Treatment Of 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

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.

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.

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.

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.

Treatment of recalcitrant viral warts with topical diphencyprone

Treatment of recalcitrant viral warts with topical diphencyprone

Recalcitrant viral warts treated by diphencyprone immunotherapy.

Recalcitrant viral warts are a troublesome therapeutic problem. Immunotherapy with the universal allergic contact sensitizer diphencyprone (DCP) has been used successfully in such cases. We have reviewed our experience of the use of DCP in the treatment of resistant hand and foot warts during an 8-year period. Sixty patients were sensitized to DCP during this time; the median duration of warts was 3 years. Twelve patients defaulted from treatment. Of the remaining 48 individuals, 42 (88%) cleared of all warts. The median number of treatments to clear was five (range one to 22) and the median time to clear was 5 months (range 0.5-14). Adverse effects occurred in 27 of 48 patients (56%), most commonly painful local blistering (n = 11), blistering at the sensitization site (n = 9), pompholyx-like reactions (n = 7) and eczematous eruptions (n = 4). Three of those who defaulted did so due to side-effects, one became pregnant and eight dropped out for unknown reasons. Three of the 48 patients who cleared or had at least six treatments also discontinued DCP therapy due to side-effects, but most tolerated treatment well. Twenty-five patients were followed up for periods of 1 month to 8 years (median 2 years) and none had a recurrence. DCP immunotherapy is an effective option for the treatment of recalcitrant viral warts but patients must be motivated to attend for sequential applications and must be warned about potential uncomfortable side-effects.

The treatment of recalcitrant viral warts with high dose cryosurgery under local anaesthesia

The treatment of recalcitrant viral warts with high dose cryosurgery under local anaesthesia