Local Hyperthermia Versus Cryotherapy for Treatment of Plantar Warts: A Prospective Multi-centre Non-randomized Concurrent Controlled Clinical Trial
DOI:
https://doi.org/10.2340/actadv.v102.1082Keywords:
local hyperthermia, cryotherapy, warts, clinical trialAbstract
Cryotherapy is one of the most common treatments for warts; however, pain during treatment and relatively high recurrence rates limit its use. Local hyperthermia has also been used successfully in the treatment of plantar warts. The aim of this study was to compare the clinical effectiveness of local hyperthermia vs cryotherapy for the treatment of plantar warts. This multi- centre, open, 2-arm, non-randomized concurrent controlled trial included 1,027 patients, who received either cryotherapy or local hyperthermia treatment. Three months after treatment, local hyperthermia and cryotherapy achieved complete clearance rates of 50.9% and 54.3%, respectively. Recurrence rates were 0.8% and 12%, respectively. Pain scores during local hyperthermia were significantly lower than for cryotherapy. Both local hyperthermia and cryotherapy demonstrated similar efficacy for clearance of plantar warts; while local hyperthermia had a lower recurrence rate and lower pain sensation during treatment.
Downloads
References
Lipke MM. An armamentarium of wart treatments. Clin Med Res 2006; 4: 273-293.
https://doi.org/10.3121/cmr.4.4.273 DOI: https://doi.org/10.3121/cmr.4.4.273
Thomas KS, Keogh-Brown MR, Chalmers JR, Fordham RJ, Holland RC, Armstrong SJ, et al. Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model. Health Technol Assess 2006; 10: iii, ix-87.
https://doi.org/10.3310/hta10250 DOI: https://doi.org/10.3310/hta10250
Wust P, Hildebrandt B, Sreenivasa G, Rau B, Gellermann J, Riess H, et al. Hyperthermia in combined treatment of cancer. Lancet Oncol 2002; 3: 487-497.
https://doi.org/10.1016/S1470-2045(02)00818-5 DOI: https://doi.org/10.1016/S1470-2045(02)00818-5
Ghonemy S. Treatment of recalcitrant plantar warts with long-pulsed Nd: YAG laser versus cantharidin-podophylline resin-salicylic acid. J Cosmet Laser Ther 2017; 19: 347-352.
https://doi.org/10.1080/14764172.2017.1326608 DOI: https://doi.org/10.1080/14764172.2017.1326608
Hsu VM, Aldahan AS, Tsatalis JP, Perper M, Nouri K. Efficacy of Nd: YAG laser therapy for the treatment of verrucae: a literature review. Lasers Med Sci 2017; 32: 1207-1211.
https://doi.org/10.1007/s10103-017-2219-5 DOI: https://doi.org/10.1007/s10103-017-2219-5
Izadi Firouzabadi L, Khamesipour A, Ghandi N, Hosseini H, Teymourpour A, Firooz A. Comparison of clinical efficacy and safety of thermotherapy versus cryotherapy in treatment of skin warts: a randomized controlled trial. Dermatol Ther 2018; 31: e12564.
https://doi.org/10.1111/dth.12564 DOI: https://doi.org/10.1111/dth.12564
Gao XH, Gao D, Sun XP, Huo W, Hong YX, Li XD, et al. Non-ablative controlled local hyperthermia for common warts. Chin Med J (Engl) 2009; 122: 2061-2063.
Huo W, Gao XH, Sun XP, Qi RQ, Hong Y, McHepange UO, et al. Local hyperthermia at 44 degrees C for the treatment of plantar warts: a randomized, patient-blinded, placebo-controlled trial. J Infect Dis 2010; 201: 1169-1172.
https://doi.org/10.1086/651506 DOI: https://doi.org/10.1086/651506
Li X, Gao XH, Jin L, Wang Y, Hong Y, McHepange UO, et al. Local hyperthermia could induce migrational maturation of Langerhans cells in condyloma acuminatum. J Dermatol Sci 2009; 54: 121-123.
https://doi.org/10.1016/j.jdermsci.2008.12.004 DOI: https://doi.org/10.1016/j.jdermsci.2008.12.004
Yoshioka A, Miyachi Y, Imamura S, Hiraoka M, Jo S, Abe M. Suppression of contact sensitivity by local hyperthermia treatment due to reduced Langerhans cell population in mice. Br J Dermatol 1989; 120: 493-501.
https://doi.org/10.1111/j.1365-2133.1989.tb01322.x DOI: https://doi.org/10.1111/j.1365-2133.1989.tb01322.x
Cockayne S, Hewitt C, Hicks K, Jayakody S, Kang'ombe AR, Stamuli E, et al. Cryotherapy versus salicylic acid for the treatment of plantar warts (verrucae): a randomised controlled trial. BMJ 2011; 342: d3271.
https://doi.org/10.1136/bmj.d3271 DOI: https://doi.org/10.1136/bmj.d3271
Sterling JC, Gibbs S, Haque Hussain SS, Mohd Mustapa MF, Handfield-Jones SE. British Association of Dermatologists' guidelines for the management of cutaneous warts 2014. Br J Dermatol 2014; 171: 696-712.
https://doi.org/10.1111/bjd.13310 DOI: https://doi.org/10.1111/bjd.13310
Hogendoorn GK, Bruggink SC, de Koning MNC, Eekhof JAH, Hermans KE, Rissmann R, et al. Morphological characteristics and human papillomavirus genotype predict the treatment response in cutaneous warts. Br J Dermatol 2018; 178: 253-260.
https://doi.org/10.1111/bjd.15758 DOI: https://doi.org/10.1111/bjd.15758
Bruggink SC, Gussekloo J, Egberts PF, Bavinck JNB, de Waal MWM, Assendelft WJJ, et al. Monochloroacetic acid application is an effective alternative to cryotherapy for common and plantar warts in primary care: a randomized controlled trial. J Invest Dermatol 2015; 135: 1261-1267.
https://doi.org/10.1038/jid.2015.1 DOI: https://doi.org/10.1038/jid.2015.1
Walczuk I, Eertmans F, Rossel B, Cegielska A, Stockfleth E, Antunes A, et al. Efficacy and safety of three cryotherapy devices for wart treatment: a randomized, controlled, investigator-blinded, comparative study. Dermatol Ther (Heidelb) 2018; 8: 203-216.
https://doi.org/10.1007/s13555-017-0210-5 DOI: https://doi.org/10.1007/s13555-017-0210-5
Hildebrandt B, Wust P, Ahlers O, Dieing A, Sreenivasa G, Kerner T, et al. The cellular and molecular basis of hyperthermia. Crit Rev Oncol Hematol 2002; 43: 33-56.
https://doi.org/10.1016/S1040-8428(01)00179-2 DOI: https://doi.org/10.1016/S1040-8428(01)00179-2
Wang X, Gao XH, Li X, Hong Y, Qi R, Chen HD, et al. Local hyperthermia induces apoptosis of keratinocytes in both normal skin and condyloma acuminata via different pathways. Apoptosis 2009; 14: 721-728.
https://doi.org/10.1007/s10495-009-0344-8 DOI: https://doi.org/10.1007/s10495-009-0344-8
Albert ML, Sauter B, Bhardwaj N. Dendritic cells acquire antigen from apoptotic cells and induce class I-restricted CTLs. Nature 1998; 392: 86-89.
https://doi.org/10.1038/32183 DOI: https://doi.org/10.1038/32183
Kaplan DH, Jenison MC, Saeland S, Shlomchik WD, Shlomchik MJ. Epidermal Langerhans cell-deficient mice develop enhanced contact hypersensitivity. Immunity 2005; 23: 611-620.
https://doi.org/10.1016/j.immuni.2005.10.008 DOI: https://doi.org/10.1016/j.immuni.2005.10.008
Published
How to Cite
License
Copyright (c) 2022 Xing-Hua Gao
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All digitalized ActaDV contents is available freely online. The Society for Publication of Acta Dermato-Venereologica owns the copyright for all material published until volume 88 (2008) and as from volume 89 (2009) the journal has been published fully Open Access, meaning the authors retain copyright to their work.
Unless otherwise specified, all Open Access articles are published under CC-BY-NC licences, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for non-commercial purposes, provided proper attribution to the original work.
