Nongenital warts: recommended approaches to management (original) (raw)
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Nongenital warts: clinical features and recommended treatment
Prescriber, 2009
Viral warts are one of the most common cutaneous diseases, and treatment can be difficult and frustrating with frequent failures. In our Drug review we discuss the clinical presentations and treatment options, followed by sources of further information.
Nongenital warts: recommended management in general practice
Prescriber, 2012
Nongenital warts are benign skin lesions caused by HPV infection and can be easily treated in primary care. Our Drug review presents the different clinical types and discusses the properties and efficacy of the available treatment options, followed by sources of further information. N ongenital warts are very common and most people at some stage of their lives will be affected. Although the exact frequency of this infection is difficult to establish, it is estimated that 3.9 to 4.9 per cent of all children and adolescents in the UK are affected. 1 Warts are caused by infection of the epidermis with the human papillomavirus (HPV). There are more than 100 different HPV genotypes identified, each associated with distinct clinical and histological features. Depending on the genotype, infection with this nonenveloped DNA virus results in proliferation of cornified stratified squamous epithelium of the skin or uncornified mucous membrane at particular anatomical sites. 2 HPV is spread by either direct or indirect contact. Broken or macerated skin facilitates infection and is therefore common in people with nail-biting habits or those who regularly use communal swimming pools. Autoinoculation is also common and results in local www.prescriber.co.uk Prescriber 19 March 2012 35 Drug review Warts
Promising New Wart Treatment: A Randomized, Placebo-Controlled, Clinical Trial
Iranian Red Crescent Medical Journal, 2016
Background: Warts are common dermatological lesion caused by skin epithelial cells' infection with human Papillomavirus (HPV). Objectives: This study aimed to assess the efficacy of a new method for the treatment of dermal warts. Patients and Methods: In this clinical trial study, 60 patients (older than 10 years) with dermal warts living in Baneh city, west of Iran, were allocated into the intervention and control groups using the block randomized method in 2012. In the intervention group, outer layers of the dermal wart carved using scalpel and HD tablet set on it and covered with adhesive. In the second and third days, it was repeated again. All stages in the intervention group were similar to the placebo group. Placebo was prepared by a pharmacologist, which was similar to the HD tablet. In both groups, patients were examined one week and one month after taking the last tablet by the physician in terms of improvement or lack of improvement. Data were analyzed by SPSS software version 18 using chi-square test, Fisher's exact test, Mann-Whitney test and ANOVA for repeated measures. Results: In the first week after the intervention, warts were changed in 93.3% of the cases; however, no changes were recorded in the control group. One month after follow-up, the mean was 0.4 ± 0.7 in the intervention group and 5.5 ± 4.9 in the control group (P = 0.0001). Based on ANOVA for repeated measures and t-test, the average number of warts, before, one week and one month after the intervention was statistically significant for both intervention (P = 0.009) and control groups (P = 0.0001). Conclusions: This method is recommended for the treatment of dermal warts, owing to the effectiveness, short duration of treatment, and low cost of topical treatment for dermal warts using HD tablets.
Investigation of Treatment Regimen of the Genital Warts Using Various Chemotherapeutic Agents
Biomedical Sciences, 2020
Genital warts are the most commonly sexually transmitted viral infection of human beings caused by Human Papillomavirus, infecting both male as well as female sexes. The disease is clinically characterized by the appearance of external warts on the genital organs viz penis, scrotum, vulva, anus and perineal area. The present study was designed for the investigation of chemotherapeutic agents for the successful treatment/removal of lesions of genital warts in terms of recovery of patients and clearance percentage of genital organs from the warts. For this purpose, a total of 12 patients infected with genital warts were selected and randomly distributed into four different groups, each group comprising 03 patients. Group A was treated using locally available wart removal preparation Dewart® (Verrugon, Milk Acid), Group B was treated using Podophyllotoxin 15-25%, procured from chemical suppliers, Group C was treated using locally available Duofilm™ (Salicylic Acid 16.7% w/v, Lactic Acid 16.6% w/v) and Group D served as negative control. The results of the current study revealed that the standard and most effective treatment of the genital warts is found to be Podophyllotoxin @15-25%, which showed 100% recovery of the patients and 100% clearance of their genital areas from the stubborn warts. However, Duofilm™ was also found effective, because all the patients were recovered and 80% warts were cleared off from their genitalia, but after few weeks, the lesions reappeared in the patients treated with Duofilm™. Also the warts did not go off with the local brands of Dewart® nor spontaneously recovered.
Destructive therapies for cutaneous warts: A review of the evidence
Australian Journal of General Practice
COMMON WARTS (Verruca vulgaris), plantar warts (Verruca plantaris) and flat/plane warts (Verruca plana), collectively known as cutaneous warts, are benign growths of the skin caused by the human papillomavirus (HPV). In Australia, up to 24% of children and 5% of adults are affected. 1 A break in the epidermal barrier of the skin allows entry of HPV and subsequent infection of basal epithelial cells. HPV replicates alongside the natural lifecycle of epithelial cells, and is eventually released from desquamated keratinocytes on the surface of warts, potentially infecting other sites via direct contact or through fomites. 2 Cutaneous warts generally self-resolve. Up to two-thirds of immunocompetent children experience spontaneous clearance of their cutaneous warts by two years of age. 3 Adults tend to take longer. Patients might request treatment for their warts when they cause discomfort, functional impairment, social ostracism, are numerous, grow large or raise concerns regarding transmission. 4 Treatment for cutaneous warts can be painful, scar, cause pigmentary disturbances and might not be effective. 5 Therefore, clinicians should be wary of the evidence behind the efficacy of cutaneous wart treatment. This review summarises high-quality studies investigating the efficacy of chemical and physical destructive wart therapies. Methods We performed a literature review (up to June 2021) of published articles for wart management from the MEDLINE and Embase databases. No language restrictions were applied. We considered systematic reviews, randomised controlled trials (RCTs), cohort studies and case series. Case reports were excluded. For MEDLINE, we used the Boolean operation to combine MeSH terms 'warts' AND 'therapeutics'. For Embase, we used the Boolean operation to combine MeSH terms 'Verruca vulgaris' AND 'therapy'. We included studies that investigated chemical or physical destructive therapies.
Common warts revisited: a clinical study
International Journal of Research in Dermatology
Background: Common warts are cutaneous viral infections caused by various strains of human papilloma virus (HPV). Their variants include filiform, periungual and pigmented warts. At present more than 200 different HPV genotypes have been detected and a periodic clinical analysis will reveal whether any new morphological variations have occurred. Methods: Hundred and ten patients with common warts were taken up for this study. Results: The clinical characteristics of 637 common warts in 110 patients were studied over a span of 1 and a half years. The age group ranged from 18 years to 72 years. Seventy six were males and 34 were females. Majority belonged to the age group of 18-30 years. The most common occupational group involved were students followed by housewives. The initial site of onset in 44.5% of patients was on the fingers. Eleven patients had atopic diathesis. Similar complaints in friends and family were seen in 30%. The most common sites of involvement for classical common warts were on the fingers and for filiform warts were on the head. 30% had association with other warts out of which 28.1% had palmoplantar warts. Conclusions: Common warts usually present as a cosmetic concern in most patients. Our study concluded that young male students are susceptible to acquiring them. Characteristics of warts in atopics did not differ significantly from non atopics. Regions most prone to contact and susceptible to trauma are the most common sites of inoculation i.e. fingers, scalp and face.
Genital warts are the most commonly sexually transmitted viral infection of humans caused by Human Papillomavirus, affecting both male and female sexes, clinically characterized by the appearance of external warts on the genital organs including penis, scrotum, vulva, anus and perineal area. The present study was designed for the investigation of chemotherapeutic agents for the successful treatment of genital warts in terms of recovery of patients and clearance percentage of genital organs from the warts. For this purpose, a total of 12 patients infected with genital warts were selected and randomly distributed into four different groups, each group comprising 03 patients. Group A was treated using locally available wart removal preparation Dewart ® (Verrugon, Milk Acid), Group B was treated using Podophyllotoxin 15-25%, acquired from chemical suppliers, Group C was treated using locally available Duofilm™ (Salicylic Acid 16.7% w/v, Lactic Acid 16.6% w/v) and Group D served as negative control. The results of the current study revealed that the standard and most effective treatment of the genital warts is found to be Podophyllotoxin 15-25%, which showed 100% recovery of the patients and 100% clearance of their genital areas from the stubborn warts. However, Duofilm™ was also found effective, because all the patients were recovered and 80% warts were cleared off from their genitalia. But the warts did not go off with the local brands of Dewart ® nor spontaneously recovered.
Guidelines for the management of cutaneous warts
British Journal of Dermatology, 2001
These guidelines for the management of cutaneous warts have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation. Other warty conditions Epidermodysplasia verruciformis Epidermodysplasia verruciformis (EV) is an inherited disorder in which there is a mild defect of cell-mediated 4
BMC Medical Research Methodology, 2018
Background: Anogenital warts are the second most common sexually transmitted infection diagnosed in sexual health services in England. About 90% of genital warts are caused by human papillomavirus (HPV) types 6 or 11, and half of episodes diagnosed are recurrences. The best and most cost-effective treatment for patients with anogenital warts is unknown. The commonly used treatments are self-administered topical agents, podophyllotoxin (0.15% cream) or imiquimod (5% cream), or cryotherapy with liquid nitrogen. Quadrivalent HPV (qHPV) vaccination is effective in preventing infection, and disease, but whether it has any therapeutic effect is not known. Methods and design: To investigate the efficacy of clearance and prevention of recurrence of external anogenital warts by topical treatments, podophyllotoxin 0.15% cream or imiquimod 5% cream, in combination with a threedose regimen of qHPV or control vaccination. 500 adult patients presenting with external anogenital warts with either a first or subsequent episode of anogenital warts will be entered into this randomised, controlled partially blinded 2 × 2 factorial trial. Discussion: The trial is expected to provide the first high-quality evidence of the comparative efficacy and cost-effectiveness of the two topical treatments in current use, as well as investigate the potential benefit of HPV vaccination, in the management of anogenital warts. Trial registration: The trial was registered prior to starting recruitment under the following reference numbers: International Standard Randomized Controlled Trial Number (ISRCTN) Registry-ISRCTN32729817 (registered 25 July 2014); European Union Clinical Trials Register (EudraCT)-2013-002951-14 (registered 26 June 2013).