Recalcitrant Viral Warts Research Articles

Topical cidofovir for the treatment of recalcitrant viral warts and molluscum contagiosum in Jacobsen syndrome.

Jacobsen syndrome is caused by a terminal deletion on the long arm of chromosome 11 and can be associated with immunodeficiency. Patients with Jacobsen syndrome can be predisposed to cutaneous viral infections that are difficult to treat. We report successful use of topical 1% cidofovir as treatment of recalcitrant verruca vulgaris in one patient and molluscum contagiosum in another patient with Jacobsen syndrome. Topical cidofovir appears to be a good treatment option in this cohort and should be considered early for treatment-resistant cutaneous viral infections.

The use of intralesional measles-mumps-rubella vaccine in the treatment of recalcitrant viral warts

The use of intralesional measles-mumps-rubella vaccine in the treatment of recalcitrant viral warts

Treatment of recalcitrant viral warts with CO2 laser

Treatment of recalcitrant viral warts with CO2 laser

A comparative study of pulsed dye laser versus long pulsed Nd:YAG laser treatment in recalcitrant viral warts

Background: Viral warts are common infectious skin disease induced by human papillomavirus (HPV). But the treatment of recalcitrant warts is still challenging.Objective: In this study, we compared the effectiveness of pulsed dye laser (PDL) and long pulsed Nd:YAG (LPNY) laser in the treatment of recalcitrant viral warts.Methods: We retrospectively analyzed the medical records of patients with recalcitrant warts treated with laser therapy between January 2013 and February 2016.Results: Seventy-two patients with recalcitrant warts were evaluated. Thirty-nine patients were treated with pulsed dye laser and thirty-three patients were treated with LPNY laser. The following parameters were used: PDL (spot size, 7 mm; pulse duration, 1.5 ms; and fluence, 10–14 J/cm2) and LPNY (spot size, 5 mm; pulse duration, 20 ms; and fluence, 240–300 J/cm2). Complete clearance of two patients (5.1%) in PDL group, and three patients (9.1%) in LPNY group were observed without significant side effects. The patients who achieved at least 50% improvement from baseline were 20 (51.3%) in PDL and 22 (66.7%) in LPNY, respectively.Conclusion: This research is meaningful because we compared the effectiveness of the PDL and LPNY in the recalcitrant warts. Both PDL and LPNY laser could be used as a safe and alternative treatment for recalcitrant warts.

Treatment of recalcitrant viral warts using a 577-nm wavelength high-power optically pumped semiconductor laser

Abstract We report the use of a 577-nm wavelength high-power optically pumped semiconductor laser (HOPSL) to treat 12 patients with multiple recalcitrant non-genital warts that had not responded to conservative and invasive treatment. The patients were treated weekly using a 577 nm HOPSL connected to a scanner device. Ten patients with warts showed complete clearance after treatment. One patient had partial clearance and one did not respond at all. Slight to medium pain (visual analog scale, VAS=2–6) was reported during treatment. After treatment there was no evidence of scarring. After the 6-month follow-up there was no recurrence of the completely cleared warts.

Pulsed‐dye laser treatment for recalcitrant viral warts: a retrospective case series of 227 patients

Pulsed‐dye laser treatment for recalcitrant viral warts: a retrospective case series of 227 patients

Treatment of Recalcitrant Viral Warts with Photodynamic Therapy with Mal and Red Light

Background: Photodynamic therapy (PDT) is a treatment for non-melanoma skin cancer. In recent years, its use has expanded to new indications. Viral warts (VW) are some of the most promising. Methods: A retrospective, descriptive, observational study was carried out. Patients who did not respond to cryotherapy were selected and were occluded with methyl aminolevulinate (MAL) for three hours and they were illuminated with red light. Tolerance to treatment was evaluated using a visual analog scale for pain (from 0 to 10). Results: A total of 15 patients with 134 VW were treated. A complete response was obtained in 13 of 15 patients (87%) and in 127 of 134 lesions (95%). The mean number of sessions was 3.1 (range 1 to 6) and the average pain score was 3.1 (range 0 to 8). Conclusions: PDT is a treatment that offers good results in the treatment of VW that are resistant to routine treatment. The treatment was well tolerated in our patient group.

A novel mutation of the WAS gene in a patient with Wiskott-Aldrich syndrome presenting with recalcitrant viral warts

Wiskott-Aldrich syndrome (WAS) is a rare X-linked immunodeficiency disorder characterized by a combination of immunodeficiency, microthrombocytopenia, recalcitrant eczema, and high susceptibility to cancers and autoimmune diseases [1]. WAS has a broad range of clinical phenotypes associated with different mutations in the gene encoding the WAS protein (WASP), which is involved in cell signaling, cell locomotion, and immune synapse formation [2,3].

Treatment of recalcitrant viral warts with pulsed dye laser MAL-PDT

Background: Photodynamic therapy (PDT) has been explored for the treatment of recalcitrant viral warts (VW) with good results in recent publications. Methods: We carried out a descriptive and observational study in 19 patients with recalcitrant VW. Methyl aminolaevulinic acid (MAL) was occluded for 3 hours and pulsed dye laser (PDL) was used as the light source. VW were treated weekly until they were clear or for a maximum of six sessions. Results: A total of 53% of the VW cleared, and 26% of the patients demonstrated complete clearance of all their VW. The treatment was well tolerated and no adverse events were recorded. Conclusions: PDL-PDT is an effective and well-tolerated treatment option for patients with recalcitrant VW. Though only half of patients show any improvement, responders are likely to show complete clearance of their warts.

Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: A randomized clinical trial with blinded outcome evaluation

Treatment of recalcitrant viral warts remains a therapeutic challenge. Intense pulsed light (IPL) has been suggested effective to clear wart tissue. The objective was in a randomized controlled trial to assess the efficacy of paring followed by IPL versus paring alone for recalcitrant hand and foot warts. Eighty-nine patients with recalcitrant hand and foot warts were included and randomized (1:1) to three treatments at 3-week intervals with either paring of warts followed by IPL or paring of warts alone. IPL was given with the Ellipse Flex IPL system (Danish Dermatologic Development A/S, Hørsholm, Denmark, 400-950 nm, 5.5 millisecond pulse duration in double pulses with a 2 millisecond interval, 26.0-32.5 J/cm(2) repetitive passes). The primary outcome was complete and partial clearance of warts evaluated by blinded photo assessment at 6 weeks after final treatment. Secondary outcomes were treatment related pain and adverse reactions. We found no significant difference in clearance of warts between the two intervention groups (OR 1.64, 95% confidence interval 0.62-4.38). Paring followed by IPL resulted in complete or partial clearance of wart tissue in nine (22%) and five patients (12.2%) versus five (13.5%) and four patients (10.8%) from paring alone. Mostly plantar warts were treated (92.1%). The pain intensity after paring and IPL was moderate and significantly higher than the pain intensity after paring alone (P<0.0005). No adverse reactions were observed from the two interventions. Paring followed by IPL did not differ significantly from paring alone in clearance of recalcitrant hand and foot warts but caused significantly more pain.

Photodynamic therapy using light‐emitting diodes for the treatment of viral warts

Photodynamic therapy with topical 5-aminolevulinic acid is an effective and safe treatment for actinic keratosis and superficial non-melanoma skin cancer. Further, some studies have reported good efficacy when using photodynamic therapy to treat viral warts. The light-emitting diode is an incoherent, narrow-spectrum light source. The purpose of this study is to evaluate the efficacy of photodynamic therapy using a light-emitting diode for viral warts. Six patients with a total of 41 foot and hand warts were recruited in this study. They were treated with 20% 5-aminolevulinic acid cream under occlusion for 5 h. Thereafter, the treated area was irradiated with the light from a red light-emitting diode (633 +/- 6 nm) with a dose of 126 J/cm(2). This treatment was repeated at 2- or 3-week intervals. The rate of improvement observed in patients was 68.3%. The adverse effects included mild to moderate pain and erythema, which was well-tolerated by all six patients. No patients withdrew from the study due to the adverse effects. Photodynamic therapy with topical 5-aminolevulinic acid using the light from a red light-emitting diode has the advantage of non-invasiveness, minimal associated adverse reactions, and production of good results in a significant proportion of cases: therefore, it is an alternative treatment for recalcitrant viral warts.

The treatment of viral warts with topical cidofovir 1%: our experience of seven paediatric patients

Conflicts of interest: none declared. Sir, Warts caused by human papillomavirus (HPV) can represent a therapeutic challenge. Recently topical, intralesional and intravenous cidofovir has been reported for treatment of viral warts in children1–4 and adults.5 6–7 Cidofovir is a potent nucleoside analogue antiviral agent, which acts as a competitive inhibitor of DNA polymerase.8 Cidofovir is licensed for parenteral treatment of cytomegalovirus retinitis in patients with acquired immune deficiency syndrome. We present a series of seven children treated with topical cidofovir 1% ointment for severe recalcitrant viral warts that were limiting quality of life. Cidofovir 1% in Unguentum M® ointment (Reckitt Benckiser, Hull, U.K.) was compounded from the injectable cidofovir 75 mg mL−1 (Vistide®, Gilead, Foster City, CA, U.S.A.) by St Mary’s Pharmaceutical Unit, Cardiff. The ointment was applied in a thin layer to each individual wart at night; the area was occluded with a simple dressing. Of the seven children four were male and ages ranged from 9 to 12 years. Five children had warts on their hands and two on their feet. All children had failed to respond to at least two other forms of therapy (Table 1). The warts had persisted for a mean of 2 years (range 1·5–3).

Pulsed Dye Laser Treatment is Effective in the Treatment of Recalcitrant Viral Warts

BACKGROUND Verrucae vulgaris can be removed in a variety of ways but a specific therapy of choice has not yet been developed. Doctors are faced with a challenge, especially in the treatment of recalcitrant warts. It has been suggested that the success of pulsed dye laser treatment lies in the fact that warts contain an increased number of dilated blood vessels. METHODS Seventy-three patients (42 female, 31 male) with verrucae vulgaris on their hands or feet (1:1.5) were given a maximum of 12 treatments with a flashlamp-pumped pulsed dye laser every 2 weeks over a period of 24 weeks until complete clearance had been achieved. A laser energy density of 8 to 12 J/cm2 with a spot size of 5 mm and a pulse duration of 450 μsec were used. The minimum follow-up period was 6 months. RESULTS A total of 15.1% patients achieved complete clearance after 1 session and 47.9% after 2 to 5 sessions, resulting in a remission of 63.0% patients after a maximum of 5 treatment sessions. A remission of 23.3% patients was seen after 6 to 9 treatments and a total of 89.0% of patients showed remission after a maximum of 10 sessions. Only three patients (4.1%) failed and five patients (6.9%) stopped the treatment on account of pain/noncompliance. Only one patient, from a group of patients treated between January 2003 and April 2004, has relapsed. CONCLUSION Pulsed dye laser treatment is effective and safe in the treatment of recalcitrant viral warts.

Pulsed Dye Laser Treatment is Effective in the Treatment of Recalcitrant Viral Warts

Verrucae vulgaris can be removed in a variety of ways but a specific therapy of choice has not yet been developed. Doctors are faced with a challenge, especially in the treatment of recalcitrant warts. It has been suggested that the success of pulsed dye laser treatment lies in the fact that warts contain an increased number of dilated blood vessels. Seventy-three patients (42 female, 31 male) with verrucae vulgaris on their hands or feet (1:1.5) were given a maximum of 12 treatments with a flashlamp-pumped pulsed dye laser every 2 weeks over a period of 24 weeks until complete clearance had been achieved. A laser energy density of 8 to 12 J/cm2 with a spot size of 5 mm and a pulse duration of 450 microsec were used. The minimum follow-up period was 6 months. A total of 15.1% patients achieved complete clearance after 1 session and 47.9% after 2 to 5 sessions, resulting in a remission of 63.0% patients after a maximum of 5 treatment sessions. A remission of 23.3% patients was seen after 6 to 9 treatments and a total of 89.0% of patients showed remission after a maximum of 10 sessions. Only three patients (4.1%) failed and five patients (6.9%) stopped the treatment on account of pain/noncompliance. Only one patient, from a group of patients treated between January 2003 and April 2004, has relapsed. Pulsed dye laser treatment is effective and safe in the treatment of recalcitrant viral warts.

Photodynamic therapy with 20% aminolevulinic acid for the treatment of recalcitrant viral warts in an Asian population

Topical photodynamic therapy (PDT) is based on the principle of targeted tissue destruction using selective photosensitization via a topical porphyrin precursor, followed by light exposure. It is well established for the treatment of actinic keratoses and superficial nonmelanoma skin cancers. Some studies have reported good efficacy when using PDT to treat viral warts in the Western population. We carried out a prospective, single-arm, phase II study of 5-aminolevulinic acid (5-ALA)-PDT in the treatment of recalcitrant viral warts in an Asian population. Recalcitrant viral warts were surgically pared, and then treated with 20% 5-ALA cream (Medac, Hamburg, Germany) under occlusion for 4 hours before irradiation with a red light source (Waldmann PDT1200; wavelength, 590-700 nm) at an irradiance of 50 mW/cm(2) and a total dose of 50 J/cm(2). PDT was repeated fortnightly for a maximum of four times. Twelve adult Asian patients were enrolled into the study (10 males, two females). The mean age of the patients was 32.8 years (range, 18-70 years). They had skin phototypes III-IV. Nine patients had plantar warts and three patients had hand warts (two had warts on the fingers, one had a wart on the palm). Five patients (42%) showed complete disappearance of their warts, one patient (8%) showed partial clearance (greater than 50% decrease in the wart area), five patients (42%) had stable disease (less than 50% decrease in the wart area), and one (8%) showed progressive disease (increase in the wart area). Adverse effects included mild to moderate pain and erythema, which lasted no longer than 48 hours and was well tolerated by all patients. None of the patients withdrew from the study because of side-effects. 5-ALA-PDT, given its noninvasiveness, minimal adverse effects, and good cosmetic results, is a promising alternative treatment for recalcitrant viral warts. Further studies with a larger cohort of patients would be of value.

Idiopathic CD4+ T-cell Lymphocytopaenia Associated with Recalcitrant Viral Warts and Squamous Malignancy

Idiopathic CD4+ T-cell Lymphocytopaenia Associated with Recalcitrant Viral Warts and Squamous Malignancy

Treatment of extensive and recalcitrant viral warts with acitretin

International Journal of DermatologyVolume 45, Issue 4 p. 480-482 Treatment of extensive and recalcitrant viral warts with acitretin Yun-Lim Choi MD, Yun-Lim Choi MD Seoul, South KoreaSearch for more papers by this authorKwang-Jun Lee MD, Kwang-Jun Lee MD Seoul, South KoreaSearch for more papers by this authorWon-Serk Kim MD, Won-Serk Kim MD Seoul, South KoreaSearch for more papers by this authorDong-Youn Lee MD, Dong-Youn Lee MD Seoul, South KoreaSearch for more papers by this authorJoo-Heung Lee MD, Joo-Heung Lee MD Seoul, South KoreaSearch for more papers by this authorEil-Soo Lee MD, Eil-Soo Lee MD Seoul, South KoreaSearch for more papers by this authorJun-Mo Yang MD, Jun-Mo Yang MD Seoul, South KoreaSearch for more papers by this author Yun-Lim Choi MD, Yun-Lim Choi MD Seoul, South KoreaSearch for more papers by this authorKwang-Jun Lee MD, Kwang-Jun Lee MD Seoul, South KoreaSearch for more papers by this authorWon-Serk Kim MD, Won-Serk Kim MD Seoul, South KoreaSearch for more papers by this authorDong-Youn Lee MD, Dong-Youn Lee MD Seoul, South KoreaSearch for more papers by this authorJoo-Heung Lee MD, Joo-Heung Lee MD Seoul, South KoreaSearch for more papers by this authorEil-Soo Lee MD, Eil-Soo Lee MD Seoul, South KoreaSearch for more papers by this authorJun-Mo Yang MD, Jun-Mo Yang MD Seoul, South KoreaSearch for more papers by this author First published: 05 April 2006 https://doi.org/10.1111/j.1365-4632.2005.02643.xCitations: 27Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume45, Issue4April 2006Pages 480-482 RelatedInformation

Treatment of extensive and recalcitrant viral warts with acitretin

Treatment of extensive and recalcitrant viral warts with acitretin

Treatment of recalcitrant viral warts with topical diphencyprone

Treatment of recalcitrant viral warts with topical diphencyprone

Complete Remission of Recalcitrant Viral Warts under Oral Isotretinoin in a Patient with Low-grade B-cell Lymphoma

Sir, Viral warts are the most frequent clinical manifestations of the ubiquitous human papillomaviruses (HPV) infection. Particularly in immunocompromised patients they may become extensive in both size and area of involvement, representing a frustrating problem, and can progress to squamous cell carcinomas (1, 2). We report herein the complete remission of recalcitrant and extensive warts in a patient with low-grade B-cell small lymphocytic lymphoma under treatment with oral isotretinoin (13-cis retinoic acid).