Treatment of Cutaneous Warts
- 1 April 2012
- journal article
- review article
- Published by Springer Science and Business Media LLC in American Journal of Clinical Dermatology
- Vol. 13 (2), 73-96
- https://doi.org/10.2165/11594610-000000000-00000
Abstract
Cutaneous warts are common skin lesions caused by human papillomavirus infection. Treatment is aimed at relieving the patient’s physical and psychological discomfort and at preventing the spread of infection by autoinoculation. Among the available medical and destructive therapeutic options for cutaneous warts, none is uniformly effective or virucidal. Moreover, in most cases their safety and efficacy has not been assessed in double-blind, controlled clinical trials, so that the reproducibility of many of the listed treatments is difficult to evaluate and a possible placebo effect cannot be ruled out. The aim of this article is to describe the outcome of current therapies for each clinical wart type according to evidence-based medicine studies published in the literature. For each clinical form, the existing treatments are classified as first-, second-, and third-line therapy. First-line therapy includes medical treatments (salicylic acid, silver nitrate, glutaraldehyde) that are useful to treat a single wart or a few and/or small common warts of short duration (less than 1 year). If these treatments have failed or are contraindicated, cryotherapy may be considered as second-line therapy. For recurrent or difficult-to-treat lesions, third-line therapy includes a variety of alternative therapeutic options (topical, intralesional, systemic, and physical destruction) that are generally off-label (not US FDA approved), and whose use is limited by drawbacks or adverse effects. From pooled evidence-based medicine data, it is possible to conclude that significantly higher remission rates may be expected only with cryotherapy and salicylic acid used in combination.Keywords
This publication has 109 references indexed in Scilit:
- Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: randomized controlled trialCMAJ : Canadian Medical Association Journal, 2010
- The EVERT (effective verruca treatments) trial protocol: a randomised controlled trial to evaluate cryotherapy versus salicylic acid for the treatment of verrucaeTrials, 2010
- Identification of B-Cell Epitopes on Virus-Like Particles of Cutaneous Alpha-Human PapillomavirusesJournal of Virology, 2009
- Evaluation of oral zinc sulfate effect on recalcitrant multiple viral warts: A randomized placebo-controlled clinical trialJournal of the American Academy of Dermatology, 2009
- Photodynamic therapy with 20% aminolevulinic acid for the treatment of recalcitrant viral warts in an Asian populationInternational Journal of Dermatology, 2007
- Wart Regression in Children: Comparison of Relaxation-Imagery to Topical Treatment and Equal Time InterventionsAmerican Journal of Clinical Hypnosis, 1998
- Cimetidine therapy for multiple viral warts in childrenJournal of the American Academy of Dermatology, 1996
- Cimetidine therapy for warts: A placebo-controlled, double-blind studyJournal of the American Academy of Dermatology, 1996
- Salicylic acid in karaya gum patch as a treatment for verruca vulgarisJournal of the American Academy of Dermatology, 1989
- Reduced dose of bleomycin in the treatment of recalcitrant wartsJournal of the American Academy of Dermatology, 1986