Plantar wart medical therapy: Difference between revisions

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| First-line therapy  || over the counter [[salicylic acid]]
| First-line therapy  || Over the counter [[salicylic acid]]
|-  
|-  
| Second-line therapy || [[Cryosurgery]], intralesional [[immunotherapy]], or pulsed dye laser therapy
| Second-line therapy || [[Cryosurgery]], intralesional [[immunotherapy]], or pulsed dye laser therapy
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[[Podiatrist]]s and [[Dermatology|dermatologists]] are considered specialists in the treatment of plantar warts, though most warts are treated by [[primary care physician]]s.
[[Podiatrist]]s and [[Dermatology|dermatologists]] are considered specialists in the treatment of plantar warts, though most warts are treated by [[primary care physician]]s.


; [[Keratolytic|Keratolytic Chemicals]]: The [[treatment of warts by keratolysis]] involves the peeling away of dead surface skin cells with [[trichloroacetic acid]] or [[salicylic acid]].  
; Keratolytic Chemicals: The [[treatment of warts by keratolysis]] involves the peeling away of dead surface skin cells with [[trichloroacetic acid]] or [[salicylic acid]].  
; [[Immunotherapy]]: Intralesional injection of antigens ([[mumps]], candida or trichophytin antigens USP) is a new wart treatment which may trigger a host immune response to the wart virus, resulting in wart resolution. Distant, non-injected warts may also disappear.
; Immunotherapy: Intralesional injection of antigens ([[mumps]], candida or trichophytin antigens USP) is a new wart treatment which may trigger a host immune response to the wart virus, resulting in wart resolution. Distant, non-injected warts may also disappear.
; [[Chemotherapy]]: Topical application of dilute [[glutaraldehyde]] (a virucidal chemical, used for cold sterilization of surgical instruments) is an older effective wart treatment.  More modern chemotherapy agents, like 5-fluoro-uracil, are also effective topically or injected intralesionally. [[Retinoid]]s, systemically (eg. [[isotretinoin]]) or topically ([[tretinoin]] cream) may be effective.
; Chemotherapy: Topical application of dilute [[glutaraldehyde]] (a virucidal chemical, used for cold sterilization of surgical instruments) is an older effective wart treatment.  More modern chemotherapy agents, like 5-fluoro-uracil, are also effective topically or injected intralesionally. [[Retinoid]]s, systemically (eg. [[isotretinoin]]) or topically ([[tretinoin]] cream) may be effective.


:As warts are contagious, precautions should be taken to avoid spreading.
:As warts are contagious, precautions should be taken to avoid spreading.
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[[Category:Foot diseases]]
[[Category:Foot diseases]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]


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Latest revision as of 18:43, 18 September 2017

Plantar wart Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Plantar wart from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

No treatment in common use is 100% effective. The most comprehensive medical review found that no treatment method was more than 73% effective and using a placebo had a 27% average success rate.

Treatment

The American Family Physician recommends:

First-line therapy Over the counter salicylic acid
Second-line therapy Cryosurgery, intralesional immunotherapy, or pulsed dye laser therapy
Third-line therapy Bleomycin, surgical excision

Podiatrists and dermatologists are considered specialists in the treatment of plantar warts, though most warts are treated by primary care physicians.

Keratolytic Chemicals
The treatment of warts by keratolysis involves the peeling away of dead surface skin cells with trichloroacetic acid or salicylic acid.
Immunotherapy
Intralesional injection of antigens (mumps, candida or trichophytin antigens USP) is a new wart treatment which may trigger a host immune response to the wart virus, resulting in wart resolution. Distant, non-injected warts may also disappear.
Chemotherapy
Topical application of dilute glutaraldehyde (a virucidal chemical, used for cold sterilization of surgical instruments) is an older effective wart treatment. More modern chemotherapy agents, like 5-fluoro-uracil, are also effective topically or injected intralesionally. Retinoids, systemically (eg. isotretinoin) or topically (tretinoin cream) may be effective.
As warts are contagious, precautions should be taken to avoid spreading.

Other

  • X-ray is an old method that is seldom recommended due to the long term adverse side effects of irradiation.
  • Duct tape occlusion therapy: The wart is kept covered with duct tape for six days, then soaked and debrided with a pumice stone. The process is repeated for 6 to 8 weeks.
  • Watchful waiting may be appropriate since many warts will eventually resolve due to the patient's own immune system. In many cases, the body will become naturally immune to the wart and verrucæ will turn black and effectively fall off, although it can be two years before this takes place.

References


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