Estimating the Impact of Extragenital Warts versus Genital Warts on Quality of Life in Immunocompetent Indian Adult Patients: A Comparative Cross-Sectional Study

Topical antimitotic treatments for plantar warts are more beneficial: A Bayesian network meta-analysis of randomized controlled trials

BACKGROUND

Plantar warts are common infectious cutaneous growths causing severe physiological and psychological discomforts in patients and heaving global financial burdens. However, paucity of clear-cut guidelines for plantar warts, selecting appropriate treatments for plantar warts remains challenging. The objective of the study is to evaluate the efficacy and safety of common treatments for plantar warts.

METHODS

PubMed, EMbase, and The Cochrane Library were searched from inception to March 1, 2023 for randomized controlled trials (RCTs) of plantar warts. The primary outcome (complete response) and secondary outcome (recurrence and pain) were extracted and combined using Bayesian network meta-analysis (NMA) with random-effect and fixed-effect models.

RESULTS

Totally, 33 RCTs were included in the systematic review and quantitative NMA. In NMA of complete response, topical application of 1% cantharidin, 20% podophylotoxin, 30% salicylic acid (CPS), microneedles plus bleomycin (MNB), and intralesional bleomycin injection (INB) were the only three treatments significantly superior to no treatment (NT) and CPS was of the highest possibility to be the top-ranked treatment (SUCRA = 0.9363). However, traditional warts treatments, salicylic acid (SA) and cryotherapy were not superior to NT.

CONCLUSIONS

The NMA has produced evidence for using CPS, MNB, and INB, which are all topical antimitotic treatments, to improve the management of plantar warts. The classic treatment modalities for plantar warts, including SA and cryotherapy, may play a less important role in the clinical practice of plantar warts.

Estimating the Effect of Genital vs Extragenital Warts on Immunocompetent Indian Adult Patients; Quality of Life: A Comparative Cross-Sectional Study

Introduction

Extragenital warts, often known as EGWs, affect between 7% and 10% of the population. Despite the plethora of research on the impact of genital warts (GWs) on "Quality Of Life", EGWs have received little attention. The purpose of this study was to conduct a cross-sectional investigation with the objective of contrasting the effects of GWs and EGWs on the health-related quality of life and other characteristics.

Participants and Procedures

A cross-sectional clinical study was piloted at a tertiary care center. Participants in the study included two groups of healthy adults, each group consisting of 100 adult subjects. Those diagnosed with EGWs were included in group A, while patients diagnosed with GWs made up group B. The "Dermatology Life Quality Index" questionnaire was used to evaluate various parameters. Observations were compared for significance.

Results

The majority of the subjects in both the groups were observed to have less than 10 warts. The Dermatology Life Quality Index score for the EGWs had an average of 8.66 ± 2.31 score; GWs had an average of 5.12 ± 3.25. This mean variance was statistically significant. The level of the dissatisfaction was highly significantly different among the groups and the subjects being more in the EGW group dissatisfied.

Conclusion

The findings of this investigation indicate that EGWs have a significant and detrimental effect on the Quality Of Life. Medical experts must teach people how to prevent the disease's spread and recurrence due to its persistence. They must also consider the psychological and societal repercussions of the disease while discussing therapy choices.

Evaluation of Dermatology Life Quality Index, Depression-Anxiety-Stress Scores of Patients with Genital Dermatoses

Background

Genital dermatoses contain a group of diseases that affect the skin of the genital area. Genital dermatoses are classified as venereal and nonvenereal. They can affect a patient's life quality and can cause depression, anxiety and stress.

Aims

This study aimed to evaluate and compare the quality of life index, depression, stress and anxiety in patients with genital dermatoses.

Materials and Methods

Patients admitted to the dermatology outpatient clinic with genital skin complaints between October 2020 and March 2021 were included. A questionnaire including demographic information, a 10-item dermatology life quality index (DLQI) and a 21-item depression anxiety stress score (DASS-21) was filled out by the patients and was calculated.

Results

A total of 103 patients were included in this study. Seventy-seven (74.8%) were male and 26 (25.2%) were female. A total of 48.5% (n = 50) patients had venereal genital dermatoses, and 51.5% (n = 53) of the patients had nonvenereal genital dermatoses. In the venereal diseases, syphilis had the highest DLQI, depression, anxiety and stress score while in the nonvenereal diseases, scabies had the highest DLQI, depression, anxiety and stress score. In the nonvenereal group, the mean DLQI score, depression, anxiety and stress scores were statistically significantly higher than the venereal genital dermatoses group (P < 0.01, P = 0.04, P = 0.03 and P = 0.02).

Conclusion

The quality of life of patients with genital dermatoses is often poor, with significant levels of depression, anxiety and stress. We believe that screening these patients with DLQI and DASS-21 scores at their first admission and follow-up will benefit dermatologists and patients.

Comparison of the Efficacy of Intralesional 5-Fluorouracil/Lidocaine/Epinephrine Injection with Cryotherapy to Treat Common and Palmoplantar warts: a Randomized, Controlled Trial

Cutaneous warts are treated by different treatments with various efficacy. Intralesional injection of 5-fluorouracil (IL 5-FU) has been compared with placebo and a few other wart treatments. Our objective was to compare the efficacy of IL 5-FU injection with cryotherapy to treat common and palmoplantar warts. Forty-five patients with common and palmoplantar warts were treated with either IL 5-FU admixed with lidocaine and epinephrine (5-FU+LE) or cryotherapy, once weekly for six sessions. The patients were assessed for clinical response score, the thickness of warts, pain score, and quality of life in treatment sessions, two weeks and eight weeks after the last session. Nine patients (64.3%) in the 5-FU+LE group, and 5 patients (35.7%) in cryotherapy group experienced complete response (p=0.285). Both treatments caused improvement of clinical response score in the patients during the treatment time (p<0.001), but the efficacy of treatments was not significantly different (p=0.793). Changes in wart thickness were significantly more marked in the 5-FU+LE group compared to the cryotherapy group (p=0.021). The patients in the cryotherapy group experienced more severe pain compared to the 5-FU+LE group (p=0.011). The quality of life better improved in the 5-FU+LE group compared to the cryotherapy group (p = 0.02). To conclude, most of the patients that experienced complete clinical response had received 5-FU+LE injection, though the difference was not significant. However, 5-FU+LE injection accompanied less pain and caused more reduction in wart thickness and more improvement in quality of life compared to the cryotherapy.