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Journal of Medical Virology Jun 2021Cutaneous warts are infectious disorders caused by human papillomavirus (HPV). A recent study revealed that the HPV genotype influences the natural course and response...
Cutaneous warts are infectious disorders caused by human papillomavirus (HPV). A recent study revealed that the HPV genotype influences the natural course and response to treatment for plantar warts, suggesting that HPV genotyping could potentially be used to optimize wart treatment schemes. For this purpose, a wart-associated HPV genotyping assay was developed. The assay was subjected to an intensive validation process including, i.a., empiric determination of the annealing temperature, primer-probe optimization, evaluation of the analytical specificity and sensitivity, viral load quantification, and qualitative as well as quantitative analysis of intra-run repeatability and inter-run reproducibility. The newly developed assay was employed in a small-scale HPV genotyping study of wart biopsies (n = 50). The assay exhibited an analytical type-specific sensitivity and specificity of 100% (95% confidence interval [CI]: 83.9%-100%). The limit of quantification of the tested sequences corresponded to less than 17 viral copies/µl, while the limit of detection was less than 5 copies/µl. Very good to excellent agreements were gained between intra- and inter-run measurements (κ = 0.85-1.00) and coefficients of variation of the quantitative agreements were less then 3%. 22.5% (95% CI: 11%-39%) of the analyzed biopsies were negative for the tested HPV types, while 35% (95% CI: 21%-52%) contained multiple infections. The wart-associated HPV quantitative polymerase chain reaction assay was proven to be highly sensitive and specific. Multiple HPV infections were detected in 35% of lesions, contradicting the current literature claiming that in immunocompetent patients only 4%-16% of warts exhibit multiple HPV infections. This assay is qualified to be implemented in development of future genotype specific wart treatment strategies.
Topics: DNA, Viral; Genotype; Genotyping Techniques; Humans; Papillomaviridae; Papillomavirus Infections; Real-Time Polymerase Chain Reaction; Reproducibility of Results; Skin; Viral Load; Warts
PubMed: 33090508
DOI: 10.1002/jmv.26623 -
Cutis Aug 2022
Topics: Foot Diseases; Gout; Humans; Injections, Intralesional; Papillomavirus Vaccines; Symptom Flare Up; Warts
PubMed: 36219651
DOI: 10.12788/cutis.0595 -
Archives of Dermatological Research May 2024Plantar warts are common skin lesions that continue to represent a therapeutic challenge. They are still resistant to therapy and are highly recurrent, despite the...
Plantar warts are common skin lesions that continue to represent a therapeutic challenge. They are still resistant to therapy and are highly recurrent, despite the diverse number of treatments available. Therapies targeting vasculature, such as pulsed dye laser, have been used successfully in the treatment of plantar warts. Polidocanol, a detergent sclerosant approved for the sclerotherapy of incompetent and dilated saphenous veins, has also been used as an off-label therapy for a wide range of skin conditions with vascular components such as hemangiomas and pyogenic granuloma. The current, open-label, prospective, pilot study aimed to evaluate the safety and efficacy of the intralesional polidocanol 3% in the treatment of plantar warts. Twenty patients (11 females and 9 males), with plantar warts, aged 12-50 years received biweekly sessions of intralesional polidocanol 3% until complete clearance or for a maximum of 6 sessions. Response to treatment was graded as complete (100% clearance), partial (50-99%), and no response (< 50%). At the end of the study, 12 (60%) patients achieved complete clearance of their warts after 1-5 sessions, 5 (25%) patients had only partial response, and 3 (15%) patients did not achieve any clearance of their warts. The procedure was largely tolerable by patients. Pain at the injection site and bruises were reported by 9 (45%) and 2 (10%) patients, respectively. Both side effects resolved spontaneously and completely within a few days. The findings of the current study suggest that intralesional injection of 3% polidocanol in biweekly sessions may be a safe, effective, and tolerable method for the treatment of plantar warts.
Topics: Humans; Polidocanol; Pilot Projects; Female; Male; Adult; Sclerotherapy; Warts; Adolescent; Middle Aged; Treatment Outcome; Injections, Intralesional; Young Adult; Sclerosing Solutions; Prospective Studies; Child
PubMed: 38787466
DOI: 10.1007/s00403-024-02939-9 -
Acta Dermatovenerologica Alpina,... Mar 2021Many therapeutic modalities have been used for management of plantar warts; however, no optimal treatment with high efficacy and no or low recurrence has been explored... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Many therapeutic modalities have been used for management of plantar warts; however, no optimal treatment with high efficacy and no or low recurrence has been explored to date. Intralesional immunotherapy has shown promising results in the treatment of different types of warts.Here we compare the efficacy of Candida albicans-specific antigen versus measles, mumps, and rubella (MMR) vaccine for treatment of plantar warts by intralesional injection.
METHODS
Sixty patients with refractory or recurrent plantar warts were randomly divided into two equal groups. Group A was treated with C. albicans antigen and Group B with MMR vaccine. Both groups were injected intralesionally in a single wart every 3 weeks until complete clearance of the wart or for a maximum of five sessions. The patients were followed up for an additional 2 months.
RESULTS
C. albicans antigen yielded a statistically significant higher cure rate (80,0%) than MMR vaccine (26.7%) in the treatment of plantar warts through a mean of 3.98 sessions versus 4.24 sessions, respectively (p = 0.002), and both modalities were well tolerated, with no remarkable side effects and no recurrence in cured patients during follow-up.
CONCLUSIONS
Intralesional C. albicans antigen injection is an easy and effective treatment tool for plantar warts, even resistant and recalcitrant ones, with no post-procedural downtime and only transient occasional side effects. MMR vaccine is thought to be less effective.
Topics: Candida albicans; Humans; Injections, Intralesional; Measles; Measles-Mumps-Rubella Vaccine; Mumps; Treatment Outcome; Warts
PubMed: 33765749
DOI: No ID Found -
Indian Dermatology Online Journal 2021Warts are benign proliferations of keratinocytes caused by Human Papilloma Virus (HPV). Plantar warts are caused by HPV types 1, 2, 4, 27 and 57. It is challenging to...
BACKGROUND
Warts are benign proliferations of keratinocytes caused by Human Papilloma Virus (HPV). Plantar warts are caused by HPV types 1, 2, 4, 27 and 57. It is challenging to treat them due to frequent recurrences.
AIM
To compare the efficacy and safety of topical 5% 5-Fluorouracil (5-FU) with needling versus 30% Trichloroacetic acid (TCA) with needling in the treatment of plantar warts.
MATERIALS AND METHODS
Sixty consecutive patients of plantar warts were randomly allocated into two groups of 30 each and treated with either 30% TCA with needling or 5% 5-FU with needling once in four weeks, until complete clearance of warts or for a maximum of three sessions. Baseline clinical photographs were taken and subjective response at the end of treatment was recorded. Objective assessment at 4, 8, and 12 weeks was carried out and outcome was evaluated by reduction in number and size of warts. Adverse effects of each group were noted and compared. Follow-up of patients was done at 6 months for clinical assessment of results and to study recurrence.
RESULTS
Out of 30 patients in 30% TCA group, 28 patients (93.33%) had complete response and 02 patients (6.66%) had partial response at the end of 12 weeks. In 5-FU group, 26 patients (86.66%) showed complete response, 02 patients (6.66%) had partial response, and 02 patients (6.66%) had no response to treatment. The mean reduction in size and number of warts was better in the TCA group and was significant at 4 week of follow up while at the end of 8 week and 12 week, the response was identical. There was no recurrence of warts in the complete responders at the end of 6 months. The main adverse effect seen in both groups was pain at the needling site.
CONCLUSION
Needling with both topical 5% 5-FU and 30% TCA are highly effective in clearing plantar warts. However, 30% TCA has the advantage of early action and complete clearance of plantar warts with fewer adverse effects.
PubMed: 34211907
DOI: 10.4103/idoj.IDOJ_507_20 -
Dermatologic Therapy Nov 2022Plantar warts continue to represent a therapeutic challenge due to treatment resistance and high recurrence rates. Intralesional methotrexate, a cytotoxic...
Plantar warts continue to represent a therapeutic challenge due to treatment resistance and high recurrence rates. Intralesional methotrexate, a cytotoxic chemotherapeutic agent with in-vitro anti-viral properties has been used for many dermatological indications. Two previous studies evaluated intralesional injection of diluted methotrexate (in 0.5, 1, and 2 mg/ml dilutions) in the treatment of warts and found it poorly effective. The concentrations used in these studies were much lower than those used for other indications. The current, open-label, prospective, pilot study aimed to evaluate the safety and efficacy of the intralesional injection of full concentration (25 mg/ml) methotrexate in the treatment of plantar warts. Twenty patients with plantar warts, 10 (50%) males, and 10 (50%) females, with mean ± SD age of 28.45 ± 8.66 years (range, 18-46 years) received biweekly sessions of intralesional methotrexate (25 mg/ml) until complete clearance or for a maximum of 6 sessions. Complete clearance of warts was achieved in 2 (10%), 6 (30%), and 7 (35%) patients after 4, 5, and 6 sessions, respectively. Another 8 (40%) patients showed partial improvement after 6 sessions. The response rate did not correlate significantly with the number of warts. Nine (45%) patients did not report any side effects. Pain and bruises were reported by 8 (40%) and 6 (30%) patients, respectively. These findings suggest that biweekly sessions of full (25 mg/ml) concentration of methotrexate are a safe and effective treatment for plantar warts. It may be considered an alternative line of treatment for resistant cases.
Topics: Male; Female; Humans; Adolescent; Young Adult; Adult; Middle Aged; Pilot Projects; Methotrexate; Prospective Studies; Warts; Injections, Intralesional; Treatment Outcome
PubMed: 36101002
DOI: 10.1111/dth.15815 -
The Journal of Dermatological Treatment May 2020The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in... (Comparative Study)
Comparative Study
The aim of this study was to assess the efficacy of combination between microneedling with dermapen and topical bleomycin in the treatment of plantar warts in comparison with intralesional bleomycin and intralesional saline (placebo). Fifty-four patients were assigned into three groups, each containing 18 patients. The first group treated by micro-needling phenotype with topical bleomycin at 2 weeks interval, the second group received intralesional bleomycin at 3 weeks interval and the control group was intralesional saline for a maximum of four weeks. Complete clearance of warts in 16 patients in the micro-needling group (88.9%) versus 15 patients (83.3%) in the intralesional bleomycin group versus one patient (5.6%) in the control group. Microneedling assisted topical bleomycin spraying seems to be a promising effective and noninvasive therapeutic modality for recalcitrant plantar warts that facilitates delivery and absorption of bleomycin into the lesion.
Topics: Adolescent; Adult; Antibiotics, Antineoplastic; Bleomycin; Cryotherapy; Female; Foot Diseases; Humans; Injections, Intralesional; Male; Middle Aged; Needles; Warts; Young Adult
PubMed: 31096794
DOI: 10.1080/09546634.2019.1612837 -
Photodiagnosis and Photodynamic Therapy Apr 2024Plantar wart is one of the most recalcitrant types of cutaneous warts with a high recurrence rate. Recalcitrant plantar warts are resistant to traditional treatments... (Review)
Review
Plantar wart is one of the most recalcitrant types of cutaneous warts with a high recurrence rate. Recalcitrant plantar warts are resistant to traditional treatments such as cryotherapy. Photodynamic therapy (PDT) is a modern, non-invasive method utilized to treat benign and malignant skin disorders. Several previous studies have reported the effective application of PDT treatment for plantar warts. We reported three cases of recalcitrant plantar warts successfully treated with PDT.
Topics: Humans; Warts; Photochemotherapy; Photosensitizing Agents; Male; Female; Aminolevulinic Acid; Adult; Treatment Outcome; Young Adult; Foot Dermatoses
PubMed: 38614271
DOI: 10.1016/j.pdpdt.2024.104087 -
International Journal of Environmental... Jan 2022Cutaneous plantar warts may be treated using several optional methods, with the use of laser surgery having increased in the last few years. This work examined the...
Cutaneous plantar warts may be treated using several optional methods, with the use of laser surgery having increased in the last few years. This work examined the efficacy of laser treatment combined with simple cooling to reduce pain. The cure rate was approximately 84%. There were no significant differences in the efficacy of treatment for different viral genotypes. The laser parameters were 500 msec pulses, 30 W of power, and a fluence of 212 J/cm delivered in up to four sessions. Successful treatment was achieved after an average of 3.6 sessions.
Topics: Foot Diseases; Genotype; Humans; Laser Therapy; Lasers; Treatment Outcome; Warts
PubMed: 35055623
DOI: 10.3390/ijerph19020801 -
Dermatologic Therapy Jul 2020Plantar warts can cause pain near the toes and the sole of the foot and may result in referral for treatment. This study was aimed at comparing 40% trichloroacetic acid... (Randomized Controlled Trial)
Randomized Controlled Trial
Plantar warts can cause pain near the toes and the sole of the foot and may result in referral for treatment. This study was aimed at comparing 40% trichloroacetic acid (TCA) and cryotherapy (Cryo) for the treatment of plantar warts. This single-blind, randomized clinical trial was performed on 60 subjects presenting with plantar wart in Sabzevar, Iran in 2018. The first intervention group was treated with 40% TCA in four sessions within 4 weeks. The second intervention group was treated with Cryo using liquid nitrogen in four sessions within 8 weeks. The mean (SD) age of subjects was 20.16 ± 5.96 years and 68.33% (n = 41) were male. Although the resolution rate of warts in the TCA 40% group was greater than the Cryo group, there was no statistical association found between the two groups by adjusting age, sex, and basal time (P = .648). Findings suggest that although 40% TCA was almost as effective as Cryo in the treatment of plantar warts, considering the lower adverse effects of TCA 40% group as compared to the Cryo group, it could be a proper alternative.
Topics: Adolescent; Adult; Cryotherapy; Female; Humans; Iran; Male; Single-Blind Method; Treatment Outcome; Trichloroacetic Acid; Warts; Young Adult
PubMed: 32396250
DOI: 10.1111/dth.13559