Clinical effect of surgical removal combined with 5-aminolevulinic acid photodynamic therapy for plantar warts
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Abstract:
Objective
To observe the clinical efficacy of surgical operation combined with photodynamic therapy for plantar warts.
Methods
From July 2017 to June 2018, 16 patients with plantar warts were enrolled in the Department of Dermatology, the Fifth People's Hospital of Suzhou City. The enrolled patients aged 10 to 42 years, including 12 males and 4 females, with a course of 4 to 15 month, and a total of 47 plantar warts. The plantar warts was removed by surgical operation and bipolar coagulation, followed by the photodynamic treatment with 5-aminolevulinic acid for 3 to 4 times with an interval of 7-10 days.
Results
Eleven patients showed complete clearance after operation and three times photodynamic treatments, and the other 5 patients underwent 2 operations and four times photodynamic treatments. 47 plantar warts in 16 patients were disappeared completely during 6-month post-treatment follow up. The plantar warts clearance rate was 100%, and the skin texture still presented. In addition to local mild erythematous, pain and burning sensation presented after surgery, but no adverse reactions such as infection, ulcers and obvious scars occurred.
Conclusions
Surgery combined with 5-aminolevulinic acid photodynamic therapy is a favorable treatment for plantar warts.
Key words:
Metatarsus; Warts; Surgical procedures; Photodynamic therapy; Aminolevulinic acidKeywords:
Plantar warts
Many studies have been conducted showing that aminolevulinic acid (ALA)-photodynamic therapy (PDT) can be an alternative treatment for recalcitrant warts. Recently, we performed a study evaluating methyl-aminolevulinic acid (MAL)-PDT for the treatment of hand warts in a population of renal transplant patients. Two symmetrical targets were selected on each hand and randomly assigned to chemical keratolytic treatment followed by three cycles of ALA-PDT (75 J cm(-2) red light). Patients were evaluated after 3 months and a second run of PDT was performed if the total area and number of warts decreased less than 50%, with evaluation every 3 months for 1 year. Twenty patients were included and 16 were evaluable (9 M, 7 F). After 6 months the reduction of warts' area was 48.4% on the treated side versus 18.4% in the control area (P = 0.021). The decrease in the total number of warts was 41%versus 19.4% (P = NS). The global tolerance of the treatment was good with acceptable pain during irradiation. These results suggest that ALA-PDT is a safe and efficient treatment for transplanted patient warts. The improvement between treated and control zone is 20% due to the decrease in untreated warts' area and number.
Keratolytic
Common warts
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Objective To investigate the clinical efficacy of ALA photodynamic therapy(ALA-PDT) on periungual warts. Methods Altogether 19 patients with 46 lesions in the PDT group were treated with ALA-PDT while the patients in the control group being treated with cryotherapy.The warts clearance rates and side effects were evaluated 2 weeks after the last treatment.The recurrence rate was observed 3 months later. Results For the PDT group,41 lesions were removed completely after 3 times of treatment,indicating a clearance rate of 89.13%.Neither recurrence of warts nor severe side effect was found during the follow-up period of 3 months.On the other hand,the control group yielded a clearance rate of 61.90% and a recurrence rate of 15.38% in addition to a frequent occurrence of adverse reactions. Conclusions ALA-PDT was effective and safe in treating periungual warts.
Cryotherapy
Clearance rate
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Abstract Background Plantar warts are refractory to any form of treatment. High cure rates have been reported with a topical proprietary formulation consisting of 1% cantharidin, 5% podophyllotoxin and 30% salicylic acid (CPS). However, no data exists comparing the efficacy of this formulation with another treatment. Cryotherapy is a method that is also widely used in the treatment of plantar warts. Likewise, there is no evidence that it is more effective than any topical treatment. Objective We aim to compare the efficacy of topical CPS and cryotherapy in the treatment of plantar warts. Methods Patients with plantar warts were consecutively treated with either cryotherapy or topical CPS. Both treatments were performed every 2 weeks for up to five sessions. In patients without complete clearance, the therapy was switched to the other treatment option. Results Twenty‐six patients with a total of 134 warts were included. Fourteen patients were completely cleared of their warts with topical CPS, whereas only in five of 12 patients (41.7%) warts were completely cleared with cryotherapy ( P = 0.001). In seven patients without complete clearance, the therapy was switched to CPS. Four of these patients missed the follow‐up. While the two of the remaining three patients were cleared of their warts, one patient’s warts still failed to clear. Conclusion Topical CPS is more effective than cryotherapy in the treatment of plantar warts.
Cryotherapy
Plantar warts
Clearance
Cantharidin
Common warts
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Clearance
Erythema
Target lesion
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Objective:
To assess the efficacy of intralesional bleomycin in treating plantar warts.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Combined Military Hospital Lahore, from Jan 2015 to Sep 2015.
Material and Methods:
The study was conducted in Dermatology outpatient department, Combined Military Hospital Lahore, from Jan 2015 to Sep 2015. Total of 60 plantar warts in 20 patients were treated with 1 mg/ml intralesional injection of bleomycin. Patients received a total of four doses of bleomycin every three weeks, and were followed for next three months. We categorized the response to treatment as complete or partial resolution, and nonresponsive.
Results:
Out of 60 warts 46 warts (76.66%) showed complete resolution and 8 (13.33%) warts showed partial resolution (p<0.001). The cure rate was better in warts smaller than 20 mm in diameter in comparison with larger lesions. After six months follow-up, 3 (15%) of the completely resolved warts showed recurrence. Recurrence was more among those with greater number of warts.
Conclusion:
Intralesional bleomycin injections were found to be a reliable, safe and acceptable mode of treatment for plantar warts.
Plantar warts
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Background and objective: Plantar warts are hard, grainy growths that usually appear on the heels or balls of feet. Plantar warts are caused by the human papillomavirus, usually self-limiting, but treatment is generally recommended to lessen symptoms, decrease duration, and reduce transmission. The study aimed to evaluate the clinical effectiveness of topical 40% salicylic acid in comparison to cryotherapy in the treatment of plantar wart. Methods: This study was conducted from March 2015 to January 2016 on 70 patients with plantar wart who attended the consultation clinic of dermatology department in Rizgary teaching hospital. Patients were randomly allocated to two groups: cryotherapy treatment with liquid nitrogen every two or three weeks and self-application of salicylic acid daily. Results: Sixty patients aged 12 to 60 years were included in the analysis at 13 weeks. Cure rates were 66.7% in the cryotherapy group and 80% in the salicylic acid group. A significant association was found between the duration of wart before treatment and cure rates (P <0.001). Conclusion: No difference in effectiveness between cryotherapy and topical salicylic acid 40% in the treatment of plantar warts was found.
Plantar warts
Cryotherapy
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Plantar warts
Clearance
Foot (prosody)
Complete response
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Citations (1)
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.
Plantar warts
Common warts
Genital warts
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Objective To observe the effect of 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts. Methods Thirty two patients with recalcitrant facial flat warts were randomly divided into two groups,each group had 16 patients,the patients in the treatment group were treated with 5-alpha aminole-vulinic acid photodynamic therapy once a week for three weeks in total while 16 cases in the control group received topical Imiquimod cream once every two days for three weeks. The efficacy was compared between the two groups after 3 weeks. Results The cure rate of 5-aminolevulinic acid photodynamic therapy in recalcitrant facial flat warts was 100. 00% while the control group was 33. 33% ,There was a significant difference be-tween the two groups(P 0. 01) . Twelve patients in the treatment group had a slight pigmentation on the face which faded away within 2 months later. In the control group one patient withdrew from treatment due to obvious redness and swelling,eight cases with slight redness had not stopped treatment. None of the patients in the two groups had a recurrence in the follow-up. Conclusion Topical 5-aminolevulinic acid photodynamic therapy for recalcitrant facial flat warts has high safety and significant effect.
Cure rate
Imiquimod
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Cryotherapy
Plantar warts
Electrosurgery
Cryosurgery
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Citations (15)