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At least 163 records · Page 9Linked to original sources
PubMed2006

Efficacy of duct tape vs placebo in the treatment of verruca vulgaris (warts) in primary school children.

OBJECTIVE: To determine the efficacy of duct tape compared with placebo in the treatment of verruca vulgaris. DESIGN AND SETTING: A randomized placebo-controlled trial in 3 primary schools in Maastricht, the Netherlands. PARTICIPANTS: One hundred three children aged 4 to 12 years with verruca vulgaris. INTERVENTIONS: Duct tape applied to the wart or placebo, a corn pad (protection ring for clavi), applied around the wart for 1 night a week. Both treatments were applied for a period of 6 weeks. Patients were blinded to the hypothesis of the study. MAIN OUTCOME MEASUREMENT: Complete resolution of the treated wart. RESULTS: After 6 weeks, the wart had disappeared in 16% of the children in the duct tape group compared with 6% in the placebo group (P = .12). The estimated effect of duct tape compared with placebo on diameter reduction of the treated wart was 1.0 mm (P = .02, 95% confidence interval, -1.7 to -0.1). After 6 weeks, in 7 children (21%) in the duct tape group, a surrounding wart had disappeared compared with 9 children (27%) in the placebo group (P = .79). Fifteen percent of the children in the duct tape group reported adverse effects such as erythema, eczema, and wounds compared with 0 in the placebo group (P = .14). CONCLUSION: In a 6-week trial, duct tape had a modest but nonsignificant effect on wart resolution and diameter reduction when compared with placebo in a cohort of primary school children.

Adhesives↗
PubMed2001

Treatment of recalcitrant-pigmented flat warts using frequency-doubled Q-switched Nd-YAG laser.

BACKGROUND AND OBJECTIVE: Recalcitrant-pigmented flat warts may persist for years despite treatment. Many methods have been used to manage pigmented flat warts, but their efficiencies are varied. Since pigmented flat warts are very similar to lentigo clinically, we used frequency-doubled Q-switched (FDQS) Nd-YAG laser at the wavelength of 532 nm to treat recalcitrant-pigmented flat warts and evaluated the effect. STUDY DESIGN/MATERIALS AND METHODS: Seven patients with recalcitrant-pigmented flat warts were enrolled in this study. We set the FDQS Nd-YAG laser to deliver 2.5 J/cm(2) fluence at the wavelength of 532 nm to treat these lesions. After 6 months, we evaluated the recurrence of pigmented flat warts, pigmentary, and textural changes on the treated areas. RESULTS: There were absences of recurrent lesions, pigmentary, and textural changes on the treated areas of these seven patients after 6 months. CONCLUSIONS: Through both selective photothermolysis effect and propagation of photoacoustic waves, FDQS Nd-YAG laser at the wavelength of 532 nm can be used as an effective alternative to treat recalcitrant pigmented flat warts.

Adolescent↗
PubMed1997

Phylogenetic analysis of the human papillomavirus type 2 (HPV-2), HPV-27, and HPV-57 group, which is associated with common warts.

Human papillomavirus types 2 (HPV-2), HPV-27, and HPV-57, are three closely related viruses within the phylogenetic supergroup formed by the remotely related genital papillomaviruses. In contrast to this phylogenetic association, these three viruses are most often found in common warts at nongenital sites, but also occasionally in genital warts and mucosal lesions of the nasopharyngeal cavity. We studied the genomic diversity of HPV sequences in skin warts presumably caused by these viruses. These biopsies were sampled from 75 patients living in Germany, Japan, or Singapore. Among 27 warts with HPV-2, we found seven new genomic variants and among 32 with HPV-57, eight new variants. In both cases, we did not detect the original prototype genomes. In contrast, 13 of 16 warts with HPV-27 contained the prototype genome, and only one new variant was found in three patients. We did not find variants clearly intermediate between any two types, although HPV-2 and HPV-27 are among the most closely related of the extent HPV types. We also did not detect novel HPV types, although the samples were examined with polymerase chain reaction protocols that would have detected remotely related HPVs. So we propose that the phylogenetic group formed by HPV-2, HPV-27, and HPV-57 has no or only very are additional members. One of the HPV-57 variants found, HPV-57-G44, was most likely identical to the subtype HPV-57b, previously proposed to be associated with nasal neoplasia, but found here frequently in common skin warts. Our publication establishes a foundation for pathological and phylogenetic comparisons of HPV types in skin warts.

Base Sequence↗
PubMed1982

Two anatomoclinical types of warts with plantar localization: specific cytopathogenic effects of papillomavirus. Type I (HPV-1) and type 2 (HPV-2).

In this study, the clinical and histopathological aspects of 50 plantar warts are reported in relation to the type of papillomavirus present in the lesions, as detected by immunofluorescence tests, using specific guinea pig fluorescein-labelled IgG. Warts of plantar localization are not caused by the same human papillomavirus (HPV) since they are found to be associated with both HPV type 1 (HPV-1) and HPV type 2 (HPV-2). HPV-1 is always associated with deep and painful plantar warts (myrmecia), whereas HPV-2 is found to be associated with superficial, painless plantar warts (vulgaris or often mosaic type). Histologically, these two types of plantar warts are quite different. In myrmecia (HPV-1), characterized by an endophytic growth, large eosinophilic, keratohyaline-like granules are observed in the cytoplasm and nucleus of infected, often vacuolated cells. These granules appear early in stratum spinosum and are very numerous in stratum granulosum. In the mosaic type (HPV-2), the histopathological aspect is not different from that of common warts; these lesions have an exophytic growth and are characterized by foci of clear vacuolized cells which are found in stratum granulosum. Their cytoplasm contains round, basophilic keratohyalin granules which often have a heterogenous aspect. These differences are observed in other localizations of morphologically related warts associated with HPV-1 and HPV-2 and seem to be related to a specific cytopathogenic effect of HPV-1 an HPV-2 in human papillomas.

Cytopathogenic Effect, Viral↗
PubMed1996

Cytokine mRNA expression in cutaneous warts: induction of interleukin-1 alpha.

The persistence of human papillomavirus at cutaneous sites may be due to impaired trafficking of immune effector cells to the epidermis. We investigated whether HPV infection modulates cytokine mRNA expression in skin, thereby influencing local immunity. The mRNA expression of tumour necrosis factor-alpha, interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-1 receptor antagonist (IL-1ra), IL-4, IL-8, IL-10, IL-12, granulocyte macrophage colony-stimulating factor, transforming growth factor-beta, interferon-gamma and amphiregulin were assayed in cutaneous warts and normal skin by semiquantitative reverse transcriptase-polymerase chain reaction. The expression of the cytokines was heterogeneous in the specimens but, of the 12 mRNA species investigated, only IL-10 mRNA was significantly downregulated in warts compared with normal skin (P = 0.002). IL-1 alpha mRNA expression was significantly upregulated in common warts (P = 0.019) and plantar warts (P = 0.003) compared with normal skin. The expression of IL-1 alpha and IL-1ra mRNAs were significantly correlated in plantar warts (P < 0.05). Warts expressing IL-1 alpha also expressed amphiregulin, and there was a significant correlation between the expression of these two genes (P < 0.05). It is possible that IL-1 alpha expression in cutaneous warts may modulate the growth of papillomavirus-infected keratinocytes, mediated by amphiregulin, thus ensuring viral persistence.

Adolescent↗
PubMed1988

Papillomaviruses in human skin warts and their incidence in an Argentine population.

Human papillomavirus genomic types present in human warts of an Argentine population were studied. HPV DNA from single warts was obtained using an alkaline extraction procedure that resulted in a clean DNA preparation, which could be analyzed with several endonucleases. This method was used to isolate and insert the HPV DNAs of two genomic types into the Bam HI site of the pBR322 plasmid. Restriction maps of both HPV DNAs were constructed. According to these maps, one of the genomic variations was identical to HPV1a and the other to HPV2a. The incidence of HPV2 and of HPV1 in different types of skin warts was studied by a dot blot hybridization assay. Twenty-two out of 28 common warts were positive for HPV2 and negative for HPV1; four were positive for HPV1 and negative for HPV2 and two were negative for both. Five out of six plantar warts were positive for HPV1, and one was negative for both. Three out of seven filiform warts were positive for HPV2, three were positive for both probes, and one was negative for both. Southern blot analysis of HPV2 positive samples indicated that 80% were HPV2a and 20% another subtype not yet characterized. All plantar warts contained HPV1a. Msp I/Hpa II restriction analysis confirms previous results indicating that HPV1a DNA is partially methylated, while no evidence of methylation was found for HPV2a DNA.

Argentina↗
PubMed1988

Tolerance and efficacy of recombinant human interferon gamma in the treatment of refractory genital warts.

PURPOSE: The intralesional administration of recombinant interferon alpha has led to resolution of genital warts in 50 to 70 percent of cases. However, continuous warts do not respond to such treatment, and human papillomavirus (HPV) infection of other anatomic sites remains untreated, so infection may continue to be transmitted. Since interferons have shown promise as effective therapies for genital warts, we decided to investigate the tolerance and efficacy of recombinant human interferon gamma in the treatment of refractory genital warts. PATIENTS AND METHODS: Nineteen women and nine men with refractory genital warts were treated in an open-label, dose-response trial of intramuscular recombinant human interferon gamma. RESULTS: Complete responses were seen in two (7 percent) and partial responses were seen in 13 (46 percent). Of 12 women with concomitant cervical HPV infection, eight demonstrated resolution with therapy. Response rates were higher in those patients who had warts less than nine months (73 percent) prior to therapy and in women (63 percent). Responses were not associated with HPV type. Flu-like symptoms during treatment were frequent but well tolerated. Transient abnormal laboratory results were more frequent with daily administration than with three times weekly therapy. Eleven of 16 subjects treated with cryotherapy after treatment with interferon experienced long-term remissions. CONCLUSIONS: In ambulatory patients with refractory genital warts, recombinant human interferon gamma appears to be biologically active and to have few adverse effects. The high efficacy rate achieved in subjects treated with cryotherapy after treatment with interferon suggests that further studies of combination therapy with these modalities are warranted.

Adolescent↗
PubMed1994

Urethral meatal warts in men: results of urethroscopy and biopsy.

Human papillomavirus is a common sexually transmitted infection associated with cervical dysplasia. We investigated the extent of urethral human papillomavirus infection by performing urethrocystoscopy on 90 men who presented to a sexually transmitted disease clinic with external meatal warts. A total of 83 men underwent biopsies and in 49 human papillomavirus typing was done. Of 90 men with external meatal warts 75 (83.3%) had no other warts, while 15 (16.7%) also had more proximal lesions. Only 5 men (5.6%) had lesions at or beyond the pendulous urethra. Of the 90 men 12 (13.3%) had 2 warts, 3 (3.3%) had 3 warts and none had more than 3 warts. A total of 39 men had human papillomavirus type 6/11, 1 had type 31/33/35 and 9 were negative for human papillomavirus antigens. Histological evaluation of biopsies showed no dysplasia. Our study confirms that the frequency of internal urethral warts is low. Human papillomavirus infection was not associated with urethral dysplasia.

Adolescent↗
PubMed1979

Immunity in wart resolution.

The involvement of the humoral and cell-mediated immune systems in the regression of wart infection has been investigated extensively in recent years. This review examines the supporting evidence for the roles of humoral and cellular immunity in wart regression and its possible implications. From the available data it does not appear that a conclusion can be drawn that only humoral or cell-mediated immunity is involved, or that both are essential, in the regression of wart infection. Studies by several investigators, however, suggest that, since agents known to stimulate the cell-mediated immune system have been reported to be followed by the successful resolution of warts, the cell-mediated immune system appears to play a critical role in wart resolution. It may be that the direction which should be taken in eradication of warts resistant to conventional modalities of treatment is one which relies upon the stimulation of the patient's immune system in a very specific manner. Probably the most efficient way to accomplish this, based on available data, would be by autogenous vaccination. Following the patient's humoral and cell-mediated immune response prior to, during, and following treatment with autogenous vaccination may help to elucidate the precise mechanism by which the successful resolution of warts occurs.

Antibody Formation↗
PubMed1984

Response of warts in epidermodysplasia verruciformis to treatment with systemic and intralesional alpha interferon.

The susceptibility of human papillomavirus infection to polyclonal human leukocyte interferon (IFN-alpha) has been evaluated in patients with epidermodysplasia verruciformis (EV), a disease with extensive chronic papillomavirus-induced warts. In a double-blind, placebo-controlled study with intralesional IFN-alpha, four of five IFN-alpha-treated warts regressed; none of the placebo-treated warts responded (p = 0.024). Three patients with EV were treated with systemic IFN-alpha for 4 weeks in an open study, achieving partial regression of warts in all three. In a double-blind, placebo-controlled study, warts in two children with EV regressed with systemic IFN-alpha while two who received placebo showed no improvement. The lesions recurred following cessation of therapy. At the completion of therapy with IFN-alpha, histologic normalization was accompanied by a 95% decrease in the number of viral antigen-containing cells in the warts (p less than 0.001). We conclude that warts in EV respond to systemic and intralesional IFN-alpha.

Adult↗
PubMed1970

Serological studies with human papova (wart) virus.

Methods for demonstrating antibody to wart virus by complement fixation and passive haemagglutination tests are described and compared with the precipitin test of Almeida & Goffe (1965). The results reveal the much greater sensitivity of the passive haemagglutination method, particularly in the detection of the immunoglobulin M class of antibody. Both complement-fixing and precipitating antibody were detected in sera from patients whose warts had undergone a spontaneous resolution.The presence of antibody to wart virus was demonstrated in sera from persons who had had warts up to 10 years previously, and in a few cases from those who thought they had never had warts.The antigenic identity of virus from hand warts and plantar warts of the simple and mosaic types was revealed, and some evidence was obtained for similar identity of the virus from genital warts.

Adolescent↗
PubMed2000

Self-administered topical 5% imiquimod for the treatment of common warts and molluscum contagiosum.

BACKGROUND: Despite numerous therapeutic options the treatment of common warts and molluscum contagiosum remains unsatisfactory for both patients and physicians. Imiquimod, a novel topical immune response modifier, has been successfully used for the treatment of external anogenital warts. OBJECTIVES: We aimed to evaluate the safety, tolerance and efficacy of imiquimod for the treatment of common cutaneous warts and mollusca that were resistant to previous therapeutic interventions. METHODS: Imiquimod 5% cream was self-applied by the patients to the warts or mollusca once daily for 5 days per week and left in place overnight. Assessment for response and the occurrence of side-effects was performed every 4 weeks until clinical cure or up to a maximum of 16 weeks. RESULTS: Twenty-eight of 50 (56%) patients with warts achieved a total clearance (n = 15; 30%) or a > 50% reduction in wart size (n = 13; 26%) after a mean treatment period of 9.2 weeks. Twelve of 15 (80%) patients with mollusca achieved a total clearance (n = 8; 53%) or a > 50% reduction in molluscum size (n = 4; 27%). There was no difference in response with regard to gender, human immunodeficiency virus serostatus or atopic predisposition. CONCLUSIONS: Patient-applied 5% imiquimod cream holds promise as an effective treatment of common warts and mollusca in a difficult-to-treat patient population.

Adolescent↗
PubMedDate not supplied

A double-blind, randomized, placebo-controlled trial of eutectic lidocaine/prilocaine cream 5% (EMLA) for analgesia prior to cryotherapy of warts in children and adults.

Liquid nitrogen cryotherapy is an effective treatment modality for verrucae in children. However, sometimes the pain of the procedure is too much for the young child. In such instances the availability of an effective topical anesthetic would be of tremendous benefit. Warts are usually present on hardened skin, that is, the palms, periungual areas, and soles. In a double-blind, randomized, placebo-controlled, single-center, parallel-group trial with one visit, children (6-18 years old) and adults (>18 years old) had 2.5 g of lidocaine/prilocaine cream 5% applied under an occlusive dressing to the wart and a 1 to 2 mm area surrounding it 1 hour prior to liquid nitrogen cryotherapy. In both age groups the warts were subdivided by location-hardened skin areas versus nonhardened skin sites. The topical anesthetic was then removed and cryotherapy applied for 5 to 10 seconds. The pain of cryotherapy was assessed by the patient on a visual analogue scale (VAS) immediately after the cryotherapy and 4 and 8 hours later. There was no statistically significant difference in the pain of cryotherapy experienced following the application of active cream (n = 64) and placebo (n = 64). Exploratory subgroup analysis by wart location showed promising results for lidocaine/prilocaine cream 5% over placebo in children with warts on hardened skin sites (palms and soles). The topical anesthetic was safe and generally well-tolerated. Lidocaine/prilocaine cream 5% may provide some anesthesia in children receiving cryotherapy when the wart is on the palms or soles. Further studies are needed to better understand the site and age specificity of the anesthetic properties of lidocaine/prilocaine cream 5% when used to reduce the pain experienced during cryotherapy of warts.

Administration, Topical↗
PubMedDate not supplied

Use of squaric acid dibutylester (SADBE) for cutaneous warts in children.

We evaluated the efficacy of squaric acid dibutylester (SADBE) contact immunotherapy for the treatment of warts on a series of 188 children. Included in the study were those children who satisfied at least two of the following criteria: single or multiple sites with several warts, warts resistant to repeated medical and/or surgical treatments, recurrent multiple warts, and patient or parent refusal to undergo destructive or surgical treatment. Excluded from the study were children with single warts or with flat warts located exclusively on the face and children less than 2 years of age. Treatment consisted of twice weekly applications of serial dilutions of SADBE (0.03-3%) for no more than 10 weeks. Of the 148 children who completed the study, 124 (84%) showed complete clinical resolution with no significant side effects. Of those with total clinical resolution, 101 completed a 24-month follow-up with no relapses. Twenty-four (16%) children were nonrespondent. No apparent correlation between treatment response and age, gender, anatomic site, lesion type, or atopy was found. Contact immunotherapy with SADBE is a relatively safe and effective alternative treatment in the management of multiple and resistant cutaneous warts in children.

Adjuvants, Immunologic↗
PubMed2000

Squaric acid immunotherapy for warts in children.

BACKGROUND: Warts are a common pediatric skin infection caused by human papillomavirus (HPV). Spontaneous clearance of warts involves anti-HPV immunity, which may be enhanced by contact sensitizers. Squaric acid dibutylester (SADBE) is a nonmutagenic sensitizing agent useful for immunotherapy of alopecia areata. OBJECTIVE: We hypothesized that SADBE home application might be effective therapy for warts. METHODS: An open-label, retrospective study of 61 children with warts was performed. Sensitization with 2% SADBE on the forearm was followed with home application of 0.2% SADBE to warts 3 to 7 nights per week for at least 3 months. RESULTS: Complete clearing occurred in 34 patients (58%), with a mean duration of therapy of 7 weeks. Partial clearing occurred in 11 (18%), and no response in 14 (24%). Clearance correlated with plantar distribution, wart duration under 2 years (P <.05), and first-line therapy with SADBE. Mild side effects occurred in one third of patients, were limited most commonly to mild erythema at the site of sensitization, and necessitated discontinuation of therapy in only 2 patients. CONCLUSION: SADBE topical immunotherapy is a safe, effective option for home therapy of warts in children.

Adjuvants, Immunologic↗
PubMed2000

Pulsed-dye laser versus conventional therapy in the treatment of warts: a prospective randomized trial.

BACKGROUND: The clinical management of verrucae vulgaris is often challenging, and no ideal treatment currently exists. Early studies suggested that pulsed-dye laser (PDL) therapy might be highly effective in the treatment of verrucae, although more recent reports have been less optimistic. Previous studies have been retrospective or have consisted of a series of patients treated with PDL alone. OBJECTIVE: Our objective was to prospectively evaluate the efficacy of PDL therapy versus conventional therapy with liquid nitrogen cryotherapy or cantharidin in the treatment of warts. METHODS: Forty healthy adult patients with verrucae were randomized to receive either PDL (585 nm) therapy or conventional therapy. All enrollees also performed home therapy. Patients were eligible for up to 4 treatment sessions at 1-month intervals. Warts were individually counted and measured at the time of each treatment session. Complete response was defined as complete absence of verrucae with the presence of dermatoglyphics, and partial response was defined as a 50% or greater reduction in wart size. RESULTS: A total of 194 warts were evaluated by the conclusion of the study. Complete response was noted in an average of 70% of the warts treated with conventional therapy and in 66% of those in the PDL group; this was statistically insignificant. Partial response was observed in an average of 82% of the warts in patients treated with conventional therapy and 87% in the PDL group. Verruca vulgaris responded more readily than verruca plantaris in both treatment groups. The mean number of treatments to achieve success was similar in both groups. CONCLUSION: The PDL is an efficacious form of therapy for verrucae, as is conventional therapy. PDL therapy should be considered among the better established approaches in the treatment of warts, although data from this trial suggest that this approach is probably not superior.

Adult↗
PubMed1999

HPV prevalence in anal warts tested with the MY09/MY11 SHARP Signal system.

Anal warts are, from an aetiological point of view, a diverse category of lesions including condylomata acuminata, fibroepithelial polyps and seborrhoeic keratosis. Human papillomavirus induced anal warts, in contrast to other types of warts, are contagious and not infrequently sexually transmitted, they therefore need to be accurately identified. A total of 24 anal warts were randomly collected and the histopathological diagnoses based on microscopy, alone or in combination with a sensitive PCR-based human papillomavirus test, were compared using the SHARP Signal system for detection. Three lesions were identified as condyloma acuminatum by morphology alone due to the obvious presence of koiloytotic atypia; 11 warts without koilocytes were identified only after a positive test for anogenital human papillomavirus. One additional lesion contained human papillomavirus DNA of cutaneous type and 9 papillomas were human papillomavirus-negative and tentatively diagnosed as fibroepithelial polyps or seborrhoeic keratosis. All 14 condylomas contained human papillomavirus of low-risk type. Of these, 12 warts showed a positive human papillomavirus reaction with in situ hybridization. Morphology alone cannot reveal the true nature of most anal papillomas, even when koilocytotic atypia is considered as a diagnostic hallmark. An optimal diagnosis of anal warts requires a sensitive PCR-based human papillomavirus DNA test. A test for identification of cutaneous human papillomavirus DNA is also worthwhile.

Adult↗
PubMed1980

Trichilemmoma. Benign follicular tumor or viral wart?

Trichilemmoma is a follicular tumor because of its resemblance to follicular outer root sheath, overlapping features with other tumors in the spectrum of benign follicular neoplasms, occurrence as multiple dominantly inherited and solitary noninheritable tumors, and occasional complication of organoid nevus. The dangerous misinterpretation that trichilemmomas are viral warts, unsupported by scientific evidence, has harmed patients. All electron-microscopic, immunologic, and clinical transmission attempts to demonstrate viral etiology of trichilemmoma have failed. If trichilemmomas were simply old warts, we might expect to see them frequently in children, extrafacially, of long duration, associated with multiple authentic ("young") warts, as multiple lesions, and associated with authentic warts in patients with Cowden's syndrome (multiple trichilemmomas). Actually, trichilemmomas are rarely seen in children, extrafacially, of long duration, associated with multiple authentic warts, as multiple lesions in patients without Cowden's syndrome, and associated with authentic warts in Cowden's syndrome. Unfortunately, patients with multiple trichilemmomas, Cowden's syndrome, and associated internal disease have been passed off as "simply old viral warts." The missed opportunity to identify women with a 50% risk of breast cancer is a disservice to the patient, to say nothing about malpractice implications for the physician when generally accepted medical standards are not applied.

Breast Neoplasms↗