Warts Research Articles

Long Pulsed Nd-YAG Lasers versus Q Switched Nd-YAG Lasers in the treatment of recalcitrant Plantar Warts - Comparative Randomized Study

Long Pulsed Nd-YAG Lasers versus Q Switched Nd-YAG Lasers in the treatment of recalcitrant Plantar Warts - Comparative Randomized Study

Characteristic phenotypes of ADH5/ALDH2 deficiency during childhood

ADH5/ALDH2 deficiency is a rare inherited syndrome characterized by short stature, microcephaly, delayed mental development, and hematopoietic dysfunction and has recently been proposed as a disease paradigm. Acute and severe presentations include aplastic anemia, myelodysplastic syndrome, or leukemia, requiring bone marrow transplantation during childhood. Conversely, non-hematological manifestations may exhibit a prolonged and nonspecific clinical trajectory, with growth failure and developmental delay, most of which are often overlooked, particularly in patients with milder symptoms. Here, we describe the clinical course of a girl with a wide spectrum of clinical presentations, including nonspecific hematopoietic disorders, growth retardation, mild developmental delay, amblyopia, hemophagocytic lymphohistiocytosis, and verruca vulgaris, culminating in a genetic diagnosis of AMeD syndrome at 12 years of age. We also summarized the clinical manifestations of previously reported cases of AMeD syndrome. Cumulatively, 13 females and 5 males have been documented, with a cardinal triad of symptoms, aplastic anemia, short stature, and intellectual disability. Additional characteristic observations included pigmentary deposition in approximately half of the cases and skeletal difficulties in one-quarter. We propose that early diagnosis of patients who exhibit relatively mild phenotypes of skin or skeletal lesions is important for managing and improving the quality of life of patients with AMeD syndrome.

Wet table salt and its saturated hypertonic solution for treating retinoic acid resistant plane viral warts on face.

Plane viral warts on the face can be difficult to treat at times. Various treatment approaches for facial viral warts have had variable degrees of effectiveness. In contrast, the majority of existing treatments are more costly, painful, and difficult to manage. In approximately 15.6% of instances, retinoic acid (0.05%) is also ineffective. It is very difficult to cure warts on the face at a young age. In pyogenic granuloma, table salt (NaCl) is useful as a sclerosing agent, and its hypertonic solution (15%) is effective in prolabial mucoceles. The aim of treating viral warts is to necrose infected cells and sclerose or thrombose their feeding capillaries at the wart's base.

Comparative Study between the Efficacy of Intralesional Injection of Platelet Rich Plasma versus Topical Zink Oxide Paste 20% in the Treatment of Common Warts

Comparative Study between the Efficacy of Intralesional Injection of Platelet Rich Plasma versus Topical Zink Oxide Paste 20% in the Treatment of Common Warts

Efficient Skin Lesion Detection using YOLOv9 Network

Skin lesion detection plays a crucial role in dermatological diagnosis and treatment. In this study, we propose an efficient approach for skin lesion detection using the YOLOv9 network. Leveraging state-of-the-art deep learning techniques, our model demonstrates robust performance in accurately identifying various skin lesion types, including acne, atopic dermatitis, keratosis pilaris, leprosy, psoriasis, and wart. We conducted comprehensive experiments using a curated dataset comprising 2721 training images, 288 validation images, and 145 test images. The model was trained and evaluated based on standard metrics such as Precision, Recall, and mean Average Precision (mAP). Our results indicate promising detection accuracy, with an overall Precision of 60.5%, Recall of 86.0%, and an mAP of 81.4%. Class-wise analysis reveals varying levels of performance across different disease classes, highlighting the model's proficiency in detecting common dermatological conditions such as acne and wart lesions. Furthermore, we provide insights into potential challenges and limitations, including dataset size and class imbalance, and discuss avenues for future research to address these issues. Our study contributes to the advancement of AI-driven solutions for dermatological diagnosis and underscores the efficacy of the YOLOv9 network in skin lesion detection

Progress in the treatment of Cutaneous warts

Viral warts are caused by HPV infection and result in the formation of benign proliferative lesions in humans. The diagnosis of viral warts is relatively simple and can be made on the basis of lesion characteristics, physical examination, laboratory tests and histopathology. Clinically, warts can be classified as common warts, flat warts, plantar warts, condyloma acuminatum and epidermodysplasia verruciformis. As warts tend to recur during treatment, a combination of treatments is more likely to prevent recurrence. This article is a review of advances in the treatment of warts. The aim of this article is to provide guidance to more dermatology clinicians to better understand the optimal choice of clinical treatment for warts.

Prevalence of oral papillomas in Brazilian children: a retrospectivestudy of biopsied lesions

Introduction: Human papillomavirus (HPV) is an etiologic factor for several diseases of the oralmucosa and skin that can undergo a malignant process. Vaccination is the most important form of prevention, with girls being vaccinated between the ages of 9 and 13 and boys between the ages of 11 and 13. There is still no consensus on the prevalence of the HPV virus in children. Aim: To review the prevalence of HPV in children aged 1 to 13 years based on a database of reports of biopsied lesions diagnosed with papilloma analyzed in a national reference laboratory. Material and methods: Anatomic-pathologic reports of biopsies received at the Oral and Maxillofacial Pathology Laboratory of the Faculty of Dentistry of the College of São Paulo were analyzed over a 20-year period, between 2002 and 2022. Information on gender, lesion location and diagnostic hypotheses was also collected. Results: In a database of 93,950 reports, the age group analyzed accounted for 4,203 and 99 (2.3%) were diagnosed with papilloma. The proportion of male and female reports was similar at 50.5% and 49.5% respectively. The most common location of the lesion found was the lip region (48%). The most frequently cited diagnostic hypotheses were epulis and verruca vulgaris. Conclusion: The prevalence of papillomas in Brazilian children aged 1 to 13 years was 2.3%. Early diagnosis and advice on HPV vaccination can prevent and avoid exacerbation of the disease. Recognizing the clinical features of lesions is essential for correct diagnosis and early intervention and counseling.

Amelanotic melanoma masquerading as a plantar wart: A case report and review

A 69-year-old male presented with asymptomatic skin coloured, exophytic, verrucous plaque on right sole of three months duration. He had been diagnosed as a plantar wart and treated with chemical destructive methods. Biopsy from the lesion showed infiltrate of nests of atypical melanocytes extending upto reticular dermis. The malignant cells were positive for S100 and human melanin black 45(HMB 45) with a high MiB-1 proliferative index thus confirming diagnosis of amelanotic melanoma (AM). We report this case to highlight the atypical presentation of amelanotic melanoma, the possibility of misdiagnosis and the importance of immunohistochemistry in diagnosing the same.

Rapid Recovery of One-Sided Verruca Vulgaris (Common Wart) with Homoeopathic Treatment: A Case Report

Abstract Background Verruca vulgaris or common wart is a very common dermatological condition resulting from human papillomavirus infection affecting epithelial tissues of the skin and mucous membrane. Only destructive therapies are available in modern medicine for the treatment of such conditions. Case The case was reported at a health camp with warts on the right hand. The patient did not manifest many symptoms in the initial case recording, but on further skilful enquiry elicited symptoms which helped in the selection of remedy. Adequate patience and timely repetition of remedies helped to recover the lesion within 58 days of initiation of treatment. Conclusion Warts are a very common condition reporting at the clinic of homoeopathic physicians expecting a recovery in a mild manner. This case reports that such a condition can be efficiently treated rapidly by homoeopathy.

Therapeutic Effects of Intralesional Injection of Vitamin D3 in Treatment of Recalcitrant Warts: An Evaluator-Blinded Clinical Trial

Background: Viral warts are a prevalent infection that affects people all over the world. Unfortunately, there is no proven antiviral treatment for them. Recalcitrant warts are also difficult to resolve and deciding on a strategy for their treatment is challenging. Recently immunotherapy modalities have led to desired treatment outcomes in patients. This study investigated the efficacy of vitamin D injection (as an immunotherapeutic agent) in the treatment of recalcitrant warts. Methods: In this clinical trial study, 40 patients were divided into two groups: the first group (intervention group) received cryotherapy with an intralesional injection of vitamin D3 (0.1 cc of vitamin D3 (300000 IU/1mL) per lesion and a maximum of 0.5 cc per session), and the second group (control group) received just cryotherapy. In each treatment session, patients were evaluated for treatment responses and any side effects. Each patient received four treatment sessions at 2-week intervals. Results: After 4 treatment sessions, the rate of response in the intervention group and the group that received just cryotherapy was 95.33%±5.87 and 76.67%±25.14, respectively, and this difference was significant (P<0.01). Furthermore, 57% (26 out of 45) of the lesions in the intervention group were completely resolved after 4 sessions, and the rest showed a moderate response to this treatment. Moreover, the minimum response rate was 80% in the intervention group and 30% in the control group. Conclusion: In recalcitrant skin warts, intralesional injection of vitamin D3 combined with cryotherapy significantly increased the treatment response and reduced the financial burden imposed on patients. The limitation of this trial was the small sample size of patients without a follow-up plan after completing the treatment sessions. Trial registration: The Iranian Registry of Clinical Trials registered this study (identifier: IRCT20200513047434N1).

Verrulyse Methionine® as Monotherapy in Children and Adolescents With Common Warts.

Common cutaneous non-genital viral warts are a common skin infection with significant morbidity in the pediatric population. Although various therapeutics are available, many of them necessitate recurrent patient visits and may be associated with significant irritation and pain. Verrulyse Methionine® (VM), a nutritional supplement, was previously suggested as a non-invasive treatment option for the disease. To assess the response to oral VM supplement as a monotherapy in a cohort of children and adolescents with multiple, non-genital viral warts after failing previous treatments. We reviewed medical records of pediatric patients (<18 y/o) with viral warts treated with VM between 2010 and 2021. Among 25 patients with multiple verrucae vulgaris lesions who failed previous treatments, 14 (56%) had complete or almost-complete response to VM within 4 months, after an average of 18 months of active disease prior to VM treatment initiation. None of the 4 patients with verruca plana had response to VM treatment. Favourable cosmetic results were found in responders, and no adverse events were recorded. Response rates in our cohort are comparable to those reported in the literature for destructive local therapeutics for viral warts. Thus, our data suggest that VM may be considered for children with multiple verrucae vulgaris, providing a painless and non-invasive therapeutic option for this common disease.

Superficial radiotherapy (SRT-100) for refractory plantar warts: An alternative noninvasive treatment strategy.

Verrucas that occur on the soles of the feet are called plantar warts, most of which can recur repeatedly and are difficult to eradicate. Hypertrophic and refractory plantar warts are often accompanied by pain and discomfort, which cause many inconveniences in patients' daily lives. This study aimed to analyze the therapeutic effect of superficial radiotherapy (SRT-100) on refractory plantar warts and further create favorable conditions for the subsequent treatment of this disease with a high recurrence rate. A retrospective analysis was conducted for refractory plantar warts treated with superficial radiotherapy in our outpatient department from January to June 2023. A total of 30 patients were included in our study (median age, 33 years). The female-to-male ratio was 1:3.29. Two to six months after radiotherapy, all of the warts subsided in 23 (76.67%) patients, most of the warts subsided in 4 (13.33%) patients, 3 (10%) patients did not respond to treatment, and 7 (23.33%) patients had recurrent or new warts after their warts subsided. Most patients with refractory plantar warts improved after superficial radiotherapy. Our study presented that men are more susceptible to plantar warts than women, and young and middle-aged people are the main population affected by the disease. Superficial radiotherapy is an effective treatment for refractory plantar warts, which can quickly remove the warts in a short period. It is safe and noninvasive, with minimal adverse reactions. Some patients relapse after the lesion is clear, and superficial radiotherapy can create favorable conditions for the subsequent treatment of viral warts in clinical practice.

Autoinoculation Therapy for the Treatment of Widespread Cutaneous Warts.

Cutaneous warts are common lesions that are often unresponsive to various therapeutic modalities. To assess the role of autoinoculation therapy in the treatment of widespread cutaneous warts. This interventional study included patients with widespread skin warts who did not respond to conventional treatments. Two methods were used to perform the autoinoculation therapy. The first procedure was performed by obtaining a small piece of the wart and inoculating it into a subcutaneous pocket. The second method was developed by the investigator and was performed by inserting a needle into the center of the wart toward the nearby subcutaneous tissue, with multiple forward and backward movements in several directions around the lesion. The prospective study included 23 patients. The illness duration ranged from 3 months to 5 years. Autoinoculation interventions revealed full recovery of all warts in 20 cases (87%) within 20 to 90 days (mean: 40.7 days). Autoinoculation procedures demonstrated effectiveness, less cost, lesser pain, less invasiveness, without leaving skin scars in comparison with other conventional therapies.

Topical antimitotic treatments for plantar warts are more beneficial: A Bayesian network meta-analysis of randomized controlled trials.

Plantar warts are common infectious cutaneousgrowths causing severe physiological and psychological discomforts in patients and heaving global financial burdens. However, paucity of clear-cut guidelines for plantar warts, selecting appropriate treatments for plantar warts remains challenging. The objective of the study is to evaluate the efficacy and safety of common treatments for plantar warts. PubMed, EMbase, and The Cochrane Library were searched from inception to March 1, 2023 for randomized controlled trials (RCTs) of plantar warts. The primary outcome (complete response) and secondary outcome (recurrence and pain) were extracted and combined using Bayesian network meta-analysis (NMA) with random-effect and fixed-effect models. Totally, 33 RCTs were included in the systematic review and quantitative NMA. In NMA of complete response, topical application of 1% cantharidin, 20% podophylotoxin, 30% salicylic acid (CPS), microneedles plus bleomycin (MNB), and intralesional bleomycin injection (INB) were the only three treatments significantly superior to no treatment (NT) and CPS was of the highest possibility to be the top-ranked treatment (SUCRA=0.9363). However, traditional warts treatments, salicylic acid (SA) and cryotherapy were not superior to NT. The NMA has produced evidence for using CPS, MNB, and INB, which are all topical antimitotic treatments, to improve the management of plantar warts. The classic treatment modalities for plantar warts, including SA and cryotherapy, may play a less important role in the clinical practice of plantar warts.

A Randomised Single Blind Control Study to Explore Clinical Potential of Homoeopathic Remedy “Calcarea Calcinata” 30 C in Management of Common Warts

Warts are benign skin growths that can occur on different body areas, in various forms and are common around the world, affecting about 10% of the population. Homoeopathy offers wide range of treatment for warts. Even though individualization and dominating miasm are the cornerstones of Homoeopathic treatment, cases might become one-sided when there are few symptoms. In such cases remedies having affinity for warts can be used for treatment. One such remedy mentioned in Clarks Dictionary of Materia Medica, is Calcarea Calcinata. This study was conducted to evaluate the effectiveness of Calcarea Calcinata, in treating common warts for period of 6 months. The results validated the alternative hypothesis, which states that Calcarea Calcinata is a useful treatment for common warts. Keywords: Calcarea Calcinata, Warts, Verrucae, Randomised Single Blind Control Study, Homoeopathy

A Rare Case of Verruca Vulgaris Lip and its Surgical Management

Oral verruca vulgaris also known as viral papilloma has been commonly associated with human papillomavirus (HPV) 6 and 11, is a rare lesion. We present a rare case of large sized verruca vulgaris over lower lip mucosa associated with other leukoplakia lesions. A 60-years-old male patient , a tobacco chewer presented with complaint of growth on lower lip for the last 8 months. On Intra oral examination, a single 5 X 3 cms well defined hyperkeratotic grayish-white lesion was found with multiple long papillary projections on the mucosal surface of lower lip . Histopathological examination was suggestive of Verruca Vulgaris. Surgical excision of the lesion with safe margins was carried out. Reconstruction was done using inferiorly based left sided Nasolabial flap. Oral Verruca Vulgaris is a rare lesion which requires a timely diagnosis and treatment to provide asthetically and functionally better outcomes.

Effectiveness of Oral Zinc Therapy as an Adjunct to Intralesional Measles, Mumps, and Rubella Vaccine in Patients of Verruca Vulgaris

Abstract Background: Verruca vulgaris (VV) is caused by human papillomavirus affecting both keratinized and nonkeratinized epithelium. Different treatment modalities are available leading to scarring, pain, and ineffectiveness. Injection of measles, mumps, and rubella (MMR) not only clears treated warts but also distant warts by stimulating cell-mediated immunity. Objectives: The objective of this study was to study the efficacy of adjuvant zinc with injectable MMR vaccine in treatment with side effects of treatments, the pattern of regression, the number of injections required for clearance, and the recurrence of verruca. Materials and Methods: Fifty patients having verruca were divided into groups A and B with 25 patients each. Group A received an injection of MMR and tablet of zinc whereas group B only injection MMR. A total of five injections were given in the largest wart at intervals of 2 weeks i.e., 0, 2, 4, 6, and 8 weeks. Follow-up was done at 3rd month and 6th months following 1st dose. Improvement in warts and patient satisfaction were assessed using visual analog scale and Likert scale, respectively. Results: Mean age of patients in groups A and B was 30.36 and 32.68 with male-to-female ratio 5.28:1 (21:4) and 1.77:1 (16:9), respectively. Mean numbers and size of lesions in group A and B were 2.24 (±1.59), 1.84 (±1.40) and 5.52 mm, 5.08 mm, respectively. Eighty-four percentage of patients in both groups needed five injections for complete clearance. Pain was the most common side effect in all patients of both groups whereas gastritis, fever, and lymphadenopathy were observed only in one patient of Group A. Patients in both groups were strongly satisfied on Likert’s scale. Conclusion: Oral zinc as an adjuvant with MMR vaccine for the treatment of VV was equally safe but did not prove to be of higher efficacy in our study.

Efficacy of Furosemide 0.125 Percent topical gel and KOH 10 Percent topical solution in the treatment of patients with warts: a comparison study

Background. Warts are a common skin disease affecting individuals of all ages worldwide. This clinical trial aims to compare the effectiveness of furosemide 0.125 Percent topical gel and KOH 10 Percent topical gel in treating patients with warts. Methods. Patients diagnosed with warts by dermatologists were included in the study and treated with either 0.125 Percent furosemide or 10 Percent KOH for two months. Patients were examined and imaged at the beginning of the study and in weeks 4 and 8 to assess the number, diameter, and height of warts and complications. Results. The study included 40 patients (48 lesions) with common warts, with 20 patients in each intervention group. In the furosemide group, the average diameter of warts decreased from 4.25 ± 1.43 mm in the first visit to 4.14 ± 1.47 mm in the final visit. In contrast, the average diameter of warts in the KOH group decreased from 3.89 ± 1.67 mm to 3.02 ± 1.49 mm. No complications were reported in the furosemide group, whereas seven complications related to redness and burning were observed in the KOH group. Conclusion. Furosemide 0.125 Percent is effective and safe for treating skin warts. However, it is less effective than KOH in reducing the diameter and height of warts. This study's findings suggest that furosemide can be a promising alternative to KOH in treating warts, especially for patients with sensitive skin or those who experience complications with KOH treatment. Further research is needed to determine the optimal treatment duration and dosage of furosemide for treating warts. Practical Implications. We can find new ways to reduce complications in treating warts.

Short-Term Follow-up of Surgical Management Verruca Vulgaris with Modified Estlander Flap: A Case Report and Recent Literature Review

Short-Term Follow-up of Surgical Management Verruca Vulgaris with Modified Estlander Flap: A Case Report and Recent Literature Review

A case report on paediatric verruca vulgaris: A homoeopathic journey to remarkable recovery

A case report on paediatric verruca vulgaris: A homoeopathic journey to remarkable recovery