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Journal of Evidence-based Medicine Sep 2022Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic...
AIM
Cutaneous warts caused by human papillomavirus are benign proliferative lesions that occur at any ages in human lives. Updated, comprehensive and systematic evidence-based guidelines to guide clinical practice are urgently needed.
METHODS
We collaborated with multidisciplinary experts to formulate this guideline based on evidences of already published literature, focusing on 13 clinical questions elected by a panel of experts. We adopted Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to form classification of recommendations as well as the improved Delphi method to retain respective recommendations with a consensus degree of over 80%.
RESULTS
Our guideline covered aspects of the diagnosis and treatment of cutaneous warts such as diagnostic gold standard, transmission routes, laboratory tests, treatment principle, clinical cure criterion, definitions, and treatments of common warts, flat warts, plantar warts, condyloma acuminatum, and epidermodysplasia verruciformis. Recommendations about special population such as children and pregnant women are also listed. In total, 49 recommendations have been obtained.
CONCLUSIONS
It is a comprehensive and systematic evidence-based guideline and we hope this guideline could systematically and effectively guide the clinical practice of cutaneous warts and improve the overall levels of medical services.
Topics: Child; Female; Humans; Papillomaviridae; Pregnancy; Warts
PubMed: 36117295
DOI: 10.1111/jebm.12494 -
International Journal of Environmental... Dec 2022Cutaneous warts are common lesions in children caused by the Human Papilloma Virus (HPV) and for most lesions spontaneously resolve within months of the initial... (Review)
Review
Cutaneous warts are common lesions in children caused by the Human Papilloma Virus (HPV) and for most lesions spontaneously resolve within months of the initial infection, regardless of treatment. The infection is most prevalent in the second decade of life affecting over 40% of children. Studies have demonstrated wart virus carriage on normal skin is higher in children with active lesions and family members. Subtypes HPV 2, HPV 27, HPV 57 and HPV 63 are particularly common in paediatric populations. Warts arising on the plantar surface of the foot (verrucae) can be particularly problematic owing to the location. They may interfere with daily activities causing pain and embarrassment. Plantar lesions have been shown to be more resistant to treatment than warts elsewhere on the skin. Systematic reviews and studies conducted over the last decade have demonstrated little evidence of innovation or effective improvements in treatment of recalcitrant lesions over the last 30 years. However, newer modalities such as immunotherapy (using injected vaccines) and hyperthermia using microwave treatment may hold promise in improving the treatment of these common and therapeutically frustrating lesions.
Topics: Humans; Child; Papillomavirus Infections; Foot Diseases; Warts; Skin; Papillomaviridae
PubMed: 36554279
DOI: 10.3390/ijerph192416400 -
Dermatologic Therapy Jan 2021There are a wide variety of treatments for plantar warts, but none has been shown to be effective in all patients. We aimed to perform a systematic review of the... (Review)
Review
There are a wide variety of treatments for plantar warts, but none has been shown to be effective in all patients. We aimed to perform a systematic review of the efficacy of different topical treatments on plantar warts. Systematic electronic searches (Pubmed, Cochrane Library, Embase, and Web of Science) were conducted in April 2020. Meta-analyses, systematic reviews, and retrospective or prospective clinical trials of the effects of topical and nonsurgical treatments of plantar warts were included. Two authors performed the study selection and data extraction. Any discrepancies between the two reviewers were discussed with a third reviewer. Forty-four studies were included. The average cure rates of the most frequent treatments were variable across the studies: cryotherapy (45.61%), salicylic acid (13.6%), cantharidin-podophyllin-salicylic acid formulation (97.82%), laser (79.36%), topical antivirals (72.45%), intralesional bleomycin (83.37%), and intralesional immunotherapy (68.14%). Twenty-two studies (50%) had a level of evidence 1b and grade of recommendation A, five studies (11.4%) had a level of evidence 2b and grade of recommendation B, two studies (4.5%) had a level of evidence 3b and grade of recommendation B, and 15 studies (34,1%) with a level of evidence 4 and grade of recommendation C. First-choice treatments for common warts, such as cryotherapy and salicylic acid, have low-cure rates for plantar warts. Other treatments, such as CPA formulation, immunotherapy, and intralesional bleomycin, which have compassionate use, have higher cure rates. This review should stimulate future high-quality research to evaluate these specialized treatments.
Topics: Cryotherapy; Humans; Prospective Studies; Retrospective Studies; Salicylic Acid; Warts
PubMed: 33263934
DOI: 10.1111/dth.14621 -
Primary Care Mar 2022Primary care physicians provide a wide variety of treatments and conditions affecting the foot. This article discusses the removal of toenails, both full and partial... (Review)
Review
Primary care physicians provide a wide variety of treatments and conditions affecting the foot. This article discusses the removal of toenails, both full and partial removal. Subungual hematoma/Subungual blistering evacuation as well as wart, corn, callus, and blister management will also be discussed.
Topics: Antifungal Agents; Foot Dermatoses; Humans; Nails; Onychomycosis
PubMed: 35125159
DOI: 10.1016/j.pop.2021.10.010 -
Clinics in Podiatric Medicine and... Oct 2021Traditionally, plantar warts or verrucae are often diagnosed by visual appearance and the lateral squeeze test. At times, these methods are not able to elucidate the... (Review)
Review
Traditionally, plantar warts or verrucae are often diagnosed by visual appearance and the lateral squeeze test. At times, these methods are not able to elucidate the difference between a plantar wart and a callus. The use of the dermatoscope can not only distinguish the difference between a wart and a callus, which ultimately helps to customize treatment plans to increase efficacy, but also be used to follow the therapeutic effects of treatment. The dermatoscope is a tool that can be used in the diagnosis of plantar verrucae and in assessment of the success of therapy.
Topics: Dermoscopy; Foot Diseases; Humans; Papillomaviridae; Warts
PubMed: 34538428
DOI: 10.1016/j.cpm.2021.06.003 -
Frontiers in Bioengineering and... 2022Microneedles have garnered significant interest as transdermal drug delivery route owing to the advantages of nonselective loading capacity, minimal invasiveness, simple... (Review)
Review
Microneedles have garnered significant interest as transdermal drug delivery route owing to the advantages of nonselective loading capacity, minimal invasiveness, simple operation, and good biocompatibility. A number of therapeutics can be loaded into microneedles, including hydrophilic and hydrophobic small molecular drugs, and macromolecular drugs (proteins, mRNA, peptides, vaccines) for treatment of miscellaneous diseases. Microneedles feature with special benefits for cutaneous diseases owing to the direct transdermal delivery of therapeutics to the skin. This review mainly introduces microneedles fabricated with different technologies and transdermal delivery of various therapeutics for cutaneous diseases, such as psoriasis, atopic dermatitis, skin and soft tissue infection, superficial tumors, axillary hyperhidrosis, and plantar warts.
PubMed: 36324904
DOI: 10.3389/fbioe.2022.1032041 -
Skinmed 2020Needling is a technique for the treatment of warts that is widely unknown and underused within dermatology. Gordon Falknor, a podiatrist, first introduced the technique... (Review)
Review
Needling is a technique for the treatment of warts that is widely unknown and underused within dermatology. Gordon Falknor, a podiatrist, first introduced the technique of needling for the treatment plantar warts in 1969. He reported only two recurrences in 126 patients treated with his technique. Falknor's technique involves using a hollow needle to repeatedly penetrate the base of a wart, into the subcutaneous tissue, until there is no longer resistance to puncturing. Needling causes extensive destruction of keratinocytes and the release of high levels of viral protein into the surrounding tissue. Deep penetration of this viral protein into the subcutaneous tissue increases the likelihood of developing a systemic immune response against the virus, which often results in the resolution of both satellite and distant warts in addition to the treated primary wart. Since Falknor's original study, there have been few studies on needling for warts. Despite the paucity of literature, needling appears to be a low-risk, inexpensive, and effective treatment for warts, especially in patients with extensive or refractory disease on the hands and feet.
Topics: Female; Humans; Male; Needles; Punctures; Treatment Outcome; Warts
PubMed: 32501791
DOI: No ID Found -
Acta Dermatovenerologica Alpina,... Dec 2023Skin warts are ubiquitous, self-limiting, benign neoplasms caused by human papillomaviruses (HPV). Several studies have investigated the prevalence and diversity of HPV... (Review)
Review
Skin warts are ubiquitous, self-limiting, benign neoplasms caused by human papillomaviruses (HPV). Several studies have investigated the prevalence and diversity of HPV types in the three main types of skin warts: common, plantar, and flat warts. Using different methodological approaches and diverse populations, several HPV types were detected in skin warts, but often the etiological link remained unconfirmed. This review addresses recently improved multiple strategies for investigating the presence of HPVs in skin warts, covering proper sampling techniques for HPV testing, choice of molecular method(s) for HPV detection, and assignment of the etiological causality of the tested skin wart to a causative HPV type using cellular viral load estimation. These novel approaches provide useful insight into the range of HPV types causing skin warts and support a refined understanding of their etiology. In addition, we conducted a literature review of the main studies examining HPV prevalence and genotype distribution in common warts, plantar warts, and flat warts. Finally, HPV type-specific histopathological patterns in skin warts are briefly discussed.
Topics: Humans; Papillomavirus Infections; Human Papillomavirus Viruses; DNA, Viral; Warts; Skin; Papillomaviridae
PubMed: 38126099
DOI: No ID Found