of Ota/Hori/Ito and melasma. Further recommendations focus on the treatment of skin lesions without an increased amount of melanocytes (ephelides, postinflammatory hyperpigmentation including berloque dermatitis, seborrheic keratoses, traumatic/decorative tattoos and metallic deposits), hypopigmentation (vitiligo), benign non-pigmented neoplasms (fibrous papule of the nose, nevus sebaceus, epidermal nevus, neurofibroma, sebaceous gland hyperplasia, syringoma, xanthelasma palpebrarum), inflammatory dermatoses (acne papulopustulosa/conglobata, acne inversa, granuloma faciale, lichen sclerosus, lupus erythematosus, psoriasis vulgaris, rosacea, rhinophyma), wrinkles/dermatochalasis/striae, hypertrichosis, scars (atrophic, hypertrophic; keloids, burn/scald scars), laser-assisted skin healing, onychomycosis, precancerous lesions and malignant tumors (actinic keratoses/field cancerization, cheilitis actinica, basal cell carcinoma), vascular skin lesions (angiokeratoma, angioma, hemangioma, malformation, spider veins, granuloma telangiectaticum (pyogenic granuloma), rubeosis (erythrosis interfollicularis colli, ulerythema ophryogenes), nevus flammeus, telangiectasias and Osler's disease (hereditary hemorrhagic telangiectasia) and viral skin lesions (condylomata acuminata, mollusca contagiosa, verrucae planae juveniles/vulgares/ verrucae palmares et plantares).
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Affiliation(s)
- Uwe Paasch
- Hautaerzte Paasch, Practice Prof. Paasch, Jesewitz OT Gotha, Germany, University Hospital Leipzig, Department and Clinic for Dermatology, Venereology and Allergology, Leipzig
| | - Miriam Zidane
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Berlin
| | - Jens Malte Baron
- University Hospital Aachen, Department for Dermatology and Allergology - Skin Medicine, Aachen
| | - Thorsten Bund
- Department for Plastic, Esthetic, and Reconstructive Microsurgery, Hand Surgery at Ernst von Bergmann Hospital, Potsdam
| | | | - Michael Drosner
- Skin & Laser Schwerin, Skin & Laser Rostock, Schwerin and Rostock
| | | | - Tanja Fischer
- Skin & Laser Center Berlin-Potsdam, Berlin and Potsdam
| | - Gerd Gauglitz
- Skin and Laser Center Glockenbach Quarter, Munich, Department for Dermatology and Allergology, Ludwig-Maximilians University, Munich
| | - Peter Arne Gerber
- Dermatology at Luegplatz, Düsseldorf, Department for Dermatology, Medical Faculty, Heinrich-Heine University, Düsseldorf
| | - Sonja Grunewald
- University Hospital Leipzig, Department and Clinic for Dermatology, Venereology and Allergology, Leipzig
| | - Katharina Herberger
- University Hospital Hamburg-Eppendorf (UKE), Department for Dermatology and Venereology, Hamburg
| | - Anja Jung
- Center for Proctology, Evangelisches Elisabeth Hospital, Berlin, Deutschland
| | | | - Gerd Kautz
- Skin and Laser Hospital Dres. Gerd and Ingrid Kautz, Konz
| | - Carsten Philipp
- Center Laser Medicine, Evangelisches Elisabeth Hospital, Berlin
| | | | - Anna-Theresa Seitz
- University Hospital Leipzig, Department and Clinic for Dermatology, Venereology and Allergology, Leipzig
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Berlin
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Paasch U, Zidane M, Baron JM, Bund T, Cappius HJ, Drosner M, Feise K, Fischer T, Gauglitz G, Gerber PA, Grunewald S, Herberger K, Jung A, Karsai S, Kautz G, Philipp C, Schädel D, Seitz AT, Nast A. S2k-Leitlinie: Lasertherapie der Haut. J Dtsch Dermatol Ges 2022; 20:1248-1270. [PMID: 36162017 DOI: 10.1111/ddg.14879_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Uwe Paasch
- Hautärzte Paasch, Praxis Prof. Paasch, Jesewitz OT Gotha, Deutschland, Universitätsklinikum Leipzig, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Leipzig
| | - Miriam Zidane
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Berlin
| | - Jens Malte Baron
- Universitätsklinikum Aachen, Klinik für Dermatologie und Allergologie - Hautklinik, Aachen
| | - Thorsten Bund
- Klinik für Plastische, Ästhetische und Rekonstruktive Mikrochirurgie, Handchirurgie am Klinikum Ernst von Bergmann, Potsdam
| | | | - Michael Drosner
- Haut & Laser Schwerin, Haut & Laser Rostock, Schwerin und Rostock
| | | | - Tanja Fischer
- Haut- & Lasercentrum Berlin-Potsdam, Berlin und Potsdam
| | - Gerd Gauglitz
- Haut- und Laserzentrum im Glockenbachviertel, München, Klinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, München
| | - Peter Arne Gerber
- Dermatologie am Luegplatz, Düsseldorf, Klinik für Dermatologie, Medizinische Fakultät, Heinrich-Heine-Universität, Düsseldorf
| | - Sonja Grunewald
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Leipzig
| | - Katharina Herberger
- Universitätsklinikum Hamburg-Eppendorf (UKE), Klinik für Dermatologie und Venerologie, Hamburg
| | - Anja Jung
- Zentrum Proktologie, Evangelische Elisabeth Klinik, Berlin, Deutschland
| | | | - Gerd Kautz
- Haut- und Laserklinik Dres. Gerd und Ingrid Kautz, Konz
| | | | | | - Anna-Theresa Seitz
- Universitätsklinikum Leipzig, Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Leipzig
| | - Alexander Nast
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Berlin
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Pan PY, Wei KC, Wu JC, Jeng-Hsien L. A novel fractional solid-state 585 nm c on facial verruca plana: a report of three cases. J Cosmet Dermatol 2022; 21:1986-1988. [PMID: 35176192 DOI: 10.1111/jocd.14857] [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: 01/15/2022] [Accepted: 02/14/2022] [Indexed: 11/30/2022]
Abstract
A novel fractional laser system with differential-wavelength modified optically pumped semiconductor (D-WMOPS) technology can produce a pure 585 nm wavelength as PDL, which has been used to treat vascular and pigmented skin lesions. Besides, this new laser modality also showed promising results for verruca plana in our experience. In this brief report, we present 3 cases of facial flat warts treated by this novel 585 nm diode laser.
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Affiliation(s)
- Po-Yang Pan
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kai-Che Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jen-Chin Wu
- Wu Jenchin Dermatology Clinic, Pingtung, Taiwan
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Ibrahim SMA, Soliman M, Mohamed SKA, Soliman MM. Pulsed dye laser versus Nd:YAG laser in the treatment of recalcitrant plantar warts: an intraindividual comparative study. J COSMET LASER THER 2022; 23:130-136. [PMID: 34978499 DOI: 10.1080/14764172.2021.2016843] [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: 10/19/2022]
Abstract
Plantar warts are common cutaneous lesions caused by the human papillomavirus. Treatment of recalcitrant plantar warts stays a continuous challenge, and they are more refractory to treatment than common warts. To compare the efficacy of Long-Pulsed neodymium: yttrium-aluminum-garnet (Nd:YAG) laser versus pulsed dye laser (PDL) on the therapy of multiple recalcitrant plantar warts. Thirty patients with recalcitrant plantar warts were included in the current study. Half the number of warts were treated by PDL in each patient, while the other half were treated by Nd:YAG. Laser sessions were applied every 2 weeks for a maximum of six sessions. Patients were followed up both clinically and using dermoscopy. There was a complete clearance of warts in 20 patients (66.7%) with Nd:YAG laser and 19 patients (63.3%) with PDL with no statistically significant difference between both types of lasers. Pain during laser sessions was higher with Nd:YAG laser PDL and it was statistically significant (p = .0001). Both Nd:YAG laser and PDL showed efficacy and safety for the treatment of recalcitrant plantar warts. The use of dermoscopy adds great value in evaluating treatment response and in decreasing the incidence of recurrence.
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Affiliation(s)
- Shady Mahmoud Attia Ibrahim
- Associate Professor at Dermatology and Venereology Department, Faculty of Medicine, Al-Azhar University Hospital, Cairo, Egypt
| | - Mona Soliman
- Professor of Dermatology and Venereology, National Institute of Laser Enhanced Sciences, Cairo University, Egypt
| | | | - Mohamed Mohsen Soliman
- Assistant Professor of Dermatology and Venereology, National Institute of Laser Enhanced Sciences, Cairo University, Cairo, Egypt
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Hassan SNE, Hussein TM, Eldeeb MEL. Photodynamic therapy using methylene blue and intense pulsed light versus intense pulsed light alone in treatment of verruca: A randomized controlled study. Photodiagnosis Photodyn Ther 2021; 36:102541. [PMID: 34547471 DOI: 10.1016/j.pdpdt.2021.102541] [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: 06/10/2021] [Revised: 08/26/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Many therapeutic modalities are available for treatment of warts, but no single therapy is universally effective. Photodynamic therapy (PDT) using intralesional methylene blue (MB) followed by intense pulsed light (IPL) could be a successful option for treatment by several mechanisms. METHODS This prospective randomized controlled trial was carried out on eighty patients with verrucae. Patients were randomized into three groups; group A (30 patients) received MB/IPL/PDT sessions, group B (30 Patients) received IPL sessions, and group C (control). Response was assessed by clinical and dermoscopy score (0,1, 2, or 3 according to extent of clinical and dermoscopic resolution), cure rate (percent of verrucae clinically and dermoscopy cleared), and imageJ analysis (surface area of wart and haemorrhagic structures or vessels). RESULTS Clinical and dermoscopic clearance was achieved in 43.3% and 20% of patients in groups A and B respectively. Cure rate was 40.9% for group A compared to 23.4% for group B. ImageJ analysis revealed more reduction of surface area in group A being 80.05 ± 27.12% for verrucae and 89.28 ± 19.19% for vessels and haemorrhagic dots compared to 48.16 ± 34.21% and 65.99 ± 30.58% in group B. CONCLUSIONS MB/IPL/PDT is an effective option for treatment of warts with a success rate of around 40%, based on clinical and dermoscopic assessment. The efficacy was found to be higher on using imageJ utilizing both the surface area of the wart and surface area of vessels and haemorrhagic dots with the latter being more effected by treatment.
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Affiliation(s)
- Sarah Nour Eldin Hassan
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, University of Alexandria, Elkartoum Square, Elmessalah 21521 Alexandria, Egypt
| | - Tarek Mahmoud Hussein
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, University of Alexandria, Elkartoum Square, Elmessalah 21521 Alexandria, Egypt
| | - Marwa ELsaeed Eldeeb
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, University of Alexandria, Elkartoum Square, Elmessalah 21521 Alexandria, Egypt.
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Oh BH. Cidofovir Intralesional Injection for Recalcitrant Common Warts: A Comparison with Sodium Tetradecyl Sulfate Intralesional Injection. Ann Dermatol 2021; 32:273-279. [PMID: 33911754 PMCID: PMC7992651 DOI: 10.5021/ad.2020.32.4.273] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/18/2020] [Accepted: 03/09/2020] [Indexed: 11/09/2022] Open
Abstract
Background A novel treatment method is required for recalcitrant common warts. Objective This study aimed to compare the complete wart removal rate of cidofovir, a broad-spectrum antiviral agent, intralesional injection and sodium tetradecyl sulfate intralesional injection. Methods This retrospective study included 45 patients with recalcitrant common warts on the hands and/or feet, treated with cidofovir or sodium tetradecyl sulfate intralesional injection. Results The treatment results were evaluated in three groups as follows: (1) failure - recalcitrant common warts remaining despite three or more injections, (2) success - free from warts for more than 6 months after the injection, and (3) recurrence. The cidofovir group (n=22) showed significantly higher treatment success rates than the sodium tetradecyl sulfate group (n=23) (90.91% vs. 26.09%, p<0.001). Two immunosuppressed patients in the cidofovir group had recurrent lesions after 2 months of being declared free from warts. Considering adverse effects, two patients in the cidofovir group complained of bulla formation with severe pain requiring narcotic painkillers. Conclusion Although this study has the limitations of a small sample size and retrospective design, patients with recalcitrant common warts showed a dramatic response to the treatment with cidofovir intralesional injection, with minimal complications.
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Affiliation(s)
- Byung Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea
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Efficacy and Safety of Fire Needle Therapy for Flat Warts: Evidence from 29 Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9513762. [PMID: 33531926 PMCID: PMC7834788 DOI: 10.1155/2021/9513762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/06/2020] [Accepted: 12/16/2020] [Indexed: 11/17/2022]
Abstract
Flat warts are a common and recurrent skin disease that has no specific antiviral treatment. As an alternative or complementary therapy, fire needle therapy has been widely used in the treatment of flat warts. The objective of this study was to systematically evaluate the efficacy and safety of fire needle therapy for flat warts. Using the search terms "flat warts" and "fire needle," we searched the PubMed, Embase, Cochrane, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, Chinese biomedical (SinoMed) database, and the China Science and Technology Journal databases for studies until March 12, 2020. Randomized controlled trials comparing fire needle therapies with conventional therapies were also included. We calculated the risk ratios (RR) and mean differences with a 95% confidence interval (CI). We analyzed 29 trials involving 2,666 patients. Results showed that the use of fire needle therapy alone may have a higher efficacy rate compared with that of an immunomodulator (RR = 1.11, 95% CI: 1.03 to 1.20, I 2 = 0%, P = 0.006; RR = 1.19, 95% CI: 1.03 to 1.37, I 2 = 70%, P = 0.02, respectively) or tretinoin (RR = 1.39, 95% CI: 1.25 to 1.55, I 2 = 0%, P < 0.00001), with a lower risk of blisters (P = 0.03) or erythema (P = 0.04), but with a higher risk of pigmentation (P = 0.02). We also determined the efficacy rate of fire needle therapy in combination with traditional Chinese medicine (RR = 1.16, 95% CI: 1.10 to 1.23, I 2 = 21%, P < 0.00001), immunomodulators (RR = 1.17, 95% CI: 1.07 to 1.28, I 2 = 33%, P = 0.0005), imiquimod (RR = 1.21, 95% CI: 1.04 to 1.42, P = 0.02), or as multidrug therapies (RR = 1.15, 95% CI: 1.07 to 1.24, I 2 = 0%, P = 0.0001) and found that the combination treatments could reduce recurrence rates (P < 0.00001) and provided a lower risk of desquamation (P = 0.006). In conclusion, fire needle therapy seems to be effective for flat warts, with a reduced incidence of adverse events, such as blisters, erythema, and desquamation, but may increase incidence of pigmentation.
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Iranmanesh B, Khalili M, Zartab H, Amiri R, Aflatoonian M. Laser therapy in cutaneous and genital warts: A review article. Dermatol Ther 2020; 34:e14671. [PMID: 33314577 DOI: 10.1111/dth.14671] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022]
Abstract
Traditional treatment modalities for wart require long-term treatment course and usually have high recurrence rates and unwanted side effects. In this review article, we evaluated different types of laser therapy in the treatment of warts. Published articles since 2000 up to July 2020 about laser therapy in genital and non-genital warts were searched and assessed. Fifty articles were selected for the final review, including 22 pulsed dye laser (PDL), 10 neodymium-yttrium-aluminum-garnet (Nd: YAG), 3 erbium-doped yttrium-aluminum-garnet (Er: YAG), 14 carbon dioxide (CO2 ) laser and one systematic review. Complete response rates were different in terms of laser type used (0%-100%, 9.1%-100%, 83.3%-100%, and 59.15%-100% for PDL, Nd: YAG, Er: YAG, and CO2 laser, respectively). There was no significant difference between conventional treatment modalities and laser therapy regarding efficacy and recurrence rate. Combination of lasers with keratolytic agents, immunomodulators and photodynamic therapy can be helpful especially in immunosuppressed patients, refractory, and recurrent lesions. PDL has the lowest occurrence of adverse effects relative to other types of lasers.
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Affiliation(s)
- Behzad Iranmanesh
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Khalili
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamed Zartab
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Rezvan Amiri
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahin Aflatoonian
- Department of Dermatology, Kerman University of Medical Sciences, Kerman, Iran
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12
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Combined pulsed dye laser and systemic retinoids for the treatment of hypertrophic resistant warts among organ transplant patients. Lasers Med Sci 2020; 35:1653-1657. [DOI: 10.1007/s10103-020-03011-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/25/2020] [Indexed: 11/26/2022]
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13
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Leerunyakul K, Thammarucha S, Suchonwanit P, Rutnin S. A comprehensive review of treatment options for recalcitrant nongenital cutaneous warts. J DERMATOL TREAT 2020; 33:23-40. [PMID: 32116076 DOI: 10.1080/09546634.2020.1737635] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction: The treatment of recalcitrant nongenital cutaneous warts has always been challenging for dermatologists as they often recur and relapse. Multiple treatment options have been investigated to improve the outcome. This review provides an overview of the current treatment modalities and summarizes the efficacy and side effects of each treatment option for recalcitrant nongenital cutaneous warts.Methods: A PubMed search was performed through July 2019 to include all English language reports investigating the treatment for recalcitrant nongenital cutaneous warts, regardless of design.Results: A total of 144 studies were included in this review. The treatment options for recalcitrant nongenital cutaneous warts can be divided into three groups: destructive treatment, immunotherapy, and cytotoxic agents. Although both destructive therapies and cytotoxic agents demonstrated high complete response rates, immunotherapy, which is a minimally invasive method, was superior in terms of the clearance of distant warts. Intralesional mumps-measles-rubella injections and purified protein derivatives currently demonstrate high efficacy with well-established clinical evidence.Conclusions: Many upcoming treatment modalities, especially immunotherapy, are promising. However, more comparative studies are required to verify the efficacy and safety profile.
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Affiliation(s)
- Kanchana Leerunyakul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sasima Thammarucha
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suthinee Rutnin
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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14
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Chunharas C, Boen M, Alhaddad M, Wu DC. The Efficacy of Pulsed Dye Laser Pretreated With or Without Local Anesthetic on Patients Presenting With Erythema of Face, Neck, Chest, and Extremities. Lasers Surg Med 2019; 52:307-314. [PMID: 31441076 DOI: 10.1002/lsm.23146] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Erythema is one of the most common cosmetic concerns and usually responds well to pulsed dye laser (PDL) treatment. As this laser can cause significant discomfort, topical anesthesia is sometimes offered. However, it is still uncertain whether topical anesthetics can affect the outcome of the laser therapy. We performed a retrospective single site study to compare the efficacy of PDL for the treatment of erythema in patients with and without pretreatment with topical anesthetic. STUDY DESIGN/MATERIALS AND METHODS A chart review was performed and patients who presented with erythema of face, neck, chest, and extremities pretreated with topical anesthesia (23% lidocaine/7% tetracaine ointment or 7% lidocaine/7% tetracaine ointment) undergoing PDL were reviewed and compared with another group without anesthesia. Two blinded dermatologists evaluated the postlaser procedure photographs and gave an assessment compared with baseline. RESULTS A total of 69 patient charts were reviewed. The erythema resulted from various skin conditions including telangiectasia, cherry angioma, striae, and rosacea. The mean improvement was 2.2581 in the anesthesia group and 2.2632 in the nonanesthesia group. There was no significant difference between both groups as confirmed by a noninferiority test. CONCLUSIONS Topical anesthesia with lidocaine and tetracaine ointment do not interfere with the efficacy of the PDL. Since pain management is essential for any cosmetic procedure, the application of a local anesthetic will enhance patient comfort and satisfaction during treatment with PDL. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Monica Boen
- Cosmetic Laser Dermatology, 9339 Genesee Ave., Suite 300, San Diego, California, 92122
| | - Marwan Alhaddad
- Cosmetic Laser Dermatology, 9339 Genesee Ave., Suite 300, San Diego, California, 92122
| | - Douglas C Wu
- Cosmetic Laser Dermatology, 9339 Genesee Ave., Suite 300, San Diego, California, 92122
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15
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Elmaadawy EH, Shams SS, Hegab DS, Zaki RA. Pulsed-dye laser versus intralesional Candida albicans. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2019. [DOI: 10.15570/actaapa.2019.5] [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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16
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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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17
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Zhang F, Shi L, Liu P, Zhang L, Wu Q, Wang B, Zhang G, Wang P, Zhou F, Chen WR, Wang X. A novel cosmetic and clinically practicable laser immunotherapy for facial verruca plana: Intense pulsed light combined with BCG-PSN. Photodiagnosis Photodyn Ther 2018; 22:86-90. [DOI: 10.1016/j.pdpdt.2018.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 01/14/2018] [Accepted: 02/01/2018] [Indexed: 02/07/2023]
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18
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Abstract
During their lifetime, at least 10 % of the population will be infected by human papillomaviruses (HPV), clinically characterized by the formation of cutaneous or genital warts. Although warts are ubiquitous, there are no defined treatments. Especially in the first six months, warts frequently resolve without therapeutic intervention. This complicates the interpretation of study data, given that many studies do not differentiate between newly infected patients and those with infections that have persisted for a long time. Similarly, most studies do not take location, size, and thickness of lesions into account, either. The objective of the present review article is to analyze the study data currently available, taking into consideration both subtypes and locations - factors exceedingly crucial in clinical practice. In particular, the distinction between new-onset and chronic recalcitrant warts is reflected in a therapeutic algorithm. In the case of genital warts, the algorithm is more clearly determined by the extent of the area affected rather than the longevity of lesions. In immunocompetent individuals, any therapeutic intervention must be aimed at achieving complete resolution.
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19
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Costa-Silva M, Fernandes I, Rodrigues AG, Lisboa C. Anogenital warts in pediatric population. An Bras Dermatol 2018; 92:675-681. [PMID: 29166505 PMCID: PMC5674701 DOI: 10.1590/abd1806-4841.201756411] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 12/11/2016] [Indexed: 11/22/2022] Open
Abstract
The approach to children with anogenital warts in the context of sexual abuse is
a challenge in clinical practice. This study aims to review the current
knowledge of anogenital warts in children, the forms of transmission, and the
association with sexual abuse and to propose a cross-sectional approach
involving all medical specialties. A systematic review of the literature was
conducted in Portuguese and English from January 2000 to June 2016 using the ISI
Web of Knowledge and PubMed databases. Children aged 12 years or younger were
included. The ethical and legal aspects were consulted in the Declaration and
Convention on the Rights of Children and in the World Health Organization.
Non-sexual and sexual transmission events of human papillomavirus in children
have been well documented. The possibility of sexual transmission appears to be
greater in children older than 4 years. In the case of anogenital warts in
children younger than 4 years of age, the possibility of non-sexual transmission
should be strongly considered in the absence of another sexually transmitted
infection, clinical indicators, or history of sexual abuse. The importance of
human papillomavirus genotyping in the evaluation of sexual abuse is
controversial. A detailed medical history and physical examination of both the
child and caregivers are critical during the course of the investigation. The
likelihood of an association between human papillomavirus infection and sexual
abuse increases directly with age. A multidisciplinary clinical approach
improves the ability to identify sexual abuse in children with anogenital
warts.
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Affiliation(s)
- Miguel Costa-Silva
- Department of Dermatology and Venereology, Centro Hospitalar São João, EPE, Faculdade de Medicina da Universidade do Porto - Porto, Portugal
| | - Inês Fernandes
- Department and Laboratory of Microbiology, Faculdade de Medicina da Universidade do Porto - Porto, Portugal
| | - Acácio Gonçalves Rodrigues
- Department and Laboratory of Microbiology, Faculdade de Medicina da Universidade do Porto - Porto, Portugal
| | - Carmen Lisboa
- Department of Dermatology and Venereology, Centro Hospitalar São João, EPE, Faculdade de Medicina da Universidade do Porto - Porto, Portugal.,Department and Laboratory of Microbiology, Faculdade de Medicina da Universidade do Porto - Porto, Portugal
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20
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Fichman Y, Levi A, Hodak E, Halachmi S, Mazor S, Wolf D, Caplan O, Lapidoth M. Efficacy of pulsed dye laser treatment for common warts is not influenced by the causative HPV type: a prospective study. Lasers Med Sci 2017; 33:773-777. [PMID: 29218494 DOI: 10.1007/s10103-017-2413-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 12/04/2017] [Indexed: 01/17/2023]
Abstract
Verruca vulgaris (VV) is a prevalent skin condition caused by various subtypes of human papilloma virus (HPV). The most common causes of non-genital lesions are HPV types 2 and 4, and to a lesser extent types 1, 3, 26, 29, and 57. Although numerous therapeutic modalities exist, none is universally effective or without adverse events (AE). Pulsed dye laser (PDL) is a favorable option due to its observed efficacy and relatively low AE rate. However, it is not known which verrucae are most likely to respond to PDL, or whether the causative viral subtype influences this response. The objective of this prospective blinded study was to assess whether the HPV subtype was predictive of response to PDL. For that matter, 26 verrucae from 26 immunocompetent patients were biopsied prior to treatment by PDL. HPV coding sequences were isolated and genotyped using PCR analysis. Patients were treated by PDL (595 nm wavelength, 5 mm spot size, 1.5 ms pulse duration, 12 J/cm2 fluence) once a month for up to 6 months, and clinical response was assessed. Binary logistic regression analysis and linear logistic regression analysis were used in order to evaluate statistical significance. Different types of HPV were identified in 22 of 26 tissue samples. Response to treatment did not correlate with HPV type, age, or gender. As no association between HPV type and response to PDL therapy could be established, it is therefore equally effective for all HPV types and remains a favorable treatment option for all VV.
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Affiliation(s)
- Yoseph Fichman
- Plastic Surgery Department, Rabin Medical Center, Petach Tikva, Israel
| | - Assi Levi
- Photodermatoses Clinic, Laser Unit, Dermatology Department, Rabin Medical Center, Petach Tikva, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Emmilia Hodak
- Photodermatoses Clinic, Laser Unit, Dermatology Department, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Sigal Mazor
- Department of Community Dentistry, School of Dental Medicine, Hebrew University-Hadassah Medical Center, Jerusalem, Israel
| | - Dana Wolf
- Clinical Virology Unit, Department of Clinical Microbiology & Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Orit Caplan
- Clinical Virology Unit, Department of Clinical Microbiology & Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Moshe Lapidoth
- Photodermatoses Clinic, Laser Unit, Dermatology Department, Rabin Medical Center, Petach Tikva, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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21
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Abstract
BACKGROUND Warts or verrucae vulgaris are common cutaneous infections with currently no definitive curative treatments available. OBJECTIVE To determine the efficacy of pulsed dye laser (PDL) in the treatment of warts. MATERIALS AND METHODS A literature search was performed using the PubMed and MEDLINE databases. A search using {(Wart[s], verruca or condylomata)} AND [(Pulsed dye laser)] was used. Forty-four articles were identified as relevant to this review. RESULTS Simple warts were very responsive to PDL, being treated successfully in over 95% of patients. Facial and anogenital warts also demonstrated excellent outcomes. Recalcitrant warts, displayed significant variability in their response, ranging between 50% and 100% across all articles. The response rates seen in peripheral warts (involving the hands and feet) were also very variable, ranging between 48% and 95%. Recurrence rates at 4 months of follow-up were documented as 0% to 15%. Complications have been described as very few and rare, the main ones being topical discomfort and erythema. CONCLUSION Pulsed dye laser is a safe and effective modality in the treatment of warts that can be applied to most body parts. Cost and availability remain a limitation to the use of PDL; however, this modality can be used when other more traditional and accessible treatments have failed.
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22
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Radmanesh M, Omidian E. The pulsed dye laser is more effective and rapidly acting than intralesional meglumine antimoniate therapy for cutaneous leishmaniasis. J DERMATOL TREAT 2017; 28:422-425. [DOI: 10.1080/09546634.2016.1274364] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mohammad Radmanesh
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Omidian
- Department of Dermatology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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23
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Ockenfels HM. Therapeutisches Management kutaner und genitaler Warzen. J Dtsch Dermatol Ges 2016; 14:892-900. [DOI: 10.1111/ddg.12838_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Wanner M, Sakamoto FH, Avram MM, Anderson RR. Immediate skin responses to laser and light treatments. J Am Acad Dermatol 2016; 74:807-19; quiz 819-20. [DOI: 10.1016/j.jaad.2015.06.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 05/29/2015] [Accepted: 06/03/2015] [Indexed: 12/23/2022]
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25
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Bingol UA, Cömert A, Cinar C. The Overlapped Triple Circle Pulse Technique with Nd:YAG Laser for Refractory Hand Warts. Photomed Laser Surg 2015; 33:338-42. [PMID: 26067943 DOI: 10.1089/pho.2015.3883] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Inadvertent superficial treatment of hand warts causes recurrence, whereas aggressive treatment can lead to tissue defects resulting in hand dysfunction. This study aimed to determine the effectiveness of a novel laser treatment modality for recalcitrant hand warts. MATERIALS AND METHODS The study included 51 patients who were treated for 146 recalcitrant hand warts using 1064 nm long-pulsed Nd:YAG laser between 2011 and 2014. The laser treatment method is novel because each treated wart was aligned at the intersection point of the circles of 3 laser pulses per session. RESULTS Among the 146 hand warts, 88.35% were successfully treated with one session and 100% of those that required a second treatment session were treated successfully, based on the 12 month follow-up examination. CONCLUSIONS Long-pulsed Nd:YAG laser treatment was observed to be a safe, rapid, and effective method for treating recalcitrant hand warts.
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Affiliation(s)
- Ugur Anil Bingol
- 1 Department of Plastic, Reconstructive, and Aesthetic Surgery, Yeditepe University , Yeditepe Medical School, Istanbul Turkey
| | - Asuman Cömert
- 2 Department of Dermatology, Yeditepe University , Yeditepe Medical School, Istanbul Turkey
| | - Can Cinar
- 1 Department of Plastic, Reconstructive, and Aesthetic Surgery, Yeditepe University , Yeditepe Medical School, Istanbul Turkey
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26
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Goldberg DJ, Beckford AN, Mourin A. Verruca vulgaris: Novel treatment with a 1064 nm Nd:YAG laser. J COSMET LASER THER 2015; 17:116-9. [DOI: 10.3109/14764172.2015.1007068] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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27
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Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfield-Jones SE. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol 2014; 171:696-712. [PMID: 25273231 DOI: 10.1111/bjd.13310] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J C Sterling
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 OQQ, U.K
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28
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Sparreboom E, Luijks H, Luiting‐Welkenhuyzen H, Willems P, Groeneveld C, Bovenschen H. Pulsed‐dye laser treatment for recalcitrant viral warts: a retrospective case series of 227 patients. Br J Dermatol 2014; 171:1270-3. [DOI: 10.1111/bjd.13099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- E.E. Sparreboom
- Department of Dermatology Máxima Medical Centre Veldhoven De Run 4600 P.O. Box 7777 5500 MB Veldhoven the Netherlands
| | - H.G. Luijks
- Department of Dermatology Máxima Medical Centre Veldhoven De Run 4600 P.O. Box 7777 5500 MB Veldhoven the Netherlands
| | - H.A.L. Luiting‐Welkenhuyzen
- Department of Dermatology Máxima Medical Centre Veldhoven De Run 4600 P.O. Box 7777 5500 MB Veldhoven the Netherlands
| | - P.W.J.M. Willems
- Department of Dermatology Máxima Medical Centre Veldhoven De Run 4600 P.O. Box 7777 5500 MB Veldhoven the Netherlands
| | - C.P.M. Groeneveld
- Department of Dermatology Máxima Medical Centre Veldhoven De Run 4600 P.O. Box 7777 5500 MB Veldhoven the Netherlands
| | - H.J. Bovenschen
- Department of Dermatology Máxima Medical Centre Veldhoven De Run 4600 P.O. Box 7777 5500 MB Veldhoven the Netherlands
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29
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Balagué N, Vostrel P, Beaulieu JY, van Aaken J. Third degree formic acid chemical burn in the treatment of a hand wart: a case report and review of the literature. SPRINGERPLUS 2014; 3:408. [PMID: 25140289 PMCID: PMC4137414 DOI: 10.1186/2193-1801-3-408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/23/2014] [Indexed: 11/13/2022]
Abstract
Objective Cutaneous warts are very common and a large variety of topical treatments and drugs can be employed to cure these skin injuries that can arise on any part of the body. But are these products really safe? Method We performed a case description and PubMed literature review using key words “wart,” “chemical burn,” and “formic acid.” All articles in English and French were selected. Results This is the first report of a chemical burn by formic acid in the treatment of warts. Numerous topical treatments for cutaneous warts are available with many new drugs appearing every year. However, only a few treatments have proven their effectiveness, such as salicylic acid or cryotherapy with liquid nitrogen that are commonly used. Moreover, most cutaneous warts will resolve spontaneously without any treatment and several products, including topical acids and cryotherapy devices, presented adverse effects such as chemical burns or frostbites so demonstrating that even frequently used treatments can be harmful. Conclusion Topical treatments used for wart removal are not without risk even if some products are sold without prescription. For self-treatment products, we recommend enhanced warning by the pharmacist about the risks involved.
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Affiliation(s)
- Nicolas Balagué
- Service of Orthopedic Surgery, Unit of Hand Surgery University Hospitals of Geneva, Geneva, Switzerland
| | - Philippe Vostrel
- Service of Orthopedic Surgery, Unit of Hand Surgery University Hospitals of Geneva, Geneva, Switzerland
| | - Jean-Yves Beaulieu
- Service of Orthopedic Surgery, Unit of Hand Surgery University Hospitals of Geneva, Geneva, Switzerland
| | - Jan van Aaken
- Service of Orthopedic Surgery, Unit of Hand Surgery University Hospitals of Geneva, Geneva, Switzerland
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30
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Bristow IR. The effectiveness of lasers in the treatment of onychomycosis: a systematic review. J Foot Ankle Res 2014; 7:34. [PMID: 25104974 PMCID: PMC4124774 DOI: 10.1186/1757-1146-7-34] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/17/2014] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Onychomycosis is a common nail pathology which has proven to be a treatment challenge to healthcare professionals. Antifungal drugs have been the mainstay of therapy for many years. Recently, laser technologies have been introduced as a treatment for onychomycosis avoiding the disadvantages of systemic and topical drug therapies, offering a rapid treatment for an often persistent nail condition. The purpose of this study was to review published evidence regarding the effectiveness of laser technologies in the treatment of onychomycosis. METHODS The primary question for this review was "what evidence is there for the use of lasers in the treatment of onychomycosis"? A systematic literature search of published papers indexed on Pubmed and Web of Science® was undertaken in June 2014 for original, published research. The primary outcome measures for efficacy were mycological cure and clearance of the affected nail (clinical cure). RESULTS This review returned a total of twelve eligible published studies evaluating the use of lasers in the treatment of onychomycosis. Two were randomised controlled trials, four were comparative design studies (with no placebo/control groups) and the remainder were case series. The level of evidence was generally low level reflecting predominantly small sample size and lack of control groups. The results from studies were conflicting and follow up periods for patients in studies were generally short. Many studies excluded patients with severe or dystrophic onychomycosis. CONCLUSIONS The evidence pertaining to the effectiveness of laser treatment of onychomycosis is limited and of poor methodological quality. Future studies using a randomised controlled trial designs with larger study populations and clear procedures are required to permit a full evaluation of this emerging technology.
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Affiliation(s)
- Ivan R Bristow
- Faculty of Health Sciences, B67, Highfield Campus, University of Southampton, Southampton SO17 1BJ, UK
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31
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Kimura U, Takeuchi K, Kinoshita A, Takamori K, Suga Y. Long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser treatment for refractory warts on hands and feet. J Dermatol 2014; 41:252-7. [DOI: 10.1111/1346-8138.12411] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 11/29/2013] [Accepted: 12/20/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Utako Kimura
- Department of Dermatology; Juntendo University Urayasu Hospital; Chiba Japan
| | - Kaori Takeuchi
- Department of Dermatology; Juntendo University Urayasu Hospital; Chiba Japan
| | - Ayako Kinoshita
- Department of Dermatology; Juntendo University Urayasu Hospital; Chiba Japan
| | - Kenji Takamori
- Department of Dermatology; Juntendo University Urayasu Hospital; Chiba Japan
| | - Yasushi Suga
- Department of Dermatology; Juntendo University Urayasu Hospital; Chiba Japan
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32
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Choi Y, Kim DH, Jin SY, Lee AY, Lee SH. Topical immunotherapy with diphenylcyclopropenone is effective and preferred in the treatment of periungual warts. Ann Dermatol 2013; 25:434-9. [PMID: 24371390 PMCID: PMC3870211 DOI: 10.5021/ad.2013.25.4.434] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 09/14/2012] [Accepted: 10/14/2012] [Indexed: 12/04/2022] Open
Abstract
Background There exists a treatment challenge with periungual warts. Topical immunotherapy with diphenylcyclopropenone (DPCP) has recently been reported to be an effective treatment for recalcitrant warts, including periungual types. Objective We aimed to evaluate the effectiveness and preference of topical immunotherapy with DPCP in treating periungual warts. Methods Twenty-seven patients with periungual warts who were treated with DPCP immunotherapy (2007 through 2010; Dongguk University Ilsan Hospital, Goyang, Korea) were retrospectively recruited. Other treatment modalities were also used in some patients. Lesions were grouped into the types according to the following locations: proximal nail fold, lateral nail fold and hyponychium. Total and group clearance rates as well as treatment periods according to location and disease duration were evaluated. A patient questionnaire was performed to assess the satisfaction for the treatments in those who received multiple therapies. Results Total success rates were 85% (by subjects) and 91% (by individual lesions). Success rate and treatment period for proximal nail fold type seemed more desirable than other locations. Success rate decreased and treatment period increased as disease duration increased. The questionnaire revealed a significantly higher satisfaction rate for DPCP immunotherapy than for cryotherapy and pulsed-dye laser. Conclusion Topical immunotherapy with DPCP is an effective and preferred method in the treatment of periungual warts.
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Affiliation(s)
- Yunseok Choi
- Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Do Hun Kim
- Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Sang Yun Jin
- Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Ai-Young Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
| | - Seung Ho Lee
- Department of Dermatology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea
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Pulsed dye laser versus Nd:YAG laser in the treatment of plantar warts: a comparative study. Lasers Med Sci 2013; 29:1111-6. [DOI: 10.1007/s10103-013-1479-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 10/22/2013] [Indexed: 10/26/2022]
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Omi T, Kawana S. Recalcitrant molluscum contagiosum successfully treated with the pulsed dye laser. Laser Ther 2013; 22:51-4. [PMID: 24155550 DOI: 10.5978/islsm.13-or-07] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 03/06/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND AIMS Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV) and is a very common skin disorder mainly involving young children Cryotherapy, curettage or some topical therapies have been applied for MC, but all of these treatments need several sessions, can be somewhat ineffective, and very painful. The present study assessed the impact of a single session of pulsed dye laser treatment of MC lesions which had proved resistant to other approaches Subjects and methods: Fifteen children comprised the study subjects, 11 boys and 4 girls, 3-5 years of age (mean 4.2 yr) with recalcitrant MC. Lesions were counted at baseline, and a single shot from a 585 nm pulsed dye laser was applied to each lesion (3 mm, 300 ms, 8.0 J/cm(2)). Lesions were counted again at 1 week post-treatment and followed for up to 3 months thereafter. RESULTS All patients completed the study and no patient dropped out through pain or discomfort. Purpura was seen at each treated lesion immediately after irradiation, but at 1 week after treatment, lesion clearance was virtually complete which was maintained for 1 month, and no recurrence was seen at 3 months in 8 of the 15 patients who remained available for followup. CONCLUSIONS A single treatment of MC lesions with the pulsed dye laser successfully cured even recalcitrant lesions with no recurrence on follow up, and was well tolerated by the young subjects.
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Affiliation(s)
- Tokuya Omi
- Department of Dermatology, Queens's Square Medical Center, Yokohama ; Department of Dermatology, Nippon Medical School, Tokyo , Japan
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Grillo E, Boixeda P, Ballester A, Miguel-Morrondo A, Truchuelo T, Jaén P. Pulsed dye laser treatment for facial flat warts. Dermatol Ther 2013; 27:31-5. [DOI: 10.1111/dth.12038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Grillo
- Department of Dermatology; Ramon y Cajal University Hospital; University of Alcalá; Madrid Spain
| | - P. Boixeda
- Department of Dermatology; Ramon y Cajal University Hospital; University of Alcalá; Madrid Spain
| | - A. Ballester
- Department of Dermatology; Ramon y Cajal University Hospital; University of Alcalá; Madrid Spain
| | - A. Miguel-Morrondo
- Department of Dermatology; Ramon y Cajal University Hospital; University of Alcalá; Madrid Spain
| | - T. Truchuelo
- Department of Dermatology; Ramon y Cajal University Hospital; University of Alcalá; Madrid Spain
| | - P. Jaén
- Department of Dermatology; Ramon y Cajal University Hospital; University of Alcalá; Madrid Spain
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Yang C, Liu S, Yang S. Treatment of facial recalcitrant verruca vulgaris with holmium: YAG laser: An update. J COSMET LASER THER 2013; 15:39-41. [PMID: 23368688 DOI: 10.3109/14764172.2012.759233] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Chunjun Yang
- Institute of Dermatology & Department of Dermatology at No.1 Hospital, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Shengxiu Liu
- Institute of Dermatology & Department of Dermatology at No.1 Hospital, Anhui Medical University, Hefei, Anhui, P. R. China
| | - Sen Yang
- Institute of Dermatology & Department of Dermatology at No.1 Hospital, Anhui Medical University, Hefei, Anhui, P. R. China
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Al-Hamamy HR, Salman HA, Abdulsattar NA. Treatment of Plane Warts with a Low-Dose Oral Isotretinoin. ISRN DERMATOLOGY 2012; 2012:163929. [PMID: 23304543 PMCID: PMC3530790 DOI: 10.5402/2012/163929] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 11/21/2012] [Indexed: 11/23/2022]
Abstract
Objective. To assess the efficacy of a low-dose oral isotretinoin in the treatment of plane warts. Patients and Methods. Thirty-one patients with recalcitrant facial plane warts were enrolled. A cumulative dose of 30 mg/kg for two months of treatment was calculated; this was equal to a mean of 0.5 mg/kg/day. Each patient was seen every two weeks during the treatment period. Response to treatment was either complete or no response. Patients with complete response were followed up monthly for four months to record the relapse rate. Results. Twenty-six patients completed the study; their ages range from 5 to 35 with a mean ± SD 15.28 ± 8.51 years. Fifteen (57.69%) patients were females and eleven (42.30%) were males. Nineteen (73.07%) patients showed complete response and seven (26.92%) patients showed no response at the end of two months of therapy. The difference was statistically significant; P value <0.0001. Fifteen (78.94%) out of nineteen patients, who had complete response, were still free from warts at the end of four-month followup. Conclusion. Oral isotretinoin is effective in the treatment of recalcitrant facial plane warts.
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Affiliation(s)
- Hayder R. Al-Hamamy
- Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Medical Collection Office, P.O. Box 61211, Baghdad 12114, Iraq
| | - Husam Ali Salman
- Department of Dermatology and Venereology, College of Medicine, University of Baghdad, Medical Collection Office, P.O. Box 61211, Baghdad 12114, Iraq
| | - Nawar A. Abdulsattar
- Department of Dermatology and Venereology, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq
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Dall'oglio F, D'Amico V, Nasca MR, Micali G. Treatment of cutaneous warts: an evidence-based review. Am J Clin Dermatol 2012; 13:73-96. [PMID: 22292461 DOI: 10.2165/11594610-000000000-00000] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Cutaneous warts are common skin lesions caused by human papillomavirus infection. Treatment is aimed at relieving the patient's physical and psychological discomfort and at preventing the spread of infection by autoinoculation. Among the available medical and destructive therapeutic options for cutaneous warts, none is uniformly effective or virucidal. Moreover, in most cases their safety and efficacy has not been assessed in double-blind, controlled clinical trials, so that the reproducibility of many of the listed treatments is difficult to evaluate and a possible placebo effect cannot be ruled out. The aim of this article is to describe the outcome of current therapies for each clinical wart type according to evidence-based medicine studies published in the literature. For each clinical form, the existing treatments are classified as first-, second-, and third-line therapy. First-line therapy includes medical treatments (salicylic acid, silver nitrate, glutaraldehyde) that are useful to treat a single wart or a few and/or small common warts of short duration (less than 1 year). If these treatments have failed or are contraindicated, cryotherapy may be considered as second-line therapy. For recurrent or difficult-to-treat lesions, third-line therapy includes a variety of alternative therapeutic options (topical, intralesional, systemic, and physical destruction) that are generally off-label (not US FDA approved), and whose use is limited by drawbacks or adverse effects. From pooled evidence-based medicine data, it is possible to conclude that significantly higher remission rates may be expected only with cryotherapy and salicylic acid used in combination.
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Alonso-Castro L, Boixeda P, Segura-Palacios JM, de Daniel-Rodríguez C, Jiménez-Gómez N, Ballester-Martínez A. Dermatofibromas treated with pulsed dye laser: Clinical and dermoscopic outcomes. J COSMET LASER THER 2012; 14:98-101. [PMID: 22384809 DOI: 10.3109/14764172.2012.671525] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Dermatofibroma (DF), a common benign skin tumour, sometimes requires treatment either because of cosmetic concern or for associated symptoms. However, no effective treatment with optimal cosmetic outcomes has been reported. An effective and safe therapeutic option could be treatment with pulsed dye laser (PDL). Twenty-two DFs in 15 patients were treated with PDL at 595-nm wavelength, using a spot size of 7 mm, a pulse duration of 2 ms and a fluence of 11 J/cm(2) with 2 or 3 stacked pulses. Clinical and dermoscopic photographs were taken before and after therapy. Global clinical improvement was higher than 50% in 12 lesions. Patient satisfaction assessment showed 73% of patients as satisfied or very satisfied. All lesions showed changes from the previous dermoscopic pattern. We consider that PDL could be a safe, palliative treatment as it is well accepted by patients and has a better cosmetic outcome than surgical excision.
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Affiliation(s)
- L Alonso-Castro
- Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain.
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Liu A, Moy RL, Ross EV, Hamzavi I, Ozog DM. Pulsed Dye Laser and Pulsed Dye Laser–Mediated Photodynamic Therapy in the Treatment of Dermatologic Disorders. Dermatol Surg 2012; 38:351-66. [DOI: 10.1111/j.1524-4725.2011.02293.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Oni G, Mahaffey PJ. Treatment of recalcitrant warts with the carbon dioxide laser using an excision technique. J COSMET LASER THER 2011; 13:231-6. [DOI: 10.3109/14764172.2011.606465] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Fernández-Guarino M, Harto A, Jaén P. Treatment of recalcitrant viral warts with pulsed dye laser MAL-PDT. J DERMATOL TREAT 2010; 22:226-8. [DOI: 10.3109/09546631003681078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
There are many causes of heel pain. Not all are characterized as plantar fasciitis or osseous pathology. Sometimes patients present with heel pain caused by a dermatologic entity. This article describes some of the most common pathologies.
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Affiliation(s)
- George F Wallace
- Podiatry Service, University Hospital - University of Medicine and Dentistry of New Jersey, 150 Bergen Street, G-142, Newark, NJ 07103, USA.
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Togsverd-Bo K, Gluud C, Winkel P, Larsen HK, Lomholt HB, Cramers M, Bjerring P, Haedersdal M. Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: A randomized clinical trial with blinded outcome evaluation. Lasers Surg Med 2010; 42:179-84. [DOI: 10.1002/lsm.20852] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Taniguchi Y, Ohshiro T, Ohshiro T, Sasaki K. PULSED DYE LASER TREATMENT FOR RECALCITRANT VIRAL WARTS: AUTO-SIMULTANEOUS LASER TREATMENT. Laser Ther 2010. [DOI: 10.5978/islsm.19.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Affiliation(s)
- Donna A Culton
- Department of Dermatology, University of North Carolina at Chapel Hill, NC 27599, USA.
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