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Cureus Jul 2022Acral amelanotic melanoma can be difficult to diagnose and is often clinically aggressive. The present report describes a case of an acral amelanotic melanoma presenting...
Acral amelanotic melanoma can be difficult to diagnose and is often clinically aggressive. The present report describes a case of an acral amelanotic melanoma presenting as a non-healing wound after mimicking a plantar wart for two years. The decision to biopsy a borderline-suspicious lesion on the lower extremity in an elderly individual must be weighed carefully, as lower extremity biopsy carries a risk of poor wound healing and other complications. We discuss clinical and epidemiologic features that can assist in deciding when to perform a biopsy in this setting and can improve the early detection of acral amelanotic melanoma.
PubMed: 35936139
DOI: 10.7759/cureus.26615 -
Infection and Drug Resistance 2022Verruca plantaris (plantar wart) is a type of benign feet hyperplasia that is caused by a human papillomavirus (HPV) infection. In this study, we aimed to assess the...
Verruca plantaris (plantar wart) is a type of benign feet hyperplasia that is caused by a human papillomavirus (HPV) infection. In this study, we aimed to assess the clinical efficacy underlying cantharidin cream in the treatment of Verruca plantaris compared to CO laser and liquid nitrogen cryotherapy. One hundred and fifty patients affected with Verruca plantaris were enrolled in this retrospective clinical study. The treatment efficacy rate in the three groups was assessed 4 and 12 weeks after treatment. After 4 weeks of treatment, 46 cases in the externally applied cantharidin cream therapy group were cured with an apparent efficiency of 92.0% (46/50). Contrarily, 42 cases in the CO laser group were cured with 84.0% (42/50) efficiency, while 40 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 80.0% (40/50). Although the clinical cure rate of Verruca plantaris in the Cantharidin group was greater than in the CO laser group and in the liquid nitrogen cryotherapy group, there were no statistical differences found among the three groups ( = 0.225). After 12 weeks of treatment, 43 cases in the external cantharidin cream therapy group were cured with an apparent efficiency of 86.0% (43/50). Similarly, 39 cases in the CO laser group were cured with an apparent efficiency of 78.0% (39/50), while 36 cases in the liquid nitrogen cryotherapy group were cured with an apparent efficiency of 72.0% (36/50). The statistical differences among the three groups were not found ( =0.230), but the resolution rate of warts in Cantharidin group was the highest among the three groups. The results from this study demonstrated that external cantharidin cream therapy could be served as an alternative treatment for Verruca plantaris.
PubMed: 35924013
DOI: 10.2147/IDR.S375384 -
Journal of Cosmetic and Laser Therapy :... Jul 2022Common warts (verruca vulgaris) are the most commonly seen benign cutaneous tumors occurring in both males and females of various ages. However, warts on the hands and...
Common warts (verruca vulgaris) are the most commonly seen benign cutaneous tumors occurring in both males and females of various ages. However, warts on the hands and feet (plantar warts and palmar warts) often respond poorly to traditional treatments such as topical salicylic acid, cryotherapy, surgical excision, electrocautery, and bleomycin injection. Recently, the long-pulsed 1064 nm Nd:YAG laser (LPNYL) has attracted attention in the treatment of palmoplantar warts. This study aims to evaluate the effectiveness of the LPNYL in the treatment of palmoplantar warts. We conducted a comparative cross-sectional descriptive study in 88 patients (49 males and 39 females) with palmoplantar warts. During the period from 2018 to 2020, the patients underwent up to three treatment sessions at intervals of 2-4 weeks between sessions. The LPNYL parameters comprised a spot size of 5 mm, 30 ms pulse width, 1 Hz repetition rate, and a fluence range of 140-180 J/cm. The patient mean age was 29.0 ± 14.5 years (range, 4-66 years). Good results were seen in 72.9% (64/88) of patients. The remaining 27.1% (24/88) felt their treatment was unsuccessful. As for adverse events, 5 (5.6%) patients reported hemorrhagic blistering after treatment. At the 3- and 6-month follow-up assessments, no recurrence was seen (Figures 2-4). Our study showed that the LPNYL treatment was safe and effective in the majority of palmoplantar warts. The duration of treatment was shorter than most traditional methods; however, the limitations of this method are that the treatment required several sessions, the procedure was painful, and adverse events occurred in just over 5% of the patients.
Topics: Male; Female; Humans; Adolescent; Young Adult; Adult; Cross-Sectional Studies; Warts; Lasers, Solid-State; Salicylic Acid; Cryotherapy; Treatment Outcome
PubMed: 35833729
DOI: 10.1080/14764172.2022.2050761 -
Photodiagnosis and Photodynamic Therapy Sep 2022In this work, we report the treatment of a patient with recalcitrant plantar warts with aminolevulinate photodynamic therapy (ALA-PDT), pretreatment with ozone water,...
In this work, we report the treatment of a patient with recalcitrant plantar warts with aminolevulinate photodynamic therapy (ALA-PDT), pretreatment with ozone water, and superficial shaving. Following a single treatment session, the lesions completely disappeared after three weeks and did not reappear during the two-year follow-up. Photodynamic therapy has been reported to be successful for plantar warts with a low recurrence rate, while ozone water is an emerging treatment for infectious skin diseases, which can modulate immunity without obvious side effects. Pretreatment with ozone water and superficial shaving before PDT is a potential new strategy for treating recalcitrant and large plantar warts.
Topics: Aminolevulinic Acid; Humans; Ozone; Photochemotherapy; Photosensitizing Agents; Treatment Outcome; Warts; Water
PubMed: 35716995
DOI: 10.1016/j.pdpdt.2022.102968 -
The Journal of Dermatological Treatment Nov 2022Microwaves are used in medicine for diagnostics, and treatment of cancer. Recently, novel microwave devices (Swift, Emblation Ltd, UK and miraDry, Miramar Labs Inc., CA)... (Review)
Review
BACKGROUND
Microwaves are used in medicine for diagnostics, and treatment of cancer. Recently, novel microwave devices (Swift, Emblation Ltd, UK and miraDry, Miramar Labs Inc., CA) have been cleared by the FDA and Health Canada for various dermatological conditions.
OBJECTIVE AND METHODS
To review the dermatological use of microwave-based treatments (plantar warts, corns, actinic keratosis, dermatophytosis, axillary hyperhidrosis, osmidrosis, and hidradenitis suppurativa). Clinical trials, case reports, or studies for each condition are summarized.
RESULTS AND CONCLUSION
Microwaves are a promising alternative therapy for cutaneous warts, actinic keratosis, axillary hyperhidrosis, and osmidrosis, with favorable safety profiles. However, patients with hidradenitis suppurativa have had negative clinical outcomes. Limited treatment of corns showed good pain reduction but did not resolve hyperkeratosis. A preliminary study indicated that microwave treatment inhibits the growth of . We present the first case of toenail onychomycosis successfully treated with microwaves. Despite the advancements in the use of microwaves, the mechanism of action in non-ablative treatment is not well understood; further research is needed. More high-quality randomized clinical trials with larger groups and long follow-up periods are also required to evaluate the clinical benefits and possible adverse effects of microwaves in treating dermatological conditions.
Topics: Humans; Microwaves; Hidradenitis Suppurativa; Keratosis, Actinic; Callosities; Dermatology; Hyperhidrosis; Warts; Sweat Gland Diseases; Technology; Treatment Outcome
PubMed: 35699665
DOI: 10.1080/09546634.2022.2089333 -
Medicina (Kaunas, Lithuania) Apr 2022Tea tree oil is an essential oil obtained by distillation from the leaves and terminal branchlets of and is now present in numerous products for body care and...
Tea tree oil is an essential oil obtained by distillation from the leaves and terminal branchlets of and is now present in numerous products for body care and self-medication. We report a case of allergic contact dermatitis to tea tree oil in a young man who was applying a lotion containing tea tree oil on a wart localized on the plantar aspect of the right big toe, which had previously been treated with cryotherapy. He developed a severe eczematous eruption on the right foot and the right leg, with subsequent id reactions affecting the right thigh, the contralateral lower limb, the trunk and the upper limbs. The lotion was discontinued, and the dermatitis resolved after topical corticosteroid therapy. Patch testing with the aforementioned lotion 10% pet. and oxidized tea tree oil 5% pet. identified tea tree oil as the culprit agent of the dermatitis. This case report confirms that products made of natural ingredients, often perceived to be harmless, can cause allergic reactions.
Topics: Dermatitis, Allergic Contact; Emollients; Humans; Male; Oils, Volatile; Patch Tests; Tea Tree Oil; Warts
PubMed: 35629978
DOI: 10.3390/medicina58050561 -
Journal of Foot and Ankle Research Apr 2022Verrucae pedis (verrucae / VPs) are a common viral infection of the skin seen in children. There are limited studies of the prevalence, duration and impact of verrucae...
BACKGROUND
Verrucae pedis (verrucae / VPs) are a common viral infection of the skin seen in children. There are limited studies of the prevalence, duration and impact of verrucae pedis in children who are immunosuppressed. The studies available suggest that, in these children, the warts are more widespread and are more long-standing. The primary aim of this study was to determine the prevalence of verrucae pedis in children attending rheumatology clinics who may have some degree of immunosuppression due to their prescribed medication and compare this to the reported prevalence in the healthy population.
METHOD
Children attending out-patient rheumatology appointments were recruited. The young people were aged between four and 17 years old. A visual inspection of both feet was used to identify potential verrucae. Diagnosis of a verruca pedis was confirmed on observation of the typical clinical features. The location, duration of presence, previous treatments, presence of verrucae in other family members and psychological impact was recorded.
RESULTS
A total of 71 children were included. Of the group, 55 children had no verrucae present, 16 children had one or more verrucae. The prevalence of verrucae was 22.5%. Medication impacting on the immune system was prescribed in 80% of the group. There appeared to be no greater chance of having verrucae if taking immunosuppressive medication than compared to having no medication (OR = 1.1, 95%CI 0.26 to 4.48, p = 0.46). Children with verrucae tended to be between 9 and 12 years old. In total, 37.5% of the young people with verrucae had lesions reportedly present for 24 months or more. Two-thirds of the participants were not concerned about verrucae being present and most participants with a verruca were not aware of what a verruca was, but despite this the majority of participants (81%) had sought treatment for the verrucae.
CONCLUSION
Children with Juvenile Idiopathic Arthritis and other rheumatic conditions have no greater prevalence of verrucae compared to the general population. The verrucae present were of a similar clinical type and did not seem to be more widespread or have atypical features, which has been reported in other immunocompromised populations. The percentage of lesions remaining beyond 24 months was found to be slightly greater than has been reported in other healthy populations. The children in this study seemed to be less emotionally concerned about their verrucae, despite this most families had sought treatment for the verrucae.
Topics: Adolescent; Arthritis, Juvenile; Child; Child, Preschool; Cross-Sectional Studies; Foot Diseases; Humans; Skin; Warts
PubMed: 35449072
DOI: 10.1186/s13047-022-00526-7 -
Dermatologic Therapy Jun 2022Recent systematic reviews of plantar warts continue to consider cryotherapy as one of the treatments of choice, but this method appears to have lower cure rates than... (Meta-Analysis)
Meta-Analysis
Recent systematic reviews of plantar warts continue to consider cryotherapy as one of the treatments of choice, but this method appears to have lower cure rates than alternative treatments. A systematic review using meta-analyses of the efficacy of cryotherapy in plantar warts treatment was performed. Systematic electronic searches were conducted. The primary endpoint was complete clearance of plantar warts. Risk-of-bias assessment was based on Cochrane Handbook recommendations. Meta-analyses used Review Manager v5.4.1 software. Cryotherapy appears to have lower cure rates than other treatments (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.12-0.78) with substantial heterogeneity (I = 80%). A second subgroup analysis had low heterogeneity (I = 28.2%). Subgroup analysis showed that plantar wart cure rates were significantly lower with cryotherapy compared to the physical treatment group (OR 0.05, 95% CI 0.01-0.49) with substantial heterogeneity (I = 79%), and antiviral, chemotherapy, and retinoid group (OR 0.30, 95% CI 0.14-0.66) without heterogeneity (I = 0%). Intralesional versus spray-on cryotherapy appears to be more effective (OR 0.21, 95% CI 0.09-0.48). No difference in efficacy between two rounds of 10-s and four rounds of 5-s freeze-thaw cycles in cryotherapy was found. Evidence of the superiority of antivirals and chemotherapy over cryotherapy in the treatment of plantar warts was found. However, no evidence supports the superiority or inferiority of cryotherapy compared to other treatments.
Topics: Antiviral Agents; Cryotherapy; Dermatologic Agents; Humans; Treatment Outcome; Warts
PubMed: 35365922
DOI: 10.1111/dth.15480 -
Journal of the American Podiatric... Dec 2021Acquired digital fibrokeratoma is a rare and benign fibrous tumor; it is usually asymptomatic, and frequently arises from the fingers. The diagnosis is easily confirmed...
Acquired digital fibrokeratoma is a rare and benign fibrous tumor; it is usually asymptomatic, and frequently arises from the fingers. The diagnosis is easily confirmed by pathologic evaluation. However, in some cases, it may be misdiagnosed as other benign conditions, mainly adnexal tumors and common warts, especially when located on the foot and toes. In this article, we report the case of a 45-year-old man who presented to our clinic for an acquired growth over the plantar surface of the second right toe. The tumor had evolved for 1 year and affected the patient's activities and mobility. On examination, the lesion was a dome-shaped, firm tumor with keratotic distal changes and a broad base attached to the overlying skin. Pathologic assessment was consistent with the diagnosis of acquired digital fibrokeratoma, ruling out other causes of abnormal growth. The tumor was completely excised with surgery, with excellent outcomes and no recurrence at follow-up. Although acquired digital fibrokeratoma is a rare condition, mostly located on the distal upper extremities and fingers, it should be considered in the differential diagnosis of plantar soft-tissue tumors. Surgical management remains the mainstay of treatment.
Topics: Foot; Humans; Keratosis; Lower Extremity; Male; Middle Aged; Skin Neoplasms; Toes
PubMed: 35294160
DOI: 10.7547/20-215 -
Dermatologic Therapy Jun 2022Treatment of recalcitrant plantar warts represent a highly challenging issue for both patients and physicians. Candida antigen and purified protein derivative (PPD) have...
Treatment of recalcitrant plantar warts represent a highly challenging issue for both patients and physicians. Candida antigen and purified protein derivative (PPD) have shown promising efficacy in the treatment of warts, however no previous studies have compared both antigens for recalcitrant plantar warts. To assess the efficacy and safety of intralesional Candida antigen versus intralesional PPD in the management of recalcitrant plantar warts. The study included 120 adult patients with multiple recalcitrant plantar warts. They were randomly assigned to one of three groups; Candida antigen, PPD, or normal saline. Injections into the largest wart were repeated every 2 weeks until clearance or for a maximum of five sessions. Complete wart clearance was reported in 33 patients (82.5%) of the Candida antigen group, in 22 patients (55.6%) of the PPD group, and in one patient (5%) of the control saline group. A statistically significant difference was found between the studied groups in favor of Candida antigen. Adverse effects were mild and insignificant in the three groups. Intralesional antigen immunotherapy by Candida antigen or PPD is a promising, safe, and cost-effective therapeutic option for multiple recalcitrant plantar warts, with statistically significant superiority of Candida antigen.
Topics: Adult; Antigens, Fungal; Candida; Humans; Immunologic Factors; Immunotherapy; Injections, Intralesional; Saline Solution; Treatment Outcome; Warts
PubMed: 35285995
DOI: 10.1111/dth.15440