American Journal of Clinical Dermatology

, Volume 13, Issue 2, pp 73–96

Treatment of Cutaneous Warts

An Evidence-Based Review
  • Federica Dall’Oglio
  • Valentina D’Amico
  • Maria R. Nasca
  • Giuseppe Micali
Evidence-Based Review Article

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.

References

  1. 1.
    Handisurya A, Schellenbacher C, Kirnbauer R. Diseases caused by human papillomaviruses (HPV). J Dtsch Dermatol Ges 2009; 7 (5): 453–66PubMedGoogle Scholar
  2. 2.
    Lipke MM. An armamentarium of wart treatments. Clin Med Res 2006; 4 (4): 273–93PubMedCrossRefGoogle Scholar
  3. 3.
    Felt BT, Hall H, Olness KN, et al. Wart regression in children: comparison of relaxation-imagery to topical treatment and equal time interventions. Am J Clin Hypn 1998; 41 (2): 130–7CrossRefGoogle Scholar
  4. 4.
    Wilson P. Immunotherapy vs cryotherapy for hand warts; a controlled trial [letter]. Scottish Med J 1983; 28 (2): 191Google Scholar
  5. 5.
    Lee SW, Houh D, Kim HO, et al. Clinical trials of interferon-gamma in treating warts. Ann Dermatol Venereol 1990; 2: 77–82Google Scholar
  6. 6.
    Artese O, Cazzato C, Cucchiarelli S, et al. Controlled study: medical therapy (5-fluouracil, salicylic acid) vs physical therapy (DTC) of warts. Dermatol Clin 1994; 14: 55–9Google Scholar
  7. 7.
    Wang Y, Wang L, Bo I, et al. Observation on the efficacy of Chinese herbal medicine and 0.1% retinoic acid cream in the treatment of verruca planta. Chin J Dermatol Venereol 2002; 16 (5): 315–6Google Scholar
  8. 8.
    Parton AM, Sommerville RG. The treatment of plantar verrucae by triggering cell-mediated immunity. Br J Pod Med 1994; 131: 883–6Google Scholar
  9. 9.
    Zhang X. Xoakage with Chinese traditional medical liquid in the treatment of 89 plentiful plantar warts. Chin J Dermatol Venereol 1999; 13 (5): 296Google Scholar
  10. 10.
    Rossi E, Soto JH, Battan J, et al. Intralesional bleomycin in verruca vulgaris: double blind study. Dermatol Rev Mex 1981; 25: 158–65Google Scholar
  11. 11.
    Hutchinson PE, Bleiker TO. Liquid nitrogen cryotherapy of common warts: cryo-spray vs cotton wool bud [letter]. Br J Dermatol 2002; 146 (6): 1110PubMedCrossRefGoogle Scholar
  12. 12.
    Clifton MM, Johnson SM, Roberson PK, et al. Immunotherapy for recalcitrant warts in children using intralesional mumps or Candida antigens. Pediatr Dermatol 2003; 20 (3): 268–71PubMedCrossRefGoogle Scholar
  13. 13.
    Choi MH, Seo SH, Kim IH, et al. Comparative study on the sustained efficacy of diphencyprone immunotherapy versus cryotherapy in viral warts. Pediatr Dermatol 2008; 25 (3): 398–9PubMedCrossRefGoogle Scholar
  14. 14.
    Stefani M, Bottino G, Fontenelle E, et al. Efficacy comparison between cimetidine and zinc sulphate in the treatment of multiple and recalcitrant warts. An Bras Dermatol 2009; 84 (1): 23–9PubMedCrossRefGoogle Scholar
  15. 15.
    López-Garcia DR, Gómez-Flores M, Arce-Mendoza AY, et al. Oral zinc sulfate for unresponsive cutaneous viral warts: too good to be true? A double-blind, randomized, placebo-controlled trial. Clin Exp Dermatol 2009; 34 (8): e984–5CrossRefGoogle Scholar
  16. 16.
    Ahmed I. Viral warts. In: Lebwohl MG, Heymann WR, Bert-Jones J, et al., editors. Treatment of skin disease: comprehensive therapeutic strategies. 3rd ed. London: Elsevier Publication, 2010Google Scholar
  17. 17.
    Gibbs S, Harvey I, Sterling JC, et al. Local treatments for cutaneous warts. Cochrane Database Syst Rev 2001; (2): CD001781Google Scholar
  18. 18.
    Gibbs S, Harvey I, Sterling J, et al. Local treatments for cutaneous warts: systematic review. BMJ 2002; 325–461Google Scholar
  19. 19.
    Gibbs S, Harvey I, Sterling JC, et al. Local treatments for cutaneous warts. Cochrane Database Syst Rev 2003; (3): CD001781Google Scholar
  20. 20.
    Gibbs S, Harvey I. Topical treatments for cutaneous warts. Cochrane Database Syst Rev 2006; (3): CD001781Google Scholar
  21. 21.
    Auken G, Gade M, Pilgaard CE. Treatment of warts of the hands and feet with Verucid. Ugeskr Laeger 1975; 137 (51): 3036–8PubMedGoogle Scholar
  22. 22.
    Flindt-Hansen H, Tikjøb G, Brandrup F. Wart treatment with anthralin. Acta Derm Venereol 1984; 64 (2): 177–9PubMedGoogle Scholar
  23. 23.
    Abou-Auda H, Soutor C, Neveaux JL. Treatment of verruca infections (warts) with a new transcutaneous controlled release system. Curr Ther Res Clin Exp 1987; 41: 552–6Google Scholar
  24. 24.
    Bart BJ, Biglow J, Vance JC, et al. Salicylic acid in karaya gum patch as a treatment for verruca vulgaris. J Am Acad Dermatol 1989; 20 (1): 74–6PubMedCrossRefGoogle Scholar
  25. 25.
    Khattar JA, Musharrafieh UM, Tamim H, et al. Topical zinc oxide vs salicylic acid-lactic acid combination in the treatment of warts. Int J Dermatol 2007; 46 (4): 427–30PubMedCrossRefGoogle Scholar
  26. 26.
    Bruggink SC, Gussekloo J, Berger MY, et al. Cryotherapy with liquid nitrogen versus topical salicylic acid application for cutaneous warts in primary care: randomized controlled trial. CMAJ 2010; 182 (15): 1624–30PubMedCrossRefGoogle Scholar
  27. 27.
    Yazar S, Başaran E. Efficacy of silver nitrate pencils in the treatment of common warts. J Dermatol 1994; 21 (5): 329–33PubMedGoogle Scholar
  28. 28.
    Ebrahimi S, Dabiri N, Jamshidnejad E, et al. Efficacy of 10% silver nitrate solution in the treatment of common warts: a placebo-controlled, randomized, clinical trial. Int J Dermatol 2007; 46 (2): 215–7PubMedCrossRefGoogle Scholar
  29. 29.
    Hirose R, Hori M, Shukuwa T, et al. Topical treatment of resistant warts with glutaraldehyde. J Dermatol 1994; 21 (4): 248–53PubMedGoogle Scholar
  30. 30.
    Bunney MH, Nolan MW, Williams DA. An assessment of methods of treating viral warts by comparative treatment trials based on a standard design. Br J Dermatol 1976; 94 (6): 667–79PubMedCrossRefGoogle Scholar
  31. 31.
    Sonnex TS, Camp RDR. The treatment of recalcitrant viral warts with high dose cryosurgery under local anaesthesia. Br J Dermatol 1988; 119 Suppl. 33: 38–9CrossRefGoogle Scholar
  32. 32.
    Steele K, Irwin WG. Liquid nitrogen and salicylic/lactic acid paint in the treatment of cutaneous warts in general practice. J RColl Gen Pract 1988; 38 (311): 256–8Google Scholar
  33. 33.
    Berth-Jones J, Hutchinson PE. Modern treatment of warts: cure rates at 3 and 6 months. Br J Dermatol 1992; 127 (3): 262–5PubMedCrossRefGoogle Scholar
  34. 34.
    Erkens AMJL, Kuijpers RJAM, Knottnerus JA. Treatment of verrucae vulgares in general practice: a randomized controlled trial on the effectiveness of liquid nitrogen and the Histofreezer. J Dermatol Treat 1992; 3: 193–6CrossRefGoogle Scholar
  35. 35.
    Berth-Jones J, Bourke J, Eglitis H, et al. Value of a second freeze-thaw cycle in cryotherapy of common warts. Br J Dermatol 1994; 131 (6): 883–6PubMedCrossRefGoogle Scholar
  36. 36.
    Bourke JF, Berth-Jones J, Hutchinson PE. Cryotherapy of common viral warts at intervals of 1, 2 and 3 weeks. Br J Dermatol 1995; 132 (3): 433–6PubMedCrossRefGoogle Scholar
  37. 37.
    Caballero Martinez F, Plaza Nohales C, Pérez Canal C, et al. Cutaneous cryosurgery in family medicine: dimethyl ether-propane spray versus liquid nitrogen. Aten Primaria 1996; 18 (5): 211–6PubMedGoogle Scholar
  38. 38.
    Larsen PO, Laurberg G. Cryotherapy of viral warts. J Dermatol Treat 1996; 7: 29–31CrossRefGoogle Scholar
  39. 39.
    Marroquin EA, Blanco JA, Granados S, et al. Clinical trial of Jatropha curcas sap in the treatment of common warts. Fitoterapia 1997; 68: 160–2Google Scholar
  40. 40.
    Connolly M, Basmi K, O’Connell M, et al. Efficacy of cryotherapy is related to severity of freeze [abstract]. Br J Dermatol 1999; 141 Suppl. 55: 31Google Scholar
  41. 41.
    Ahmed I, Agarwal S, Ilchyshyn A, et al. Liquid nitrogen cryotherapy of common warts: cryo-spray versus cotton wool bud. Br J Dermatol 2001; 144: 1006–9PubMedCrossRefGoogle Scholar
  42. 42.
    Rahimi AR, Emad M, Rezaian GR. Smoke from leaves of Populus euphratica Olivier vs conventional cryotherapy for the treatment of cutaneous warts: a pilot, randomized, single-blind, prospective study. Int J Dermatol 2008; 47 (4): 393–7PubMedCrossRefGoogle Scholar
  43. 43.
    Banihashemi M, Pezeshkpoor F, Yazdanpanah MJ, et al. Efficacy of 80% phenol solution in comparison with cryotherapy in the treatment of common warts of hands. Singapore Med J 2008; 49 (12): 1035–7PubMedGoogle Scholar
  44. 44.
    Almeida Goncalves JC. 5-Fluorouracil in the treatment of common warts of the hand: a double-blind study. Br J Dermatol 1975; 92 (1): 89–91CrossRefGoogle Scholar
  45. 45.
    Hursthouse MW. A controlled trial on the use of topical 5-fluorouracil on viral warts. Br J Dermatol 1975; 92 (1): 93–6PubMedCrossRefGoogle Scholar
  46. 46.
    Wolff K. Result of a clinical trial of Verrumal (Hermal-Chemie) versus placebo; double-blind and randomised left/right study. Hermal internal report- Gutachten 1980: 1–3Google Scholar
  47. 47.
    Schmidt H, Jacobsen FK. Double-blind randomized clinical study on treatment of warts with fluouracil-containing topical preparation. Z Hautkr 1981; 56 (1): 41–3Google Scholar
  48. 48.
    Luk NM, Tang WY, Tang NL, et al. Topical 5-fluorouracil has no additional benefit in treating common warts with cryotherapy: a single-centre, doubleblind, randomized, placebo-controlled trial. Clin Exp Dermatol 2006; 31 (3): 394–7PubMedCrossRefGoogle Scholar
  49. 49.
    Gladsjo JA, AlióSáenz AB, Bergman J, et al. 5% 5-fluorouracil cream for treatment of verruca vulgaris in children. Pediatr Dermatol 2009; 26 (3): 279–85PubMedCrossRefGoogle Scholar
  50. 50.
    Sharquie KE, Khorsheed AA, Al-Nuaimy AA. Topical zinc sulphate solution for treatment of viral warts. Saudi Med J 2007; 28 (9): 1418–21PubMedGoogle Scholar
  51. 51.
    Gustafsson L, Leijonhufvud I, Aronsson A, et al. Treatment of skin papillomas with topical alpha-lactalbumin-oleic acid. N Engl J Med 2004; 350 (26): 2663–72PubMedCrossRefGoogle Scholar
  52. 52.
    Hengge UR, Esser S, Schultewolter T, et al. Self-administered topical 5% imiquimod for the treatment of common warts and molluscum contagiosum. Br J Dermatol 2000; 143 (5): 1026–31PubMedCrossRefGoogle Scholar
  53. 53.
    Grussendorf-Conen EI, Jacobs S, Rübben A, et al. Topical 5% imiquimod long-term treatment of cutaneous warts resistant to standard therapy modalities. Dermatol 2002; 205 (2): 139–45CrossRefGoogle Scholar
  54. 54.
    Rosado-Cancino MA, Ruiz-Maldonado R, Tamayo L, et al. Treatment of multiple and stubborn warts in children with 1-chloro-2,4-dinitrobenzene (DNCB) and placebo. Dermatol Rev Mex 1989; 33: 245–52Google Scholar
  55. 55.
    Lee AN, Mallory SB. Contact immunotherapy with squaric acid dibutylester for the treatment of recalcitrant warts. J Am Acad Dermatol 1999; 41 (4): 595–9PubMedGoogle Scholar
  56. 56.
    Micali G, Dall’Oglio F, Tedeschi A, et al. Treatment of cutaneous warts with squaric acid dibutylester: a decade of experience. Arch Dermatol 2000; 136 (4): 557–8PubMedCrossRefGoogle Scholar
  57. 57.
    Silverberg NB, Lim JK, Paller AS, et al. Squaric acid immunotherapy for warts in children. J Am Acad Dermatol 2000; 42 (5 Pt 1): 803–8PubMedCrossRefGoogle Scholar
  58. 58.
    Armour K, Orchard D. Treatment of palmoplantar warts with a diphencyprone and salicylic acid ointment. Australas J Dermatol 2006; 47 (3): 182–5PubMedCrossRefGoogle Scholar
  59. 59.
    Focht 3rd DR, Spicer C, Fairchok MP. The efficacy of duct tape vs cryotherapy in the treatment of verruca vulgaris (the common wart). Arch Pediatr Adolesc Med 2002; 156 (10): 971–4PubMedCrossRefGoogle Scholar
  60. 60.
    de Haen M, Spigt MG, van Uden CJ, et al. Efficacy of duct tape vs placebo in the treatment of verruca vulgaris (warts) in primary school children. Arch Pediatr Adolesc Med 2006; 160 (11): 1121–5PubMedCrossRefGoogle Scholar
  61. 61.
    Wenner R, Askari SK, Cham PM, et al. Duct tape for the treatment of common warts in adults: a double-blind randomized controlled trial. Arch Dermatol 2007; 143 (3): 309–13PubMedCrossRefGoogle Scholar
  62. 62.
    Munkvad M, Genner J, Staberg B, et al. Locally injected bleomycin in the treatment of warts. Dermatologica 1983; 167 (2): 86–9PubMedCrossRefGoogle Scholar
  63. 63.
    Bunney MH, Nolan MW, Buxton PK, et al. The treatment of resistant warts with intralesional bleomycin: a controlled clinical trial. Br J Dermatol 1984; 111 (2): 197–207PubMedCrossRefGoogle Scholar
  64. 64.
    Hayes ME, O’Keefe EJ. Reduced dose of bleomycin in the treatment of recalcitrant warts. J Am Acad Dermatol 1986; 15 (5 Pt 1): 1002–6PubMedCrossRefGoogle Scholar
  65. 65.
    Perez Alfonzo R, Weiss E, Piquero Martin J. Hypertonic saline solution vs intralesional bleomycin in the treatment of common warts. Dermatol Venez 1992; 30: 176–8Google Scholar
  66. 66.
    Adalatkhah H, Khalilollahi H, Amini N, et al. Compared therapeutic efficacy between intralesional bleomycin and cryotherapy for common warts: a randomized clinical trial. Dermatol Online J 2007; 13 (3): 4PubMedGoogle Scholar
  67. 67.
    Dhar SB, Rashid MM, Islam A, et al. Intralesional bleomycin in the treatment of cutaneous warts: a randomized clinical trial comparing it with cryotherapy. Indian J Dermatol Venereol Leprol 2009; 75 (3): 262–7PubMedCrossRefGoogle Scholar
  68. 68.
    Isçimen A, Aydemir EH, Göksügür N, et al. Intralesional 5-fluorouracil, lidocaine and epinephrine mixture for the treatment of verrucae: a prospective placebo-controlled, single-blind randomized study. J Eur Acad Dermatol Venereol 2004; 18 (4): 455–8PubMedCrossRefGoogle Scholar
  69. 69.
    Yazdanfar A, Farshchian M, Fereydoonnejad M, et al. Treatment of common warts with an intralesional mixture of 5-fluorouracil, lidocaine, and epinephrine: a prospective placebo-controlled, double-blind randomized trial. Dermatol Surg 2008; 34 (5): 656–9PubMedCrossRefGoogle Scholar
  70. 70.
    Sharquie KA, Al-Nuaimy AA. Treatment of viral warts by intralesional injection of zinc sulphate. Ann Saudi Med 2002; 22 (1-2): 26–8PubMedGoogle Scholar
  71. 71.
    Pazin GJ, Ho M, Haverkos HW, et al. Effects of interferon-alpha on human warts. J Interferon Res 1982; 2 (2): 235–43PubMedCrossRefGoogle Scholar
  72. 72.
    Berman B, Davis-Reed L, Silverstein L, et al. Treatment of verrucae vulgaris with alpha 2 interferon. J Infect Dis 1986; 154 (2): 328–30PubMedCrossRefGoogle Scholar
  73. 73.
    Niimura M. Application of beta-interferon in virus-induced papillomas. J Invest Dermatol 1990; 95 (6 Suppl.): 149–51SCrossRefGoogle Scholar
  74. 74.
    Varnavides CK, Henderson CA, Cunliffe WJ. Intralesional interferon: ineffective in common viral warts. J Dermatol Treat 1997; 8: 169–72CrossRefGoogle Scholar
  75. 75.
    Horn TD, Johnson SM, Helm RM, et al. Intralesional immunotherapy of warts with mumps, Candida, and Trichophyton skin test antigens: a single-blinded, randomized, and controlled trial. Arch Dermatol 2005; 141 (5): 589–94PubMedCrossRefGoogle Scholar
  76. 76.
    Kim KH, Horn TD, Pharis J, et al. Phase 1 clinical trial of intralesional injection of Candida antigen for the treatment of warts. Arch Dermatol 2010; 146 (12): 1431–3PubMedCrossRefGoogle Scholar
  77. 77.
    Nofal A, Nofal E. Intralesional immunotherapy of common warts: successful treatment with mumps, measles and rubella vaccine. J Eur Acad Dermatol Venereol 2010; 24 (10): 1166–70PubMedCrossRefGoogle Scholar
  78. 78.
    Glass AT, Solomon BA. Cimetidine therapy for recalcitrant warts in adults. Arch Dermatol 1996; 132 (6): 680–2PubMedCrossRefGoogle Scholar
  79. 79.
    Bauman C, Francis JS, Vanderhooft S, et al. Cimetidine therapy for multiple viral warts in children. J Am Acad Dermatol 1996; 35 (2 Pt 1): 271–2PubMedCrossRefGoogle Scholar
  80. 80.
    Yilmaz E, Alpsoy E, Basaran E. Cimetidine therapy for warts: a placebocontrolled, double-blind study. J Am Acad Dermatol 1996; 34 (6): 1005–7PubMedCrossRefGoogle Scholar
  81. 81.
    Karabulut AA, Sahin S, Ekşioglu M. Is cimetidine effective for nongenital warts: a double-blind, placebo-controlled study. Arch Dermatol 1997; 133 (4): 533–4PubMedCrossRefGoogle Scholar
  82. 82.
    Rogers CJ, Gibney MD, Siegfried EC, et al. Cimetidine therapy for recalcitrant warts in adults: is it any better than placebo? J Am Acad Dermatol 1999; 41 (1): 123–7PubMedCrossRefGoogle Scholar
  83. 83.
    Gooptu C, Higgins CR, James MP. Treatment of viral warts with cimetidine: an open-label study. Clin Exp Dermatol 2000; 25 (3): 183–5PubMedCrossRefGoogle Scholar
  84. 84.
    Amer M, Tosson Z, Soliman A, et al. Verrucae treated by levamisole. Int J Dermatol 1991; 30 (10): 738–40PubMedCrossRefGoogle Scholar
  85. 85.
    Parsad D, Saini R, Negi KS. Comparison of combination of cimetidine and levamisole with cimetidine alone in the treatment of recalcitrant warts. Australas J Dermatol 1999; 40 (2): 93–5PubMedCrossRefGoogle Scholar
  86. 86.
    Parsad D, Pandhi R, Juneja A, et al. Cimetidine and levamisole versus cimetidine alone for recalcitrant warts in children. Pediatr Dermatol 2001; 18 (4): 349–52PubMedCrossRefGoogle Scholar
  87. 87.
    Al-Gurairi FT, Al-Waiz M, Sharquie KE. Oral zinc sulphate in the treatment of recalcitrant viral warts: randomized placebo-controlled clinical trial. Br J Dermatol 2002; 146 (3): 423–31PubMedCrossRefGoogle Scholar
  88. 88.
    Yaghoobi R, Sadighha A, Baktash D. Evaluation of oral zinc sulfate effect on recalcitrant multiple viral warts: a randomized placebo-controlled clinical trial. J Am Acad Dermatol 2009; 60 (4): 706–8PubMedCrossRefGoogle Scholar
  89. 89.
    Gelmetti C, Cerri D, Schiuma AA, et al. Treatment of extensive warts with etretinate: a clinical trial in 20 children. Pediatr Dermatol 1987; 4 (3): 254–8PubMedCrossRefGoogle Scholar
  90. 90.
    Spanos NP, Williams V, Gwynn MI. Effects of hypnotic, placebo, and salicylic acid treatments on wart regression. Psychosom Med 1990; 52 (1): 109–14PubMedGoogle Scholar
  91. 91.
    Veien NK, Genner J, Brodthagen H, et al. Photodynamic inactivation of verrucae vulgares: II. Acta Derm Venereol 1977; 57 (5): 445–7PubMedGoogle Scholar
  92. 92.
    Stahl D, Veine NK, Wulf HC. Photodynamic inactivation of virus warts: a controlled clinical trial. Clin Exp Dermatol 1979; 4 (1): 81–5PubMedCrossRefGoogle Scholar
  93. 93.
    Stender IM, Lock-Anderson J, Wulf HC. Recalcitrant hand and foot warts successfully treated with photodynamic therapy with topical 5-aminoaevulanic acid: a pilot study. Clin Exp Dermatol 1999; 24 (3): 154–9PubMedCrossRefGoogle Scholar
  94. 94.
    Stender IM, Na R, Fogh H, et al. Photodynamic therapy with 5-aminolaevulinic acid or placebo for recalcitrant foot and hand warts: randomised double-blind trials. Lancet 2000; 355 (9208): 963–6PubMedCrossRefGoogle Scholar
  95. 95.
    Fuchs SM, Fluhr JW, Bankova L, et al. Photodynamic therapy (PDT) and water filtered infrared A (wIRA) in patients with recalcitrant common hand and foot warts. Ger Med Sci 2004; 2: Doc08Google Scholar
  96. 96.
    Wang YS, Tay YK, Kwok C, et al. Photodynamic therapy with 20% aminolevulinic acid for the treatment of recalcitrant viral warts in an Asian population. Int J Dermatol 2007; 46 (11): 1180–4PubMedCrossRefGoogle Scholar
  97. 97.
    Ohtsuki A, Hasegawa T, Hirasawa Y, et al. Photodynamic therapy using lightemitting diodes for the treatment of viral warts. J Dermatol 2009; 36 (10): 525–8PubMedCrossRefGoogle Scholar
  98. 98.
    Robson KJ, Cunningham NM, Kruzan KL, et al. Pulsed-dye laser versus conventional therapy for the treatment of warts: prospective randomized trial. J Am Acad Dermatol 2000; 43: 275–80PubMedCrossRefGoogle Scholar
  99. 99.
    Wollina U. Er:YAG laser followed by topical podophyllotoxin for hard-totreat palmoplantar warts. J Cosmet Laser Ther 2003; 5 (1): 35–7PubMedCrossRefGoogle Scholar
  100. 100.
    Smucler R, Jatsová E. Comparative study of aminolevulic acid photodynamic therapy plus pulsed dye laser versus pulsed dye laser alone in treatment of viral warts. Photomed Laser Surg 2005; 23 (2): 202–5PubMedCrossRefGoogle Scholar
  101. 101.
    Park HS, Kim JW, Jang SJ, et al. Pulsed dye laser therapy for pediatric warts. Pediatr Dermatol 2007; 24 (2): 177–81PubMedCrossRefGoogle Scholar
  102. 102.
    Passeron T, Sebban K, Mantoux F, et al. 595 nm pulsed dye laser therapy for viral warts: a single-blind randomized comparative study versus placebo. Ann Dermatol Venereol 2007; 134 (2): 135–9PubMedCrossRefGoogle Scholar
  103. 103.
    Park HS, Choi WS. Pulsed dye laser treatment for viral warts: a study of 120 patients. J Dermatol 2008; 35 (8): 491–8PubMedCrossRefGoogle Scholar
  104. 104.
    Togsverd-Bo K, Gluud C, Winkel P, et al. Paring and intense pulsed light versus paring alone for recalcitrant hand and foot warts: a randomized clinical trial with blinded outcome evaluation. Lasers Surg Med 2010; 42 (2): 179–84PubMedCrossRefGoogle Scholar
  105. 105.
    Sterling JC, Kurtz JB. Viral infections. In: Champion RH, Burton JL, Burns DA, et al., editors. Rook textbook of dermatology. 6th ed. Oxford: Blackwell Scientific Publications Ltd, 1998Google Scholar
  106. 106.
    Bedinghaus J M, Niedfeldt MW. Over-the-counter foot remedies. Am Fam Physician 2001; 64 (5): 791–6PubMedGoogle Scholar
  107. 107.
    Bacelieri R, Johnson SM. Cutaneous warts: an evidence-based approach to therapy. Am Fam Physician 2005; 72 (4): 647–52PubMedGoogle Scholar
  108. 108.
    Kwok CS, Holland R, Gibbs S. Efficacy of topical treatments for cutaneous warts: a meta-analysis and pooled analysis of randomized controlled trials. Br J Dermatol 2011; 165 (2): 233–46PubMedCrossRefGoogle Scholar
  109. 109.
    Gupta AK, Koren G, Shear NH. A double-blind, randomized, placebocontrolled trial of eutetic lidocaine-prilocaine cream 5% (EMLA) for analgesia prior to cryotherapy of warts in children and adults. Pediatr Dermatol 1998; 15 (2): 129–33PubMedCrossRefGoogle Scholar
  110. 110.
    Vesterager K, Petersen KP, Nielsen R, et al. EMLA-induced analgesia inferior to lignocaine infiltration in curettage of common warts: a randomized study. Dermatology 1994; 188 (1): 32–5PubMedCrossRefGoogle Scholar
  111. 111.
    Micali G, Dall’Oglio F, Nasca MR. An open label evaluation of the efficacy of imiquimod 5% cream in the treatment of recalcitrant subungual and periungual cutaneous warts. J Dermatolog Treat 2003; 4 (4): 233–6CrossRefGoogle Scholar
  112. 112.
    Buckley DA, Du Vivier AWP. The therapeutic use of topical contact sensitizers in benign dermatoses. Br J Dermatol 2001; 145 (3): 385–456PubMedCrossRefGoogle Scholar
  113. 113.
    Micali G, Nasca MR, Tedeschi A, et al. Use of squaric acid dibutylester (SADBE) for cutaneous warts in children. Pediatr Dermatol 2000; 17 (4): 315–8PubMedCrossRefGoogle Scholar
  114. 114.
    Micali G, Dall’Oglio F, Nasca MR, et al. Management of cutaneous warts: an evidence-based approach. Am J Clin Dermatol 2004; 5 (5): 311–7PubMedCrossRefGoogle Scholar
  115. 115.
    Nasca MR, Cicero RL, Innocenzi D, et al. Persistent allergic contact dermatitis at the site of primary sensitization with squaric acid dibutyl ester [letter]. Contact Dermatitis 1995; 33 (6): 438PubMedCrossRefGoogle Scholar
  116. 116.
    Stender IM, Borgbjerg FM, Villumsen J, et al. Pain induced by photodynamic therapy of warts. Photodermatol Photoimmunol Photomed 2006; 22 (6): 304–9PubMedCrossRefGoogle Scholar
  117. 117.
    Kubeyinje EP. Evaluation of the efficacy and safety of 0.05% tretinoin cream in the treatment of plane warts in Arab children. J Dermatol Treat 1996; 7: 21–2CrossRefGoogle Scholar
  118. 118.
    Vali A, Ferdowsi F. Evaluation of the efficacy of 50% citric acid solution in plane wart treatment. Indian J Dermatol 2007; 52 (2): 96–8CrossRefGoogle Scholar
  119. 119.
    Wu J, Wang J, Huang Y, et al. Clinical observations of the therapeutic effects of Qu You Ding on flat wart. J Tradit Chin Med 2005; 25 (3): 206–8PubMedGoogle Scholar
  120. 120.
    Aum HS, Kim YH, Kim DH. Study of pulsed dye laser followed by intralesional bleomycin treatment compared to lone intralesional bleomycin treatment for recalcitrant periungual warts. Korean J Dermatol 2006; 44 (1): 45–50Google Scholar
  121. 121.
    Bunney MH, Hunter JA, Ogilvie MM, et al. The treatment of plantar warts in the home: a critical appraisal of a new preparation. Practitioner 1971; 207 (238): 197–204PubMedGoogle Scholar
  122. 122.
    Steele K, Shirodaria P, O’Hare M, et al. Monochloroacetic acid and 60% salicylic acid as a treatment for simple plantar warts: effectiveness and mode of action. Br J Dermatol 1988; 118 (4): 537–43PubMedCrossRefGoogle Scholar
  123. 123.
    Veien NK, Madsen SM, Avrach W, et al. The treatment of plantar warts with a keratolytic agent and occlusion. J Dermatol Treat 1991; 2: 59–61CrossRefGoogle Scholar
  124. 124.
    Jennings MB, Ricketti J, Guadara J, et al. Treatment for simple plantar verrucae: monochloroacetic acid and 10% formaldehyde versus 10% formaldehyde alone. J Am Podiatr Med Assoc 2006; 96 (1): 53–8PubMedGoogle Scholar
  125. 125.
    Gibson JR, Harvey SG, Barth J, et al. Acomparison of acyclovir cream versus placebo cream versus liquid nitrogen in the treatment of viral plantar warts. Dermatological 1984; 168 (4): 178–81CrossRefGoogle Scholar
  126. 126.
    Hansen JG, Schmidt H. Plantar warts: occurrence and cryosurgical treatment. Ugeskr Laeger 1986; 148 (4): 173–4PubMedGoogle Scholar
  127. 127.
    Canpolat F, Cemil BC, Eskioglu F. Liquid nitrogen cryotherapy of plantar verrucae: cyroblast is more effective than cryo-spray. Eur J Dermatol 2008; 18 (3): 341–2PubMedGoogle Scholar
  128. 128.
    Cockayne ES, EVERT Trial Team. The EVERT (effective verruca treatments) trial protocol: a randomised controlled trial to evaluate cryotherapy versus salicylic acid for the treatment of verrucae. Trials 2010; 11: 12PubMedCrossRefGoogle Scholar
  129. 129.
    Bunney MH. The treatment of plantar warts with 5-fluorouracil. Br J Dermatol 1973; 89 (1): 96–7PubMedCrossRefGoogle Scholar
  130. 130.
    Salk RS, Grogan KA, Chang TJ. Topical 5% 5-fluorouracil cream in the treatment of plantar warts: a prospective, randomized, and controlled clinical study. J Drugs Dermatol 2006; 5 (5): 418–24PubMedGoogle Scholar
  131. 131.
    Vickers CFH. Treatment of plantar warts in children. Br Med J 1961; 2 (5254): 743–5PubMedCrossRefGoogle Scholar
  132. 132.
    Khan MT, Cerio R, Watt R, et al. A double-blind placebo study of topical Thuja occidentalis on verruca pedis in children and adults. J Eur Acad Dermatol Venerol 1999; 12: S251–2Google Scholar
  133. 133.
    Khan MT, Cerio R, Watt R, et al. Phytotherapy with subfractions of topical Thuja Occ on verruca pedis [abstract]. Br J Dermatol 2000; 143 Suppl. 57: 33Google Scholar
  134. 134.
    Vance JC, Bart BJ, Hansen RC, et al. Intralesional recombinant alpha-2 interferon for the treatment of patients with condyloma acuminatum or verruca plantaris. Arch Dermatol 1986; 122 (3): 272–7PubMedCrossRefGoogle Scholar
  135. 135.
    Aksakal AB, Ozden MG, Atahan C, et al. Successful treatment of verruca plantaris with a single sublesional injection of interferon-alpha-2a. Clin Exp Dermatol 2009; 34 (1): 16–9PubMedCrossRefGoogle Scholar
  136. 136.
    Pringle WM, Helms DC. Treatment of plantar warts by blunt dissection. Arch Dermatol 1973; 108 (1): 79–82PubMedCrossRefGoogle Scholar
  137. 137.
    Fabbrocini G, Di Costanzo MP, Riccardo AM, et al. Photodynamic therapy with topical delta-aminolaevulinic acid for the treatment of plantar warts. J Photochem Photobiol B 2001; 61 (1-2): 30–2PubMedCrossRefGoogle Scholar
  138. 138.
    Penny L, Newcombe L. The effectiveness of low level laser therapy in the treatment of verrucae pedis. Australas J Pod Med 2005; 39 (1): 7–10Google Scholar
  139. 139.
    Huo W, Gao XH, Sun XP, et al. Local hyperthermia at 44 degrees C for the treatment of plantar warts: a randomized, patient-blinded, placebocontrolled trial. J Infect Dis 2010; 201 (8): 1169–72PubMedCrossRefGoogle Scholar
  140. 140.
    Senger T, Becker MR, Schädlich L, et al. Identification of B-cell epitopes on virus-like particles of cutaneous alpha-human papillomaviruses. J Virol 2009; 83 (24): 12692–701PubMedCrossRefGoogle Scholar
  141. 141.
    Senger T, Schädlich L, Textor S, et al. Virus-like particles and capsomeres are potent vaccines against cutaneous alpha HPVs. Vaccine 2010; 28 (6): 1583–93PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2012

Authors and Affiliations

  • Federica Dall’Oglio
    • 1
  • Valentina D’Amico
    • 1
  • Maria R. Nasca
    • 1
  • Giuseppe Micali
    • 1
  1. 1.Dermatology ClinicUniversity of CataniaCataniaItaly

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