Comparative study between potassium hydroxide 5% and liquid nitrogen in treatment of plane warts

Abstract

Background Plane wart is a common disease that is caused by human papillomavirus. Many modalities of treatments are introduced in practice, but none of them proved to be effective. Potassium hydroxide (KOH) solution is a keratolytic agent with many dermatological uses. Objective To compare between topical KOH solution and cryotherapy in the treatment of plane warts. Patients and methods Lesions in each patient were divided into two groups: group A was treated with topical 5% KOH solution once at night, whereas group B was treated with cotton bud method of cryotherapy once every 2 weeks. In group A, the lesions were evaluated at second and fourth week to assess the cure rates and adverse effects. In group B, the lesions were evaluated every 2 weeks for 6–12 weeks or until warts completely disappeared. Patients were followed up for 3 months after complete cure to detect any recurrence. Results Regarding the response between lesions of plane warts treated with KOH 5% (group A) and cryotherapy (group B), lesions in group A showed a complete response in 17 (56.7%) patients, partial response in seven (23.3%) patients, and no response in six (20.0%) patients, whereas lesions in group B showed a complete response in 16 (53.3%) patients, partial response in nine (30%) patients, and no response in five (16.7%) patients. There was a statistically significant difference between the two groups regarding the response rate. Adverse effects included itching, erythema, crust, scar formation, hypopigmentation, and hyperpigmentation. No statistically significant differences were reported regarding adverse effect, except for crust and scar formation. Regarding crust, a statistically significant difference was found (P<0.05), with a higher percentage in group B. Regarding scar formation, a statistically significant difference was found (P<0.05), with a higher percentage in group B.